Chances are…chances.

Got a call from the peri with results from the first trimester screening.  Mostly good.  A tad worrisome, but I’m reserving freakthefuckout for necessity, which this is not.  Yet, maybe.  Anyway, first, the good:

  • 1 in > 10,000 risk of Downs
  • 1 in > 4,700 risk of Trisomy 13 or 18
But, of course, there has to be something.  Low PAPP-A levels.  I didn’t ask for the actual number, since I can get that from my OB next week if I want it then, I’m sure.  She said not to panic, so I will do my best, that there’s still less than a 20% chance of complications…which include IUGR, low weight for gestational age, pre-eclampsia, and pre-term labor/delivery.  Pretty much all my biggest fears after miscarriage and stillbirth.  I realize it’s still more likely than not that everything will be perfectly fine, but I have a hard time finding comfort in statistics anymore.  Miscarriage is supposed to be 1 in 4 or 5 pregnancies, and we already beat the pants off those odds (not in a good way, I should clarify, just on the off chance you’re brand spanking new around here).  (I’m probably not framing that entirely correctly, mathematically.  I’m the first to admit that I sort of hate stats and never grasped probabilities all that easily.)  All I know for sure is that SOMEONE has to be the one in whatever unimaginable number they tell you.  I’d like to think that it’s my turn to not be that someone, but I know it doesn’t work on a merit-based system; I don’t necessarily get credit for time served.  In fact, I’d lean more toward thinking that past pregnancy failures increase chances for complications even in successful pregnancies.  I haven’t googled all of this quite to death yet, and will still have to talk to my OB next Thursday of course, but right now I’m thinking that this points strongly toward staying on the heparin for the long haul.  All of these complications are placenta-related.  I of course don’t know the detailed mechanisms, but I’d still somewhat ignorantly theorize that blood clots could easily contribute to adverse effects on the size and efficiency of the placenta.  
I guess the silver lining is that it sounds like I’ll be getting lots of ultrasounds.  I’m sure my OB will have to confirm this, but the peri said detailed anatomy scan at 20 weeks, which I believe is pretty much standard for all pregnancies anymore, and then scans every four weeks until 32 weeks, and then every week until delivery.  I question whether I heard that last part correctly, but I’m pretty sure that’s what she said.  Not sure how I feel about that yet.  Obviously, proper monitoring far outweighs whatever desire I had to get as close as I could to ‘normal’ with this pregnancy, but I guess I’m a bit bummed that it sounds like I’ll actually be a perinatal patient.  I really kind of thought I would be back for the 20 week scan and that would be it.  It’s a silly thing to be sad over, and I’m sure I’ll get over it quickly…I was just beginning to enjoy somewhat seriously considering working toward a natural delivery, maybe even one in a birth center (albeit a birth center AT a hospital; I’m not THAT brave slash foolish).  Maybe I could still have these things…but maybe not.  I’ve just been happy to be allowing myself to think that far ahead, that I’ve not been telling myself that I’d better not get greedy with thoughts of a live baby.  It’s actually been remarkably positive thinking for me.  I don’t want to backslide.  
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5 thoughts on “Chances are…chances.

  1. Anonymous says:

    Oh man! It's not like us RPL'ers ever relax and don't worry anyway. Although being told not to panic is a good thing, and I'd listen to her. I go for our NT scan on Jan 13. Bloodwork will be done the week before so that they can give me all the details right after the scan. Enjoy the upcoming holidays.Shanlee

  2. Heather says:

    My doc said I shouldn't do all the tests as a lot of them give a false positive and you worry for nothing. However I am moving from my fertility doc to the oby/gyn in Jan so we'll see what he says…I also am going to get loads of ultrasounds. I somehow wonder if they are all necessary but I also know I am high risk being 37, will be 38 when baby is born, plus endo, plus infertility plus high blood pressure.. I guess we would rather be safe..

  3. Thanks, Shanlee. You're so right – every time I catch myself actually relaxing I go and ruin it with a big adrenaline rush of OMG HOW CAN I HAVE FORGOTTEN TO WORRY FOR HALF AN HOUR. Ridiculous…but unfortunately ingrained at this point. That's nice how they're doing the bloodwork ahead of time so you don't have to wait for results after the scan! I wish my people were that coordinated. My OB is trying to get my RE to talk to the peri directly so we can avoid some portion of the game of telephone. Kind of a clusterfuck right now, but will be worth it, I'm sure. Hope your holidays were enjoyable!Heather – that's true. Part of me thinks that if everything is going to be just fine, it's silly to have all this extra monitoring. But then, like you said, better safe than sorry. I would hate to not be getting extra attention if I am going to need it! Overall, glad I did the screening, I think. My OB said that 80% of her patients do it, regardless of being over 35 or not, so it's becoming close to standard. She said it's pretty much wrong not to offer/encourage it at this point. Next – AFP quad screen. Hopefully that won't bring up any new things to worry about!

  4. manapan says:

    I saw your news on LFCA and wanted to share my story with you. I also had low PAPP-A levels, though I never asked how low. First, the scary. My blood pressure started rising at 8 weeks pregnant and didn't stop until after I delivered. I was on and off bed rest from the end of my first tri onward — I ended up spending 21 weeks on some sort of bed rest. My first bed rest was for a degenerating fibroid from 12-18 weeks, then I ended up back on from 20-21 weeks because I had preterm labor due to dehydration when I had stomach flu. At 23 weeks, I was back on for pregnancy induced hypertension, then I ended up being diagnosed with preeclampsia at 26 weeks.Now for the good parts. After the RPL, I really needed extra monitoring to keep me sane and the pregnancy problems let me have it as often as I wanted. My pre-e progressed slowly and I was able to carry to term, albeit early term at 37 weeks when an amnio came back saying he had mature lungs. I really believe that all the bed rest that was unrelated to hypertension issues helped me carry him longer than I otherwise would have been able to. My son was a perfectly normal size: 7 lb, 7 oz and 21 inches long. He's 6 months old now and he's a normal, healthy baby with the exception of some reflux. You can have a healthy baby despite your screening result, and I'll be hoping for the best for you.

  5. Thanks, manapan – until now nobody had said anything other than "nothing bad happened," so it's helpful to hear a story with complications that were still manageable. And I agree – it's hard to be upset about all the extra monitoring, when hopefully it will just be reassuring, even if there are issues to be found.

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