Thursday August 17, 2006
We wanted to give everyone a quick update. We had our weekly perinatal appointment yesterday and were given news that we were not expecting. Everything we have been hoping to avoid quickly became a reality. During our routine Doppler flow study, Ben’s umbilical artery began to show signs of reverse end diastolic flow. He has been holding steady the past 7 weeks with intermittent absent end diastolic flow, continuing to grow at his own pace, but these new findings have triggered some alarm among the doctors. Given these findings along with Danielle’s cervix showing some funneling/shortening, the doctors admitted us for around the clock monitoring at the U of M Birthing Center. They also decided to give Danielle steroids to expedite Ben’s lung development, in anticipation of a possible early delivery.
So, what does all of this diastolic flow talk mean? That is what we have spent the last few days trying to understand. From what we have discussed with the team of doctors, the reversal of the umbilical artery flow means that there is increased resistance in the placenta. This resistance restricts the blood flow to Ben from the placenta and seems to be the reason behind Ben’s slower growth pattern. We have been told that babies can sustain absent and even reverse end diastolic flow for weeks, so long as they continue to show activity and growth. Monitoring the baby’s heart rates and activity is now our primary focus.
My poor wife has become a science project; complete with monitors, wires, I.V and machines tracking the babies every move. The monitors are hooked up to Danielle’s belly 24 hours a day to keep close tabs on both Jake and Ben’s heart rate and overall activity. There is also a diode that detects contraction patterns. The docs are basically looking to see when there is a contraction and how each baby reacts. They are looking for decelerations in Ben’s heart rate upon contraction. Fortunately, Ben is hanging tough and continuing to flip and somersault like crazy. Unfortunately for Danielle, all of this movement is making the monitoring very difficult. The nurse on the midnight shift yesterday was in our room literally every 30 minutes looking for the heartbeats on Danielle’s belly. In order to find the heartbeat, she uses an amplified hookup that blasts their every movement through 2400 watts of surround sound. I may be exaggerating a little, but as I lay there and tried to sleep, I might as well been at a concert. I did manage to get a few winks in throughout the madness, but Danielle was unable to get any rest whatsoever.
Tomorrow we are scheduled for an ultrasound to check the Doppler studies of both the umbilical artery and the ductus venosus. The ductus venosus connects the left umbilical vein with the interior vena cava. It allows oxygenated blood from the placenta to bypass the liver and return to the systemic circulation for distribution to the rest of the body. We will post our results as soon as we can. We don’t have internet in our rooms so it may take us some time to find a good connection.
Friday August 18, 2006
Our ultrasound went as well as expected considering how active these boys are. Ben’s umbilical artery only gave us one reading showing intermittent reverse end diastolic flow, which is an improvement from yesterday. The majority of his reading showed absent end diastolic flow. We also tried to get a good reading on Ben ductus venosus. Ben would not cooperate for the ultrasound and decided it was playtime. We picked up a few readings that looked normal, so the doctor finally gave up and said “given his activity, finding this reading does not concern me at this time”. We think that is good news because we didn’t get a negative reading, which may become a decision-making finding for the doctors. So we bought ourselves another day. On Sunday we will be 27 weeks gestational age. Our goal right now is to make it to 28 weeks. Danielle continues to be monitored closely for heart rates and baby activity. Because of the findings today, the doctors have decided that 24 hour monitoring would not be necessary and have decided to get readings every 4-6 hours. Danielle is ecstatic because now she can get some shuteye.
I almost forgot to mention, but last night the chief resident came in to take a quick Bio Physical Profile test on the boys. This measures their movement, breathing, heart rates and overall activity. They both scored 8 out of 8! They are over achievers already.
We hope to keep you all up to speed over the weekend.
Kevin and Danielle.