Not good news

[ClarisseMarie]

Actually, amnio was not an option for us, because there was no amniotic fluid to take. The most we ever had after my 19.5 week ultrasound was 2.5 cm, but usually it was around .5 cm. They told us it was basically "sweat" and that's it. It was for that reason that they never could get an idea of what was wrong - we knew there was a heart defect (so I saw a pediatric cardiologist regularly in addition to my high risk specialists and OB), but that was really all they could tell (besides the fact that she was extremely small). They did offer CVS, but due to the amniotic fluid situation, it would not have taken much to put her in distress, so we declined and opted for hospital bed rest so she could be monitored around the clock until I delivered. If her fluid levels had ever gone up enough to do an amnio, I probably would have done it. But I was not comfortable with the CVS given the circumstances. It turned out, the reason she had essentially no fluid, is because only 1 kidney formed, and it was very underdeveloped.

Are you leaning one way or another concerning having one done?

[missmc]

I'm starting to lean towards having it done. I think it would be good to know if we're dealing with something more, that could possibly affect if/how we intervene, if it becomes necessary. I read that one of the possible reasons for her condition could be caused by an infection, which could possibly be treated. That might be a long shot, but if that would happen to be the issue and I didn't find out until it was too late, I would blame myself for being so hesitant.

I've heard that the MFM practice I'm seeing is the best in St. Louis and one of the best in the country, so that makes me feel better about her care and having them perform the amnio. I'm scared to do it, but I guess it's something I'll have to get over. Everthing else about her looks good...I'm just want to do what is best for her care.

[ClarisseMarie]

I think it sounds like the amnio is a good idea in your case, and I can definitely see why you'd lean towards doing it.

May I ask who you are seeing?

[missmc]

I'm going to the Center for Women's Wellness and Fetal Health, run by the WashU School of Medicine out of MoBap and Barnes.

I was having a conversation with a co-worker (his wife went through two high risk pregnancies that required blood transfusions and his youngest is a 28 weeker). Turns out his wife went to the same practice.

[Babidol]

I totally understand your hesitation. But at the same time it will give you your answer. I know they have to tell you the possible side effects....but they also tell us those same risks in the first tri, the possibility of having a 36 weeker or a plus term baby. If you are terribly worried about the chance of miscarriage why not wait another 6-8 weeks when you hit viability and have it done then? I now it's not optimal to have a 24 or 26 weeker but the chances of them surviving are far superior to now.

Hugs Momma. I know this decision has to be weighing heavily on your heart and mind.

[missmc]

I totally understand your hesitation. But at the same time it will give you your answer. I know they have to tell you the possible side effects....but they also tell us those same risks in the first tri, the possibility of having a 36 weeker or a plus term baby. If you are terribly worried about the chance of miscarriage why not wait another 6-8 weeks when you hit viability and have it done then? I now it's not optimal to have a 24 or 26 weeker but the chances of them surviving are far superior to now.

Hugs Momma. I know this decision has to be weighing heavily on your heart and mind.

Thanks. I just called my OBs office to see if I can talk to my OB to get his advice (he is supposed to call me later). I've been seeing him for 10 years and he is definitely a medical professional that I trust.

[missmc]

The nurse called me back and said that the official report says "Pleural effusions with no other signs of hydrops."

[Babidol]

I looked up pleural effusion and I understand what it means in an adult I think. Is it an infection? I guess the big concern would be proper lung development? I know you've done some research but does this also account for lack of amniotic fluid?

And I am so glad you are consulting with your OB. I would want as many opinions as I could get. I am just praying that the news gets better and better at each visit!

[missmc]

It might be more helpful to look up fetal pleural effusion. It's a fluid accumulation in the chest area that can compress the lungs and shift a lung or the heart to one side. It could be caused by infection, genetics, chromosomes...so many different things could cause it. Proper lung development is the biggest issue. The fluid could also affect her heart.

I couldn't find any correlation between my low AFI and her condition. The MFM dr. asked if I was dehydrated, asked about m/s and said to increase my fluid intake to see if it would help, but he isn't worried about it at this point.

Thanks for the prayers!!!

[Babidol]

10 is technically on the low side of normal. Mine was 10 when I delivered ad it sure felt like a ton of water!! Gonna go check dr google

[missmc]

I talked to my OB this evening. He said that I should do the amino but doesn't want me to wait too long. He thinks that my risks are minimal at this point and the specialist I'm seeing does several a day so I'm in good hands. He sensed that I know that I need to do this and told me that he also didn't want it hanging over my head. He confirmed all the reasons for doing it that I have mentioned in previous posts.

He said that he has not seen pleural effusion in a fetus before because it is rare. He said the odds of our current situation are 1:40000. Both drs are tickled that nothing else seems to be wrong other than the fluid that is there. Her condition could change and he didn't want to tell me anything either way because we still have a way to go. Only time will tell.

[Linzo]

Huge Hugs and lots of prayers sent your way!!

[Babidol]

Sounds like you have good information to base your decision on. Still praying!!

[ozzy]

Sounds like he confirmed your thoughts and hopefully made you feel better about doing the amnio?

I'm sorry you even have to worry about all of this. I am thinking about you and your baby girl.