Hey Everyone. So, a lot to report this week. We just returned from our growth scan and doctor visit. I have gained 32 pounds now (oy) and my BP is still right on target. My blood sugar is well-regulated with diet and insulin so they aren’t worried about that either.
Now to the part everyone actually cares about – the babies! Baby A is 2 lbs. 9 oz. (30th percentile), Baby B is 3 lbs. 2 oz (53rd percentile), and Baby C is 1 lb. 15 oz. (10th percentile). Statistically, each baby is still right on their own growth curve meaning they are all still growing nicely. Baby C still has increased amniotic fluid (polyhydramnios) and they still haven’t seen a stomach for her (probably the reason for the polyhydramnios).
We had a long discussion with the doctor today concerning Baby C. One of the concerns since the 20 week sonogram was that her growth would suddenly stop. The doctor said that her educated guess is that given her growth so far, at the next growth scan in three weeks, she will probably not show any growth. This, combined with the increased resistance in blood flow in her umbilical cord (meaning she isn’t getting the best nutrition), would lead them to recommend delivering within the week - between 32 and 33 weeks. Average gestation for triplets is 31-32 weeks, so this isn’t outrageously early. The major risks to babies A and B fall off after 28 weeks, and fall off further after 31, 32 weeks. In the NICU nursery at North Shore, the rates of survival for triplets born at 32 weeks is 98% with a morbidity (long-term negative effect) of 95%. This means that babies A and B would have between a 2-5% risk of negative outcomes if we deliver at 32 weeks. This is right in line with the general overall risk for triplets so we aren’t alarmed by these numbers.
The risk for Baby C right now is greater if we were to deliver her at this point since she is still growing and her organs are still maturing. So, for now, she is much better off staying inside and cooking longer. However, if she fails to grow to her growth curve at the next scan then her risk of negative outcome would be greater if she remained inside than if she were delivered. This is because she would no longer be receiving enough nutrients via her umbilical cord anymore and could be better fed using a feeding tube in the NICU. The extra three weeks will also give her time to grow however much she can giving her a head start on reaching the 5 pounds needed for the surgery on her esophagus.
I received betamethasone today (a steroid shot that causes the babies lungs to develop quicker) and will get another one tomorrow. This should decrease their risk of respiratory distress once they are born and give them better chances. The doctor estimated 12-14 days in the NICU, barring any unforeseen problems, for Babies A and B. That isn’t too bad.
So, we are going to prepare ourselves to be delivering sometime in the week following September 17. At our visit in two weeks we have to speak to the doctor about switching me from Lovenox to Heparin, to decrease any risks of anesthesia problems from the Lovenox. Then, whenever we need to, we can schedule a c-section and have these babies! Of course, Baby C could surprise us all and continue to put on weight over the next three weeks and then we just keep going.
My next appointment for a BPP scan and doctor visit is Thursday, September 4. I will post again then!
No comments:
Post a Comment