Maternal Fetal Medicine: A Brief Overview of What to Expect

Monday is just around the corner.... Things they will check.

Nuchal translucency, this is the fluid at the back of the neck. If the NT number is high, it could mean a disorder of some sort.

They'll also take measurements of the baby's arm bones, femur, head circumference, distance across the head (biparietal diameter), circumference of the baby's abdomen. They'll measure fluid pockets around the baby. You hope for at least 10 ML of total amniotic fluid. My numbers usually are below that, which means the baby is at risk for complications later in pregnancy. They'll look for signs that the baby is swallowing fluid. This can be determined by looking at the kidneys. They'll check the four chambers of the heart, and the stomach.

They'll run a measurement of the blood flow through the umbilical cord and the placental pulse. These give an indication as to whether the baby is getting sufficient nutrients to sustain life and growth. I've run into problems here in the past as well. A decrease in blood flow can be dangerous, a reversal in blood flow is fatal in hours. With my oldest, her blood flow would stop intermittently near the end of pregnancy. They induced because the risk of it reversing once it stops is quite high.

They'll look at the placenta. In the past my placentas have been small, usually malformed. My youngest daughter's cord was too short. My oldest daughters placenta was over half dead at birth. This can be very dangerous. It's another factor that inhibits growth. When a placenta is too small or not functioning well, the baby's body will sometimes grow the vital organs at normal rates while the other organs suffer. The brain, heart, and lungs often develop faster than the kidneys, etc. This is why both my girls had trouble with blood sugar and body temperature after birth. It is also why my youngest had severe acid reflux at birth. Her body wasnt ready yet. Sometimes, in very sever cases, this kind of growth restriction can lead to multi-system organ failure.

After all that is done, they will watch for activity of the baby.

When you add all this up, calculate all the measurements. Assess all the risks, they will determine the following:
The gestation my baby measures at.
The likelihood of death in utero.
The overall health of my baby.
A treatment plan, if needed.

In the past, my babies have measured 2-6 weeks behind. Two weeks is not such a big deal, but as I get further along in the pregnancy, the numbers become more skewed. Six weeks is dangerous. To give an example, the difference in 6 weeks could be whether a baby can breathe on his own or not. Or whether he has a fully functioning brain or not. I've only lost two babies, and both were very early on, likely due to placenta problems. They weren't viable.

Even with all the risks, my babies generally do really well once they are born. It's the incubation inside my womb that seems to be the struggle.

Bedrest, lots of water, walking daily, and a balanced diet have always been the plan in the past. Oh yah, and no stress. Hahaha!