Face of hope

Face of hope
Courtesy: TIffany Kay Photography

Monday, August 15, 2011

31 week Perinatologist visit

We had our 31 week visit today.  I'm technically 31 weeks 3 days, but nonetheless, I've ended up on this schedule just due to our doctor's availability.

Meagan is still hanging in there. Her head is now measuring about 4 1/2 weeks ahead, compared to the 2 weeks ahead last month.  Her body was right on target at 31 weeks 3 days... but her head was almost 36 weeks though (35 weeks 5 days), so, obviously it has expanded more. 

He measured her remaining brain tissue. It went from 6.6mm to 5.2mm.

They were also able to grab ventricle measurements this time.  The last two times, she has been laying in a weird sideways position so they couldn't get a good cross section of the brain -- so they said they were 'immeasureable'.... this time, however, she was a bit more cooperative. 

Meagan's measurements were a little 'shocking' to hear. But only because we haven't been able to have any measurements the last two visits, so I suppose my mind had gone "numb" to the measurements.  Reading many other Hydro stories has helped, because there were quite a few with similar measurements... and it's all relative as I've learned from other families.  We just don't know what the brain will do after birth.  Nonetheless, hearing how much her fluid has expanded is a bit overwhelming and very scary.

 Keeping in mind again, the normal ventricle measurements being 4-7mm, with 10mm at the highest end of "normal"...One ventricle is now 30mm and her other is now at 65mm!!  

The rest of the ultrasound went well - other than all the Hydro related issues, her body (organs, heart, limb lengths..etc.) still look good.  I can definitely feel I have a "36 week head" inside though.  It makes more sense to me now because I feel full and feel that "limited movement" just like I felt with my other 4 kids in my last 2 weeks with them. So of course I feel this way with her head being much larger at this point.

The doctor said we will keep my Oct. 3rd c-section date ... but to come back in 3 weeks and we will "go from there."  I'm assuming that means he still wants to go to 38 weeks.  I understand this sentiment.. but with her head as it is NOW, I cannot imagine going another 7 weeks until she is delivered!
I've never gone early with any of my kids - but - I have ALWAYS gone right on time (between 39 and 41 weeks)... so I will try to be extra cautious as the next few weeks pass and her head nears 40 week size.  The last thing I want is unexpected early labor because my body is "tricked" that I am further along than I really am due to her head measuring so much larger. I am truly afraid of this happening though because my last 4 kids have been extremely "efficient" ... once they have measured that 39/40 week size, my body goes right into action and does what it's supposed to do.  It's a great thing - except when my daughter with the 40 week head really would be only about 33 weeks along..etc. My other concerns are, of course, for her brain tissue - at what point do you put off early delivery so her body is stronger for surgery.. but risk losing almost all remaining brain tissue? It is a very fine line to walk, and a difficult one.  I'm also worried that going all the way to the original date will make the surgery harder on me...that her head will be quite difficult to get out.  If her head is 40 weeks by 33 weeks, what would it be 5 weeks later? I'm not worried about my pain, just to clarify.. but.. I do want as smooth a c-section as possible because my goal and focus is Meagan - and I need to get well as fast as possible to get to to Children's and see her/hold her.

The above concerns, coupled with the great advice of some of the other Hydro families who have been in the same situation with similar measurements, tell me it's time to have a serious discussion with our doctor about delivery.  Yes, 38 weeks would be ideal ... but... to go into early labor because of her size, or even worse, wait SO much longer with her fluid levels where they are may not be the best course of action for Meagan in the long term. We are talking her brain here...   I'm at the point now where I have to start pushing them because my concern now, with her fluid levels, become brain damage...and we know she already has this to some unknown degree.... if she is a bit more premature than planned, again, not ideal.. but I think it's time to have a talk with the doctors about the adverse effects of really waiting until 38 weeks.  My next appointment wasn't scheduled until almost 36 weeks - I don't want to go to the appointment, have her head beyond full term, and have them suggest delivery with me having nothing planned.  I have the other 4 kids to worry about - childcare, etc.. and my family coming to help is traveling from quite a distance..so I do want to try and salvage some planning time.  I did call back after today's ultrasound and was able to move up my next appointment to 34 weeks now... so I think this is a fair time to bring up the earlier delivery.  So now I go again at 34 weeks, and at least if going earlier is the case, it will give me a little more planning time to make sure my girls are taken care of.  I'll keep everyone posted if our delivery date gets pushed up.

Keep up the fight Meagan. It's not long now until we can kiss you and start helping you.  Just hold on sweet girl!


  1. I am praying that all goes well and that what is best for Meagan is what happens! Stay strong dear friend, take care of yourself and keep the faith!

    Hugs and prayers!

  2. Molly, when I had the "serious talk" with our specialist about earlier delivery, I was really put off. I suppose it may be because I'm a very soft spoken person. I'm unsure. Please be stern with them! There is NO reason not to test for lung maturity to see if she can come sooner. I think 36 weeks is ideal for lung testing. 35 at the earliest.