When things went south

I can’t help but reflect on when things started going badly in my last pregnancies.  For most of them, it was right away.  For the four that made it past 5 weeks, my blighted ovum went south at my 6 week appointment—when we saw a sac but no embryo.  My pregnancy with my son seemed like it might go south at my 6w6d appointment, when we saw that blood clot/active bleed.  It ended up resolving at the end of my first trimester—thank God!  My omphalocele pregnancy started going south at 5w3d when I started having heavy bleeding.  Of course, we thought it had resolved later in the pregnancy and then found out that we had much bigger problems at my 12w appointment.  My anencephaly pregnancy went south at 16 weeks, when we got the bad results from our AFP test.

I wonder when… I mean if… things will go south here.

Here are my predictions:

Up to 7 weeks [Before which I invest 0 emotional energy into this situation.]

·        50% chance there’s no heartbeat at my ~6w5d appointment next Friday, or I start to miscarry before the appointment.* 

Up to 12 weeks [Before which I invest only a teeny tiny amount of emotional energy.]

·        2% chance we have an abnormal chromosome test result after our 10 week screening.**

·        25% chance something else goes wrong between the ~6w5d appointment and the 12 week appointment.*

·        10% chance we have another neural tube defect (diagnosed either at the 12wk appt if anencephaly or 15 week AFP test if spina bifida).***

·        3% 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.]

·        3% chance we make it all the way to 20 weeks but have catastrophic issues diagnosed then.****

Beyond 20 weeks [Devastated.]

·        1% chance something else terrible happens.*****

5% chance I end up with a healthy-ish baby.  Those odds are a million times better than I would have guessed last month.

*Based on the fact that so many of my pregnancies ended early, and general risk of early/prior to 12-week miscarriage.

**We are OLD now.  I’m 39, hubby’s turning 41.

***The published risk for recurrent neural tube defects after one pregnancy with one is about 5%.  Because I was on folic acid and apparently had a folic-acid resistant neural tube defect, and because I’ve had so many miscarriages/other pregnancies with issues, and because I wasn’t on folic acid until part-way through week 5, I think I’m at least double that.

****I’ve read the recurrence rate of omphalocele is less than 1%.  Of course ½ of all omphaloceles are associated with abnormal chromosomes, and we did not have that, and we’ve lost so many pregnancies / had other pregnancies with birth defects.  So I imagine our “birth defect rate” in general, and risk of omphalocele specifically, is much higher.

*****Always a risk.  In at least this one way, I am just like everyone else.