Today we went in for our weekly follow up ultrasound after our initial intake with the Fetal Therapy Clinic last week. Neither John or I slept very soundly last night – we were both worried about what we might hear at today’s scan. Our scan was at 8:30am followed by an appointment with one of the two doctors who head the fetal therapy team.

Our scan seemed to go well from what we could see. My fluid has increased from 1.70cm last week to 2.68cm this week which felt very exciting and promising. We were able to see fluid in baby’s stomach as well as her bladder, which indicates she is ingesting fluid which is what we want to see. The more fluid she ingests the more likely she will have developed lungs at birth. One concern we had was her growth as we knew at our last appointment that she was in the 14th percentile and above the IUGR range, but not by much – anything <10th percentile is considered possible IUGR.

When we met with the doctor after the scan, we learned that although the fluid increase was a positive, our prognosis overall was looking more grim than the week prior. Our baby’s growth was not ideal and she has only gained 56g since our last measurement date which was on 2/21 – essentially she is below the 3rd percentile and we have the IUGR and possible SGA diagnosis back on the table. Additionally, her head appears to be dolichocephalous in nature and some possible deformities are being seen in the ultrasound. It’s hard to know how accurate this information is because ultrasounds are a difficult tool to rely upon, especially when dealing with low fluid.

So what is next?

We are choosing to continue the pregnancy and have another scan scheduled for next Wednesday. We are very nervous for next week as we are not just having the ultrasound and meeting with our doctor, but we also are meeting with the Bridges team at OHSU who are the neonatal palliative care team. Palliative care for infants and children doesn’t always mean the same that it does for adults – what comes to mind for most people are things like hospice care or end of life care, however it does freak both of us out. We are hoping we have the Bridges team involved for ongoing NICU care and not to help us navigate comfort care which is not the outcome we are hoping for.

As of now we aren’t confirmed with IUGR and we aren’t confirmed with SGA – SGA is defined as babies whose birthweights are below the 10th percentile for their gestational age. What is confusing for us is we don’t have a defined reason as to why this is happening. So far, testing has supported a healthy placenta, I don’t have gestational diabetes or high blood pressure, and there is no known cause for the oligohydramnios outside of fetal anomaly or possible infection which remains undetermined. Fortunately, my results for CMV came back as immune, meaning it is not relevant to this pregnancy. It has been posed that our baby could have a rare genetic condition however due to the low amniotic fluid we aren’t safely able to draw fluid for an amniocentesis to make that determination.

For now we will continue to ride this out. I’m staying mostly off of my feet, drinking lots of fluid, and taking care of myself. We are crossing our fingers for some positive news next week.