Annabelle Updates

So this goes back to last Friday. I had my second monitoring appointment. The first one was on February 18th. At that appointment, my fluid was on the high range of normal. It was 18 cm. I think. They want it between 6-24. That wasn't the big concern that appointment since it was in the "normal" range. They were more concerned that I failed the NST and had to have a biophysical profile done. But then I passed the biophysical profile and everything was happy. I was told to come back in a week.

So my second monitoring appointment was on February 25th. I went in and started with the NST. Anna passed right away. I got the two heart rate jumps that they needed in the first 7 minutes. You still have to be hooked up for the full 20 minutes though. After those first two jumps though, Anna fell asleep. So we had to keep me on the monitors for another 30 minutes to try and wake her up. I guess eventually they were happy because around 4:15, they said I could do an ultrasound to check the fluid. We went back to the ultrasound room and looked in at Baby A. She was being adorable. So we took a few pictures. Then they checked my fluid...

My fluid was up to 26 cm. Which is too high. They didn't like that at all. They made me stay in a room while they went and found my doctor to discuss everything. Everyone seemed shocked that I didn't have diabetes, but I took the test twice and passed both times and I don't know how you can "cheat" on that test...

So after talking to my doctor, they determined that I have to come twice a week now. If it remains high, then I'll have to take fluid off of the baby. This is done like an amniocentesis, which the really long needle. Hopefully it doesn't come to that though.

So that was Friday. My next appointment was then Monday, yesterday.

So I went back yesterday. They started me off with the fluid check. It was back in the normal range, but still high. Yesterday it was 20 cm. So I still have to go twice a week but they aren't AS concerned...or something. After the fluid check we went and did the NST. It took awhile to wake her up but once she did she passed fairly quickly. It was an interesting appointment yesterday because Stella was off so I stayed home with Dom. Then Dom and I headed up to the hospital at 3 and Nick met us there. So we had our appointment with Dom in the room and he's not the most patient guy in the world! But we all managed.

So now I go back on Thursday to repeat the fluid check and do another NST. I don't really know what they will do if it's still high...

Here's the info I found off of March of Dimes website:

How are oligohydramnios and polyhydramnios diagnosed?
An ultrasound can measure the amount of amniotic fluid:

• One method is called the amniotic fluid index (AFI) . The AFI measures the depth of the fluid in four quadrants in the uterus. These amounts are then added up. If the AFI is less than 5 centimeters, the pregnant woman has oligohydramnios. If the AFI adds up to more than 24 centimeters, she has polyhydramnios (1, 2).

How common is polyhydramnios?
About 1 percent of pregnant women have too much amniotic fluid (1). Most cases are minor and are caused by a gradual buildup of fluid in the second half of pregnancy. However, a small number of women have a rapid build-up of fluid as early as 16 weeks of pregnancy that usually results in very early birth (1).

What complications can polyhydramnios cause for mother and baby?
Women with minor polyhydramnios experience few symptoms. However, those who are more severely affected may have abdominal discomfort and breathing difficulties as a result of the uterus crowding the abdominal organs and lungs.

Polyhydramnios may increase the risk of pregnancy complications including (1, 2):

• Premature birth
• PROM
• Placental abruption: This is a condition where the placenta partially or completely peels away from the uterine wall before birth.
• Stillbirth
• Postpartum hemorrhage, which is severe bleeding after birth
• Fetal malposition: The baby is not lying in a head-down position. This may mean that that the baby must be born by cesarean section.

What causes polyhydramnios?
In about half of all cases, the cause of polyhydramnios is unknown (1). Known causes include:

• Birth defects: About 20 percent of babies from pregnancies affected by polyhydramnios have a birth defect (3). The most common birth defects that cause polyhydramnios are those that affect the baby’s swallowing, such as birth defects involving the gastrointestinal tract and central nervous system (1, 2, 3). Normally, swallowing by the baby maintains the fluid at a steady level.
• Maternal diabetes
• Maternal-fetal blood incompatibilities, such as Rh and Kell diseases
• Twin-twin transfusion syndrome (TTTS): This complication affects identical-twin pregnancies. One twin gets too much blood flow and the other too little because of connections between blood vessels in their shared placenta.
• Fetal heart rate abnormalities
• Fetal infection, such as with parvovirus B19: In childhood, this infection commonly causes a mild illness called fifth disease.

How is polyhydramnios treated?
When a routine ultrasound shows evidence of polyhydramnios, a provider recommends a more detailed ultrasound to help diagnose or rule out birth defects and TTTS. The provider also may recommend amniocentesis and a blood test for diabetes. Amniocentesis is a test in which a small amount of amniotic fluid is removed through a needle inserted into the mother’s abdomen to test for certain birth defects.

In many cases, slight polyhydramnios goes away without treatment (1). In other cases, it may resolve when the problem causing it is corrected. For example, treating high blood sugar levels in women with diabetes or giving the mother medicine to treat certain fetal heart rhythm disturbances often reduces amniotic fluid levels.

Providers closely monitor women with polyhydramnios with weekly (or more frequent) ultrasounds to check amniotic fluid levels and fetal well-being tests to check for signs of fetal difficulties. If the woman is uncomfortable because she has an extremely large amount of fluid, her provider may recommend treatment with indomethacin. This drug helps reduce fetal urine production and reduces amniotic fluid levels. Amniocentesis also can be used to drain off excess fluid. This procedure may have to be repeated a number of times.

If the tests show that mother and baby are healthy, a woman with slight polyhydramnios near term usually does not need any treatment.

So I'm assuming that I have slight polyhydramnios, if anything at all, and that me and Baby A are healthy since they haven't suggested any treatment and even told me that they didn't think they would do anything at all since I'm almost full term. They just want to keep up with the twice a week monitoring.

I guess we'll see what happens on Thursday with the next fluid check.

I'm not over concerned with all of this but it is slightly scary. Everything was going PERFECT with this pregnancy and I wasn't expecting anything to come up that would have me worried. But there's nothing I can do. I trust my doctor 100% and I'll keep doing what he tells me to do. Hopefully everything continues to go well and I'll have my baby girl in just a few weeks!

That's the plan anyway!