Hey everyone! Sorry I haven’t updated the blog after our last scan on Wednesday (4/12) but we had a lot going on because I was discharged!!! It’s so nice to be writing this blog update from the comfort of home, on my sofa with my dogs, and watching Love is Blind on a screen that isn’t a laptop. Being sent home was a positive thing and I will explain why and what the plan moving forward is.

I believe the last update I posted was after our scan last Wednesday when we found out my AFI (amniotic fluid index) increased from ~2cm to over 10cm. After the MFM team measured the fluid in my hospital room, the plan moving forward was to go to the fetal therapy clinic that Friday (4/7) to have the fetal radiologist involved and another follow up Wednesday 4/12. The scan on Friday went great and the fluid was observed at around 11cm with good Doppler, indicating blood flow through the umbilical cord was good. After Friday’s ultrasound, the plan was to continue with daily non-stress tests (NSTs) until the next ultrasound. On Sunday, Chandler failed the NST due to a large decel which was a concern, however the following NSTs were passing so the doctors weren’t overly concerned with the failed NST. A NST essentially looks to measure the baseline fetal heart rate, and based on gestational age looks to measure at least a 10bpm increase over a measured period (mine were typically 20 minutes). 10-15 increases is considered passing for Chandler. On Sunday, however, she had a large drop in her heart rate where it fell into the low 60s and remained low for a period of six minutes. As to why that happened is really unknown, but some explanations given is she could have rolled onto her cord or possibly grabbed her cord. We had an additional 90 minutes or so of monitoring which all looked normal, and that paired with the monitoring in the days following is why right now intervention isn’t necessary (intervention = delivery).

After that scare on Sunday, I’ve been making sure I keep track of kick counts and ensure she is moving around and she has been. On Wednesday, John came to the hospital for the ultrasound because we had a feeling I would be discharged so he wanted to be there to take me home after. The ultrasound went great and the fluid has been stable in the 10-11cm range and the Doppler looked great.

So what next? Does this mean the pregnancy is no longer high risk? Unfortunately, no, we are not magically cured and there are still concerns that the doctors want to monitor and keep an eye on. Moving forward, we are going back to the weekly visits to make sure my placenta is performing as it should be (there has been talks that a placental issue could be the cause of these problems and not PPROM) as well as biweekly growth measurements to ensure Chandler is thriving in utero. Right now my pregnancy is still considered high risk due to her small size as she’s still in the 3rd percentile, so making sure she continues to receive the nutrition she needs to grow is the focus moving forward. Babies who are SGA/IUGR (small for gestational age/intrauterine growth restriction) and are not monitored sometimes can die in utero when they are no longer thriving, hence why we are going to be watched very closely. Based on the fluid increasing exponentially, the previous diagnosis of PPROM is no longer the case and the doctors either think my water broke and has resealed, or it never was a PPROM case and was the placenta all along, however there is no way to be sure. Due to PPROM and the risks of infection no longer being a concern, delivery at 34 weeks is no longer the plan. The doctors are hopeful to keep Chandler in utero until 37 weeks and have her delivered at that time as long as she continues to thrive.

Over the past six weeks we have had three growth scans, and at each scan she has gained 6oz. At the last growth scan she weighed 672g, which is equivalent to 1lb 7 oz. If she continues to maintain the same weight gain as she has been, at birth she may only weigh a little over three pounds so we are both prepared for intervention (again, intervention=delivery) at any time in the case her growth doesn’t advance past what we’ve seen. Although we can pontificate based on what trends she has shown, we really have no way to predict how her weight will change over the coming weeks, and to take this pregnancy week by week. Although we do not know when the right time for her to come will be, when it happens we will be so excited to meet her! Lung development is still a big concern for our doctors as although her fluid has increased, she had very low fluid at a critical time so we do not know if that was enough. For now I will be taking it easy at home, and we will visit the fetal therapy clinic again next week. I will post another update once we have one. Thanks again for everyone’s support!