Today marks two weeks in the hospital, and tomorrow I will be 26 weeks! It’s crazy how much time has flown by since I got admitted as well as looking back to the day we received the oligohydramnios diagnosis. It’s hard to believe that was over six weeks ago. Today we received some positive news, however we are approaching that positive news with cautious optimism as is our medical team.

This morning I was brought to inpatient radiology to have my weekly ultrasound where they planned on measuring the amniotic fluid levels, look at the umbilical cord and placenta on the Doppler, as well as do a fetal growth assessment on Chandler since it had been two weeks since our last check (on 3/22 she was measuring at 492g). This ultrasound was a bit different than the ones I’ve had previously, as the ones John and I attended outpatient there was a screen where we could see, and the one last week inpatient was performed in my room where I could also see the screen. In case you haven’t checked the blog lately, last week’s ultrasound along with the ultrasound on admission day both measured ~2cm, which is where we have been measuring since my intake appointment at 20w. I asked the tech if she could tell me how big Chandler was or my fluid levels and she told me she could not, but the perinatal team would be able to go over results with me. Yikes – nothing quite like that kind of anxiety.

I got back to my room around 9am and shortly after I got a notification that my results were ready to be viewed in MyChart. I looked at the results and the report showed 9cm….9cm?! This can’t be right. I called John to let him know and that I wasn’t sure if this was something for us to be happy about or if we should worry – a 7cm jump in a week seems really crazy and could this be a sign of something else going on? Around 11, the MFM team came in to go over the results with me and they brought an ultrasound machine with them. As soon as they entered my room they asked if I had seen the MyChart results, and I said yes and asked if I should be happy or worried. They told me I should be happy and this was great news, but they wanted to see this for themselves and ensure there was no error, which is why they brought in the machine.

I laid back and one of the doctors who was with John and I in the room on the day we got the oligohydramnios diagnosis (who had told John that she has never seen a case of oligohydramnios correct itself) performed the ultrasound and to say the doctors were in a state of disbelief is probably an understatement. The MFM doctor was able to measure a total of 11cm of fluid. For anyone who hasn’t spent a bazillion hours learning about AFI pockets like I have, anything from 5-25cm is what is considered standard or “normal” fluid in pregnancy, anything <5cm is considered oligohydramnios, and measurements <2cm is anhydramnios (which is what we were initially diagnosed with). Of course I had a ton of questions for the doctors because I just was blown away at how I could have 2cm of fluid consecutively for weeks on end, and how in a matter of a week it suddenly self-corrected.

Right now the doctors really don’t know why my fluid is miraculously higher. There is still the uncertainty of whether or not I was a PPROM case (ruptured membranes), if this is a placental deficiency, if there is some sort of underlying. genetic explanation, or a combination of the above. In addition to the increase in fluid, Chandler is now measuring 672g (1lb 7oz) and is now out of the “below 3rd percentile” range and is measuring at the 3rd percentile. Another interesting fact to know about fetal measurement is anything below the 3rd percentile is not measured at a granular level – if your baby falls below the 3rd percentile they are grouped in “below 3rd percentile” whether they’re the 2.9 percentile or the 0.1 percentile. Chandler graduating out of the “below 3rd percentile” to the actual third percentile is also really excellent news and may be another indicator that the low fluid was due to placental issues.

So what happens next? I assumed I should start packing my bags and they would be discharging me because now everything is fine, right? Well, not exactly. So although this is amazing and incredible news, the doctors are definitely proceeding with caution and want to ensure things are actually stable and improved. On Friday I will be going back over to the fetal therapy team to have another ultrasound performed by one of the fetal radiologists that we had been seeing prior to my admission. The placental issues that had been observed during the 3/22 scan and prior scans do have to be evaluated by a fetal radiologist just because their expertise is needed to identify the anomalies – so that’s the first step. I will also hopefully get the chance to chat with Dr. Duchovny who has overseen my care to better understand what the care plan looks like moving forward. I will have another scan on Wednesday, 4/l2 as well prior to the team deciding if discharge is the right option for me.

One thing to note is Chandler is still what is considered small for gestational age or SGA, which does still leave me in the high-risk zone. If my fluid stays where it is and Chandler stays in utero where she is supposed to be, the concerns of pulmonary hypoplasia (incomplete/under-developed lungs) can be almost entirely eliminated as a risk factor for her. Also, assuming I did rupture my membranes and assuming my fluid is elevated now because they re-sealed (it can happen but it’s not typical) we also would be looking at a modified delivery plan. We have been told that 34 weeks delivery is the latest that a PPROM patient should carry to reduce risk of infection to the mother, however if that ends up being changed I would not have to deliver possibly until 37 weeks. These are all subject to change though, because ultimately the decision to deliver is going to be based on how Chandler is doing, if she is still thriving in the womb, and how big she is. We are still being told she will be a small baby, but so far she has shown she is healthy and strong.

That’s all the updates for now. John and I are extremely excited to share this positive news with everyone, but we are still prepared for things to change as this pregnancy has demonstrated that things can change day by day. I will post a new update on Friday after the next ultrasound. Until then, thanks to everyone for your thoughts and prayers!