Adventures in Ante Partum

Fair warning, just like a birth story, which this post is not, there will be use of terms like cervix, membrane and effacement, so if that bothers you, these are not the droids you're looking for. Move along.

Tuesday afternoon, we went in for round two of our anatomy scan at 22 weeks gestation. Two weeks prior, the baby was too active to get a clear picture of everything, so we had to come back. I was running late, having just finished teaching for the day, and knowing I was the Maternal Fetal Medicine department's last appointment of the day, I figured I'd valet the car instead of battling city parking. As I handed over the keys, the parking attendant asked, "You won't be here for more than 3 hours will you?" With a flippant "I hope not" I hurried off to the ultrasound. Little did I know . . .

The sonographer was the pinnacle of professionalism and we didn't have even a whiff of concern until the very end when she said, "I'd like to do an internal u/s on you since it looks like you're dilating." It wasn't too long after that, that the high risk ob was sitting us down and saying, "We've got a big problem." I was dilated 2 cm, 100% effaced and upon internal exam, the doctor could only feel the amniotic sac, no cervix in sight.

I was admitted that night and my hospital bed was put into a position called Trendelenburg (don't worry, I was laying in a much more modified position than Wikipedia would have you believe), in the hopes that gravity might give us a bit of an edge and a shot at an emergency cerclage. Gravity must have done some good because the next day I went in for that procedure and now instead of having no cervix, there's 7mm of one. It's a small victory, but I'll take it.

One of the scariest parts in all this is that, even though I haven't had any contractions, and my water hasn't broken, we need to plan for all contingencies. When first admitted, the baby's chance of survival was 2% at 22 weeks. Now that we've made it to 23, that chance has gone up to 10-15% and next Saturday, at 24 weeks, the odds of viability will be 50/50 and will continue to go up from there. Our doctor (who is an absolute rock star) says we can have conversations about after 24 weeks once we make it to 24 weeks. The doctors are all very matter of fact, and present all the possible scenarios, then the nurses come along, give us a hug, and highlight the good news of our progress that was hidden in all of the statistics we're still struggling to digest.

At this point, it's very much one day at a time, and no new is definitely good news. In the meanwhile, they are doing everything they can to give an early delivery every chance of a positive outcome: steroids for lung development and magnesium sulfate for the baby's neural protection.  We can't help but hope that the baby will wait so long to come that we'll need to be given all those treatments again.

The next thing we have to look forward to is another u/s on Monday to check on baby's size and to see how the cerclage is holding up. We're counting on your prayers and will keep you posted. But remember, at this point, no news is good news.