Pregnancy number 2 equals premature baby number 2
Yesterday I hit the 29 week mark of my second pregnancy and had a growth scan to see how we're progressing. As many of you know, and the reason for our starting The Little One, was because my first bub, Poppy, was a gorgeous tiny premature baby, weighing just 1.6kg and arriving 7 weeks early. This was due to pre-eclampsia and ultimately my already high (even when not pregnant) blood pressure. So there was always questions around when I had a second, would it too be a growth restricted, early baby.
Well the answer I found out yesterday was a yes. So I've decided to write about my experience moving forward, partly for me to talk about how I feel, but also to reassure others that you can do it again!
Ever since I've started to show (which wasn't until around 21 weeks), the comments I constantly get from people is 'wow, you're so small, you can't possibly be 24 weeks', or 'you're so lucky to be so small - I'd love to be that tiny'. Well actually you wouldn't in my case! Carrying the way I do, aside from the fact that I'm relatively tall and maybe just carry well, is a constant reminder that this baby might not be growing as it should be and I might yet again be faced with having a premature baby that hasn't had the cooking time it really needs to be given.
My initial scans were great, 12 week and 20 week scans both came back normal, with the baby measuring in at average size - great news! At 26 weeks I saw my obstetrician who measured my tummy externally using a measuring tape, from the top of the placenta to the bottom. You're generally meant to measure a similar size in centimetres to the number of weeks you are pregnant, i.e being 26 weeks pregnant, I should have measured around 26cm. I was only 24cm and whilst this is not dramatic, it was the first sign that things weren't tracking quite as they should be. My obstetrician then told me that he wanted me to have a growth scan at 29 weeks to gauge where we are at for the start of the third trimester, and where if things are going to go wrong, generally do.
Suffice to say, yesterday morning I sat at work with clammy hands and not being able to focus before my 9.45am scan. My husband met me at the hospital and upon arrival we were told that the doctor was running behind and we'd have a short wait. Just what I wanted! We focused on trying to find a boys name that we both like - still nothing! As we headed in to the scanning room, we were told that he would be just a few minutes. It was the same doctor I had my 20 week scan with and didn't particularly like as he didn't really talk much during the scan - always an unnerving thing. This time around however, he was great. We talked through my first pregnancy with Poppy and how everything looked great until around this time. He informed me that this scan was to measure key areas of the baby to see what size it is, as well as assessing the placenta to see how it was holding up.
His first measurement was of the baby's thigh bone, the largest bone in the body. In the bottom left hand corner a little green number came up with the number of weeks gestation the baby was measuring based on size. It said 26 w 4 d. Uh oh. Before he'd even said anything I new the bub was smaller than what it should be. He then measured the head with the same result. He informed us that the baby was small, but until he put it on the growth chart he wouldn't know just how small it actually was. He did reassure us that it didn't look too small, but was definitely on the smaller side.
The next tests were done on the blood flow to and from the umbilical cord and to and from the brain. What relief it was when he told us both were normal and great (although he did pause for a long time on the brain scan and I think I nearly jumped off the table down his throat to get something out of him!). Lastly, he measured the level of amniotic fluid in the placenta, again normal and music to my ears.
He then took a slightly more serious tone and started to explain to us that my placenta was looking very 'aged' for this stage of pregnancy and pointed out dark holes around the lining that had started to show. His description was that my placenta looked a bit like 'swiss cheese' - this actually made me laugh during a stressful time and from now on how I'm going to refer to my placenta moving forward! 'Swiss cheese' is not a great thing to have at 29 weeks though and means that the placenta is already starting to shut down, so things will only get worse, not better, hence we need to closely monitor how the placenta is functioning week by week. He explained that the key areas to monitor are the blood flow through the umbilical cord and to the brain and the level of amniotic fluid. If either of these start to falter, we will have no option but to remove the baby. Finally, he charted the size of the baby against the growth chart per week. Our gorgeous little bub sat well under the lower percentile, at between 3-5%, currently weighing about 1kg when it should be about 1.4kg.
As distressing as it was to see this, I asked him to chart the size of the baby if it continued at this growth rate to 33 weeks and it came in at 1.6kg, the exact same weight Poppy was when she was born. Seeing that, I knew that although tiny, 'P2' as we call the bub, would be ok as we've done this before, know what to expect, and came out the other end with a strong, healthy, beautiful little girl who has more attitude than I'm sure I ever did!
Seeing my obstetrician directly following the scan, he reiterated what the doctor had said and told me that we're now just going to have to monitor myself and the baby until we feel we're at a point where it's more beneficial to have the bub out than in. The next step now is to see my blood pressure specialist next week, followed by a scan the day after and of course if I feel any abnormal symptoms (baby not moving, headaches, dizziness, puffy ankles etc) to ring my obstetrician immediately.
My feelings today having slept on it for 24 hours are positive ones; I know I can do this - I've followed the exact same path before; I'm grateful that the blood flow and amniotic fluid are still at normal levels; and I'm even more grateful that I have my obstetrician, my blood pressure specialist and my (new found friend!) the doctor who is going to manage my scans moving forward, all on my team. Don't get me wrong, it is extremely daunting and I hope and prey that 'P2' will have nice strong lungs and no complications when it comes out, but I've found the best way to manage my concerns is to look at the positives, which is what I'm going to do.
The final positive is that unlike last time, this time I have plenty of tiny, premature baby clothes, beanies, mittens, nappies, wraps and beautiful blankets to dress my tiny bundle in when it arrives!