Friday, September 22, 2017

Wait and see

I had my appointment today.  The ultrasound lasted forever.  At one point, I thought, this woman would not be torturing me if there were no heartbeat, so I’m just going to ask.

Me: Is there a sac with no embryo?
Ultrasound tech: No, there’s an embryo.
Me: Is there no heartbeat?
UT: No, there’s a heartbeat.
Me: It is slow?
UT: It’s not as fast as we would like.

Yea, of course it’s not.

I’ve already done a post on fetal heartbeat, so I won’t repeat it.  (http://3yearwait.blogspot.com/2016/03/hoping-my-embryos-heart-is-beating-like.html)  But here’s the gist: slow is bad, fast is good.  The faster the better, the slower the worse(r).  

I am “dated” (per my last menstrual period) to be 7w1d.  Based on my sac measurement last week, I should be around 6w5d.  (But I was told sac measurement is not that predictable.)  Fetus was measuring at 6w 6d.  (I completely forgot to ask for my fetal or yolk or sac measurements.  D’Oh!)  So I’m right around 7 weeks.

A common threshold at this point (late 6 weeks/early 7 weeks) is 120 and above is “normal,” 110 and below is “slow,” and between that is “borderline.”  If you’re in slow, you’re looking at a likely pregnancy loss.  Borderline is also at risk.  

Heartbeat today was 114.  That doesn’t sound too low when you say that 120 is “normal,” but then you have to remember that below 110 is likely to end in miscarriage.  So 114 is no good.

If you follow one of the links in my fetal heartbeat post (https://fetalmedicine.com/synced/fmf/2010_27.pdf), it gives you precise measurements based on date.  At 49 days (7 weeks) gestation, a heartbeat of 117 is in the 5th percentile.

Yea, when you put it like that, 114 does not sound so good.

Oh, and the reason the ultrasound took so long is because the tech was completely taken aback by the “prominent blood vessels” in my uterus.  She was basically like, “in the five years I’ve been doing this, I think I’ve seen another patient with blood vessels this prominent.”  We already knew I had a wonky vascular system, so that wasn’t the surprise she might have thought it would be.  She also mentioned a “small” subchorionic bleed.  Again, that comes as absolutely no surprise.  I had issues with at least two pregnancies.  (My little man—they resolved—and the gushing one with my omphalocele pregnancy.)

The doctor I met with (someone I have not met before) was super nice.  When I pressed her on my chances of success, she said, “I’m an optimist, so I’m going to say 60%.”  I appreciated her optimism and honesty, because there is no way there’s a 60% chance of success.  But she didn’t lie and tell me to just be hopeful—she gave me a pretty low number (relative to what I’m guessing she would usually say).  I asked if I could come back for another check before my marathon—I’d like to know when I’m running if I’m pregnant or not—and she said absolutely.  In fact, she told me I could come in every week.  Anyway, I have another appointment in just under two weeks.

So, where does this leave us?  Well, I’m not going to lie friends, it’s not good.  Obviously no fetus/no heartbeat/super low heartbeat would be worse, but it’s not good.  I have to update my odds because I did have a heartbeat today, but this still looks like it might be on track to end.  For those of you placing money on this pregnancy, here are the current odds:

Up to 12 weeks [Before which I invest only a teeny tiny amount of emotional energy.]
·        30% chance something else goes wrong between now and the ~9 week appointment.
·        20% chance something else goes wrong between the ~9 week appointment and the 12 week appointment.
·        4% chance we have an abnormal chromosome test result after our 10 week screening.
·        20% chance we have another neural tube defect (diagnosed either at the 12wk appt if anencephaly or 15 week AFP test if spina bifida).
·        6% chance some other catastrophic issue is diagnosed at the 12 week appointment.
Up to 20 weeks [At which time I have allowed myself to hope and will be devastated.]
·        6% chance we make it all the way to 20 weeks but have catastrophic issues diagnosed then.
Beyond 20 weeks [Devastated.]
·        2% chance something else terrible happens.

10% chance I end up with a healthy-ish baby.

Again, those odds are not great.  But they’re better than 0.

1 comment:

  1. Sorry to hear the heartbeat is a little slow potentially. I guess all you can do now is wait and see what happens at the next scan. Really hoping it will be positive.

    ReplyDelete