Regular readers will recall my first post, where I talked about how hiccups drive me crazy. Well, dear friends and family, we have had a hiccup in our pregnancy.
Before I continue, in violation of good storytelling principles, I’m going to skip to the climax and let you know that mom and baby are PERFECTLY FINE.
On Friday the 17th of June, Anne awoke in the middle of the night to discover that she was leaking fluid. We immediately traveled to our hospital, and after a quick test it was determined that yes, this was indeed amniotic fluid. Anne’s bag of waters had prematurely ruptured at 29 weeks.
As one of the salty old nurses was sinking her IV, she said, “You know that you’re going to be here until you deliver, right?” Not the best way to break us the news, I must say. Anne was admitted to the hospital at about 4 am for PPROM (preterm premature rupture of membranes).
They immediately put her on IV antibiotics. Baby is totally safe in the womb as long as the membrane surrounding her is intact, but with it punctured, there now exists a persistent risk of intrauterine infection. She was also put on betamethasone, a steroid used to stimulate fetal lung development. If the peanut needed to be sectioned sooner rather than later, it would be particularly important for her to breathe on her own. (There are some complications associated with mechanical breathing assistance for premature babies.)
Friday night was not fun. We were exhausted, having barely slept at all the night before. We were upset from the whole situation. The fetal heart monitor was extremely scratchy and difficult to keep in place. What’s more, throughout the night the peanut’s heart rate dropped to the 70s six times. The on-call doctor entered in the middle of the night to warn us that if her heart rate didn’t stabilize we’d need to do a C-section. Anne and I were afraid.
Anne realized that she was feeling minor contractions. She received a marker that allowed her to indicate on the fetal heart monitor when she felt them, and it turned out that her contractions corresponded to the drops in fetal heart rate. She was administered a drug to suppress the contractions and the peanut’s heart rate stabilized. Things started to settle down a bit. We slept a bit better on Saturday night, although we did get woken at 12, 3, and 6 to get IV medications changed.
Unfortunately, betamethasone increases blood sugar, so Anne was put on a stupid gestational diabetes diet – low sugar/carb. She was told that she would have to be on that until the betamethsone treatments finished on Sunday morning, but it turns out that they’ve kept her on it “just to be safe.” It’s kind of a dispute between the perinatalogist and our OB about what’s appropriate – the deal that was cut that Anne wouldn’t have to get stuck with the blood sugar test three times a day if she just stuck to the low sugar diet. Blarg.
You might be wondering about the amniotic fluid. Well, the breach was probably high on her uterus (not low, towards the cervix), since Anne has not lost much fluid. Apparently a normal AFI level (Amniotic Fluid Index) is at around 10 or above. When Anne was measured on that first Friday afternoon they told her that she was 6.8. They said they wouldn’t be concerned unless it was under 1. Amniotic fluid replenishes itself pretty readily, apparently. Almost a week or so ago she got a 9.5. So we’re not worried about fluid loss.
What this means is that Anne will likely have labor induced once she reaches 34 weeks. At that point, the risk of infection outweighs the benefits of additional gestation in the womb. When does she reach 34 weeks? July 19. Apparently induction is performed in the evening such as to encourage births during business hours. If that’s the case, and Anne is induced on July 19, it’s possible that she’ll have the same birthday as Grandma Pam (July 20)! How cool would that be?
The long and short of it is that we’ll get to meet the Spicy Peanut 6 weeks early. She’ll have to spend some time in the Neonatal Intensive Care Unit (NICU), but we’re at CPMC, which has the finest NICU in the Bay Area. We’re optimistic she’ll come out strong and healthy.
One day at a time. Baby steps. Our first goal was to get to Sunday at 5 am – the 48 hour mark after the first dose of betamethasone, when the medication takes effect. Our next goal was Tuesday, the 30 week mark. We just met our 31 week goal.
Next stop: the baby shower on Monday! All of you should have gotten an update that indicated that it was being moved to the hospital patio. If not, please do let me know and I can fill you in on the details.
Much love to all. Sorry for the lack of images. And humor.
Diarrhea.
