We're already 25 weeks & 3 days!
Yesterday was a long day for a girl used to bedrest! It's surprising how 2 weeks of bedrest makes such a difference in my energy level and lightheadedness/shortness of breath when I'm up and around longer than my normal very short time limits! We had an appointment with Dr Jenkins, our favorite perinatologist, and walked around the birth center at the hospital. Everything is going fine, but the reason for the appointment was that some test results from a couple weeks ago had shown a bit of concern regarding possible Preeclampsia (pre-e), which is a pregnancy complication that can be very serious, and can also inhibit a baby's natural growth in utero. Since Annie is already small, the doctors were checking for any possible issues with my health that might also affect her.
When we first discovered her AEDF 2 weeks ago I went through a bunch of labs, including a 24 hour urinalysis, to check pretty much everything that can go wrong during pregnancy. Everything came back normal except that the urinalysis showed a slightly elevated level of protein. That can indicate pre-e, so our initial perinatologist (Dr Robertson) called us early the next morning and wanted me to go to the hospital for 24 hours so they could monitor my blood pressure. Pre-e is usually diagnosed by both protein (usually higher levels than mine, every pregnant woman will 'leak' some protein into their urine) and high blood pressure.
Normally I wouldn't think there could be any downside to being hospitalized, other than being inconvenient, but after our conversation with Dr Jenkins the day before we really didn't want to do that. Dr Jenkins had informed us that once I am hospitalized, the chance that Annie will be delivered early is much, much higher. The reason for that is that when they are monitoring both Annie & I around the clock, they are much more likely to find a "red flag" that indicates a problem. Often times these issues resolve themselves within a few hours, but being in the hospital at the time might increase the chance that they will take action to deliver, rather than waiting to see if the issue resolves.
Once I am further along and Annie's chances are better, this will be more a relief than a concern, because being labeled as an extremely high-risk pregnancy causes them to take any red flags very seriously and to move quickly to save her if there are problems. However until she grows & has a better chance of viability, staying out of the hospital can help to prevent an unnecessarily early delivery.
We called the doctor on-call at the hospital (since it was the weekend) and told him we'd rather do the 24 hour blood pressure monitoring at home. He basically said alright and to call if it is ever over 140/90 (and that we should expect Dr Robertson to be annoyed--we thought it was weird that he said that but we've learned that the other doctors and even the nurses seem to think Dr R overreacts to things.) That made us feel better, and after my bp never even got close to 140/90 (averaged 110/65 with the highest being 121/80 right after the dr called!), we felt even better about our decision to monitor at home. Dr Robertson had her nurse call us first thing Monday and we went over the blood pressure readings. She said the immediate concern was no longer, but she wanted me to keep up with daily bp readings (only 3 a day, much better than hourly!) and come in to get my labs re-done in a week to be sure that pre-e doesn't sneak up on us.
Luckily we were able to see Dr Jenkins for that appt, and hear his take on the pre-e issue. The best news is that all my labs from yesterday looked perfect, so while we will still probably keep checking for preeclampsia every couple weeks, Dr Jenkins does not think I'm at high risk for it, or that it is likely to be what is causing these problems. All good news! (Pre-e can progress very quickly & is a common cause for very premature deliveries.)
My mom drove me to the appt (since the hospital is close to Jeff's office, he just met us there) and afterwards we went for a (short) walk up to the Family Birth Center, Labor & Delivery and NICU. I had toured the NICU with Jeff and the neonatalogist at our first meeting with him 2 weeks ago, but I hadn't really noticed much more than the tiny babies in the isolettes, since I was still reeling from the news that our baby will most likely end up there soon. I was hoping to tour it again, with my mom this time, so we could both get a better mental picture of what is likely to be Annie's home away from home, as well as things we can do/get to prepare for her stay. I also wanted to show my mom the areas that I would be in once I was hospitalized (Family Birth Center), and then for the birth (L&D).
It was very reassuring to visit the Birth Center and Labor & Delivery, since the nurses that we spoke with were very encouraging and sympathetic. They were able to give me quite a bit more detail regarding what my perinatal stay (before the birth, basically hospital bedrest) and postnatal stay would entail, as well as my C-section delivery & recovery. I was able to see the actual rooms I would be staying in, and even ask questions of the lactation supervisor regarding pumping while Annie is in the NICU, and getting a good hospital grade pump to use at home. We weren't able to see the NICU because our timing coincided with an emergency delivery, but they did say that if we call ahead the next time I come for an appt, they would have someone free to give us that tour as well (the normal tour guide was busy with the emergency).
I was pretty pooped after all that, but it was a very good kind of tired! I feel more prepared for the time I am in the hospital, as well as getting ready for Annie's possible extended stay. It was nice to talk to nurses who see problems like mine every day, and often see much more serious problems that are still able to be handled well. I feel very blessed that God is giving us the opportunity to prepare for the upcoming hospitalization/birth/NICU stay, because most moms in that situation have no idea that they might need such specialized care (or deliver their baby so early) until they are rushed into delivery. They have to learn what is happening with their baby while trying to recover from delivery and the trauma of learning something went wrong. I really do thank God that our situation is not that emergent, and we are able to prepare, as much as you can for a situation like this.