Friday, January 11, 2013

High Risk OB (MFM)

So this past Wednesday I had my first appointment with the MFM (Maternal Fetal Medicine) specialist.  We had to wait a little bit for the ultrasound machine to become available as they wanted to do a quick ultrasound prior to meeting with the doctor.  I was so happy for that!!

So they looked at the babies and they were measuring ahead!  By 2 and 4 days!  Which is good - nice strong heartbeats again 175 and 189 I believe.  The technician even flipped it over to 3D mode which is the coolest thing ever!!!

Then we met with the doctor.  She did not decommend placing a cerclage at this time.  She said close monitoring should be enough and we are going to start checking my cervix every other week start at 15 weeks.  We did have to sit down with a genetic counselro though because apparently being 33 and pregnant with twins puts me at an advanced maternal age and at higher risk for chormosonal and/or birth defects.  Though based on our family history they didn't think we had much of a risk.  We will do some blood work and ultrasound to see if our children have any markers for any types of issues but we don't forsee it being an issue.

So I had a ton of appointments set up between now and April, about every other week.  After that I'll probably be seen weekly because I'll be 24 weeks at that point. 

I feel better about things.  The MFM has a good plan to check a lot of different things to make sure I keep these babies in until they are ready to come out.  We agreed on a scheduled c-section at 38 weeks unless they have other plans.

Here are the pictures from Wednesday!!



 
This is the 3D ultrasound - they look like chicken nuggets!
 
 

4 comments:

  1. Awesome! Welcome to the world of serial cervical length ultrasounds. I understand from the research presented to me by my MFM that ultrasound-indicated cerclages (what you or I would get if our crevixes (sp?) show change one u/s to the next) have a much better track record and success rate than prophylactic cerclage. Of course, it took a panic attack and a thorough re-grilling of my MFM at a second appointment to convince me!

    I am SO jealous you got to see your babes in 3D! I'm going to see if UW will do that for us at our anatomy scan on Valentine's Day. If not, I fully intend to pony up the cash for a private 3D view later in pregnancy.

    Hugs!

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    1. Amy,
      I had totally set up an appointment at one of the 3D places and the MFM was like cancel it because we can do that and they also told me they could see the gender as early as 12 weeks with 95% accuracy. I'll wait until my 15 week appointment though because Todd can't be there for the NT scan at 12 weeks. So I should hopefully know before Valentine's Day with a good percentage of accuracy..

      I was also worried about not doing the cerclage. The MFM told me that any cervical measurements prior to 15 weeks mean very little so we start with those at 15 weeks.

      It's all very nerve wracking isn't it!!!

      I'm sure your MFM can make the switch over to 3D on their machine - just ask them at your next appointment!!

      They told me that is they saw shortening they could either place a cerclage at that time or they told me recent studies have showed that placing women back on vaginal progesterone has stopped the shortening as well. So it's another option.

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  2. I work with one of the top MFM docs on East Coast and he takes this very same approach with his patients, progesterone shots weekly for 1st 26 weeks, every two weeks u/s to measure length of cervix. If cervix thinning appears on u/s he orders circlage and sees these pati8ents every two weeks. Sounds like you are getting good clinical advice. I also am surprised that u/s told u sex could be determined by 12 ish weeks, most won't identify sex til after 16-18 weeks! I sure admire how public you are being with your journey

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    1. I'm already off my current progesterone per the instructions of my fertility specialist and I advised the MFM of this - she didn't see a problem of going back on it if any shortening appears in an ultrasound. I'm glad that their advice coincides with the advice your MFM would suggest.

      Thank you for the kind words. If my journey can help someone else then it is worth it to document every single step of it.

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