Capricorn or Aquarius?

Tonight will be the 9th night that Jenny has spent at Club Swedish. This week has been busier than last, complete with a neonatal doctor consult, more blood flow ultrasounds (Tuesday and Friday), a blood draw, and a frank conversation with Dr. F. Ultimately the news I think most people are interested in is “how long will Jenny be in the hospital?” and “when will we get to meet BabyJ?” While we don’t have definite answers for you, we do have some ideas about what will happen next. Here’s the scoop for the moment.

The growth ultrasound scheduled for next Tuesday morning, 1/13, will provide the missing piece to this puzzle.
a) If BabyJ measures as if she has not grown much, the plans are to induce labor and get her out into this world where she can gain weight without relying on the placenta in Jenny’s body. In this case BabyJ will be a Capricorn!
b) If BabyJ continues on her 2nd percentile growth curve or actually gains enough weight to bump her up to a higher percentile for her gestational age, then the bedrest is working, and Dr. F is likely to decide to have Jenny carry BabyJ to 37 weeks before inducing. In this case BabyJ will be an Aquarius! There will still be bedrest until then, but it’s possible Jenny can rest **at home.** This little carrot has been tossed out in a couple of conversations, but we're not clear what circumstances will allow for that option as an alternative to bedrest in the hospital.

So we’ll have to wait and see what Tuesday’s ultrasound growth measurements show. And then there always remains the possibility that BabyJ will choose to arrive of her own volition sometime before any induction takes place. But in any of these scenarios, BabyJ will arrive well ahead of schedule, in January.

The neonatal doctor who dropped by for a visit on Monday explained some of the issues for small babies who are born a little early. There are three main concerns: lung maturity, body temperature regulation, and feeding without choking. With Jenny just past the 35 week mark now, and with the plans for BabyJ to be born at week 36 or 37, we’ve been assured her lungs will be ready to breathe air. They are not even talking about giving Jenny a steroid shot to help mature BabyJ’s lungs – each OB doctor we ask says her lungs will be fine. Body temperature regulation can be a problem for low birth weight babies because of their lack of body fat, but we were told that this is rarely reason enough for hospitalization in the NICU. It’s the skill of feeding that may keep BabyJ in the hospital a few days. Apparently, sometimes little early babies don’t quite understand the sequence “suck-swallow-breathe.” (You can imagine that the sequence “suck-breathe-swallow” might be problematic! It'd be more like "suck-breathe-choke-get pneumonia." Definitely not good.) But it’s been said that it really only takes a couple of days for babies to sort that out. Then, when Dr. F. was asked on Tuesday what she thought about BabyJ staying in the hospital or coming home with us, she said very definitively, “I think your baby will go home with you.” So BabyJ’s prognosis is very good at this point.

The blood flow ultrasound on Tuesday went well and showed BabyJ’s is still head down, back and rump toward one side of Jenny’s belly, and feet up near Jenny’s ribcage on the other side. At one point BabyJ very demurely stacked her hands on top of one another and tucked them under her chin – it was very cute. The ultrasound technician for Tuesday’s ultrasound explained lots about what she was looking at and measuring in the vessels, which Jenny loves to hear. (The technician graduated from BCC, in fact!) All the blood flow and amniotic fluid measurements were deemed normal, and the ultrasound doctor on staff did not even come in to interpret the results. The next day, Dr. F. said the blood flows looked good and she didn’t expect to see any changes in BabyJ’s condition this week. The monitor strips continue to look great, as every nurse and doctor who sees them says. So we are in a holding pattern. Waiting, resting, and growing.

And then there is one more bit of info that came out this week that was new to us. The ultrasound on 12/30 indicated that BabyJ’s restricted growth is symmetric rather than asymmetric. Symmetric restricted growth means that her head and body are measuring proportionally small; with asymmetric restricted growth, the head circumference is closer to normal gestational size but the rest of the body measures small. It sounds to us that, in general, asymmetric restricted growth is often caused by placental issues late in the pregnancy, while symmetric restricted growth often indicates something like an infection affected the growth rate earlier in the pregnancy, or the baby is just constitutionally small. So Jenny’s blood was sent for some tests (we don’t have the results yet), to see if there is evidence of some kind of infection that may explain what’s going on. As far as we’re concerned, the symmetry of BabyJ’s restricted growth makes us believe even more strongly that we just so happened to make a small baby.

With another blood flow ultrasound to attend in the morning, it is time for this post to come to a close. We’ll try to keep you updated as we get more news. Thank you for all your calls, emails, and positive thoughts. We really appreciate them!