18 weeks/low fluid update (long)

Hi again everyone,

We've been to see the OBs three times in as many days. Tuesday
I was on a pre-arranged furlough from bedrest to go teach my class
and felt great. Tuesday night, I started bleeding, like a moderately
heavy day of my period. Since it didn't let up, we went to
the hospital around 10pm (after my dad came over to be here for
DS, who sure enough woke up while we were away and was not happy
about it). The OB on call checked me out at the hospital (yup,
you're bleeding) and the ultrasound tech on call did another ultrasound
(AFI 5.3, previous measurments have been 5 and 6.8, which we
understand are statistically indistinguishable).

The source of the blood is apparently the placenta, but they were
unable to spot anything in particular on the ultrasound. My cervix
is closed up nice and tight, and the baby was in there kicking
around, heart beat fine, etc. They decided not to admit me to
hospital. Were this happening at 24-26 weeks, they'd admit me and
monitor the baby, and consider an early delivery if things went
south. Since there's no hope of viability at this point (18 weeks),
it's just bedrest at home, and come if I start to miscarry.
The OB on call did say to call the office in the am if I was still
bleeding.

Well, I was, so I called and came in. By the time I'd gotten there,
it'd stopped. Checked the heartbeat again, no probs. Come back
tomorrow to see primary OB, who'd been on vacation. Overnight I had
more bleeding (not just spotting, but not as bad as the first night).
Today I had the appointment with my regular OB. Just before we
got there, she got back a positive test result from one of the things
she had tested when we originally discovered the low amniotic fluid
at 17 weeks.

It appears that I have some sort of mutation involving the MTHRC
(if I've got that right) enzyme, which can make me prone to clotting.
This can cause problems like what I'm seeing during pregnancy, but
doesn't necessarily (I had no problems with DS#1, but would have
had the same condition wrt to the enzyme then). The OB did a quick
check with the u/s (I think we're up to 6 for this baby now), and
said that she thought the fluid looked low, but that she didn't really
do AFIs this early in pregnancy, so she wasn't sure.

So, the next steps (assuming more bleeding doesn't take me into the
hospital first) are to get another u/s next Wednesday to check the
baby's growth (so far so good as of last week) and the fluid levels,
followed up with a consultation with the OB and a perinatologist.
There are basically three possibilities:

-- Really really low fluid, which would be incompatible with
carrying to term or viability even if I did (as amniotic fluid
is essential to lung development, among other things). At this
point we basically face the choice of waiting for me to miscarry
or deciding to terminate the pregnancy. Not a pleasant choice!

-- Fluid levels up to (or close to) normal range. Then I think
it's just proceed with cautious optimism. The OB didn't seem
terribly optimistic that this is what we'd see, though.

-- Fluid levels about the same: moderately decreased. Then we would
find out from the perinatologists what the prognosis is, both
for the rest of the pregnancy and for the health of the baby,
and see where to go from there. The hard part here, is that I
hear AFIs aren't really reliable this early on (from the OB), but
then everyone looking seems to agree that the fluid is "low".

So, I'm resting in bed (lying down or sometimes sitting propped
so I can get some typing or other work done) and taking low-dose
aspirin (OB's advice) to try to maximize placental function.
Any other tips on increasing amniotic fluid would be appreciated,
or just fluid vibes

--
Emily
mom to Toby 5/1/02
#2 EDD 7/19/04

Hugs, prayers, and more fluid thoughts coming your way. I hope this works
out for you. I wish there was something more I could say or do, but know
that you are in my thoughts.
--

Jamie & Taylor
Earth Angel, 1/3/03

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Oh Emily, I hope you get good news!

Vicky Bilaniuk wrote:
Oh Emily, I hope you get good news!


Thanks Jamie and Vicky. I'm just hanging in there for
now, taking things one day at a time.

--
Emily
mom to Toby 5/1/02
#2 EDD 7/19/04

Emily wrote:

So, I'm resting in bed (lying down or sometimes sitting propped
so I can get some typing or other work done) and taking low-dose
aspirin (OB's advice) to try to maximize placental function.
Any other tips on increasing amniotic fluid would be appreciated,
or just fluid vibes

Best of luck Emily, how scary for you. I'll be thinking
of you and your little one.

Mary