Thursday, May 12, 2011

Out, Out, Damn Placenta!

My crummy placenta strikes again!

I was fortunate to be able to return home last week, after 11 days in the hospital. It's been wonderful to be in my own space and reunited with my furry kids. Since I've been home, we haven't any more labor or abruption scares. Crockett was quite certain that we'd be back in the hospital within a day or two, and I am happy to have proved him wrong.

Unfortunately, it seems that my placenta is continuing to misbehave. We had our last ultrasound to check Asher's growth yesterday, and he is definitely starting to show evidence of growth restriction, indicating that he is not getting what he needs through the placenta. He currently in the 15th percentile for size overall, which is down from 24th in the last 3 weeks and puts him right at 5 lbs. He is not technically growth restricted because that diagnosis isn't given until babies dip below the 10th percentile, but the trend is concerning. Even more concerning is the distribution of his growth: his head is continuing to grow at a normal rate, but his abdomen is measuring a 2-3 weeks behind schedule, which is the pattern we see in babies whose placentas are not functioning well (it's called "head-sparing" or "asymmetric" growth restriction). This pattern of growth indicates that he isn't simply a small baby, which you might expect given my tininess, but that this is actually a pathological change in his rate of growth. The one bit of good news is that so far, he doesn't show any signs of the distress that can occur with poor placental function.

None of this is particularly surprising to us. From the beginning, we have known there was a high likelihood of this happening, given my chronic high blood pressure and abnormal first trimester Down syndrome screening results (that darn low PAPP-A level strikes again!). But it is disappointing because it is just one more thing to worry about, and from a maternal standpoint, I feel awful that my poor baby is figuratively starving and there is nothing I can do about it right now.

All of that said, this doesn't change the plan for the next couple of weeks at all. I will continue going in for fetal monitoring a couple of times a week, and delivery will still be at 37 weeks, so long as testing remains reassuring. We have a c-section scheduled on May 24th at 9:00, which happens to be our 8th wedding anniversary. I can't imagine a better anniversary gift! (I mean the baby, not the surgery.)

For now, I just hope this crummy placenta holds up for the next 12 days, but I won't be at all surprised if it doesn't. And whenever delivery happens, I will be ready and SO very happy to be separated from this stupid placenta once and for all!

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