16 & 17 Weeks

Multiple times throughout this pregnancy I have heard the word "perfect" used to describe our little one. It always made me uncomfortable. I don't like that word. Maybe I knew something was going to go wrong, or maybe I just always plan for the worst.

About three weeks ago I went for some bloodwork and my NT scan. Both occurred between 11 and 13 weeks. Since the NT scan went well, I assumed there would be no issues. I felt like I had finally entered the "safe zone" if there even is such a thing.

Along with the first set of tests, there is a second set of bloodwork that has to be done at a very specific time in the second trimester, usually between 15 and 18 weeks if you want it to be most accurate. I was planning on going the Wednesday before Thanksgiving because I had it off. But, for some reason I decided to go this past Monday, thinking nothing of it.

This past Wednesday night on the way to pick my husband up at the train station, I noticed a missed call and voicemail from my OB. At first I thought it may be a call to confirm our anatomy scan, but after quickly calculating in my head that it was still weeks away, I immediately knew it was something bad about the bloodwork I had done just days before.

When I called her back, the first words out of my mouth were, "Oh my god, what is wrong?" She tried to calm me down, but also needed to tell me the reason why she was calling. The bloodwork came back abnormal. They generally like to see your AFP (fetoprotein) levels at 1.0, although 1.0-2.0 is an acceptable range. Mine came back at 2.7, which means it is 2.7 times the median. I now fall under the category "high risk" pregnancy. Our baby is at a higher risk then most of having a neural tube defect, it can be an indicator of placenta issues, or many times a sign of complications to come in the third trimester of my pregnancy.

A few hours after the phone call I decided to reach out to the only person I knew who could provide me some type of support: my RE, DR P. I emailed her and within seconds recieved an automated response that she was out of the country until November 28th and if it was an emergency there were other numbers to contact. The tears continued. The next morning I awoke surprised to an email response from her (that is why I love her so much.) She had reached out to a friend of hers who worked at a High Risk Center at Columbia and these were her thoughts on my situation:

"AFP is totally non-specific; 2.7 is slightly high but different labs use different cutoffs (and there are different cut offs based on race, etc) That said, 2 is generally the threshold I remember. Many people will repeat it to confirm it's high before pursuing a workup but the other option is to go right to Level II ultrasound. It can be caused by many things...bleeding earlier in pregnancy, placenta issues, or can be a marker of uteroplacental insufficiency. If her scan is normal, I would not go as far as RECOMMENDing an amnio, although I would certainly offer it and then also do serial growth scans at 28 weeks and 34 weeks."

The reason for my elevated number is not bleeding, because aside from a little episode of it after a pap smear, I have had zero bleeding. The number doesn't seem to be high enough for a neural tube defect. So, my OB is leaning toward it is most likely an issue with the placenta. She said this will mean more monitoring for me come 24 weeks. Sometimes this can lead to low birth weight, premature labor, preeclampsia, and growth problems with the baby. Sometimes, it can mean nothing and we will deliver a happy, healthy baby.

Hysterical crying and the worst anxiety I have ever felt came over me for the first 48 hours after getting the phone call. I did go to work on Thursday and Friday, but avoided everyone and everything. I went in to talk to my principal and explain what was going on, only to break into huge sobs. She couldn't believe I even was at work and tried to get me to go home, but I knew it was best if I kept busy. She told me whenever I needed to leave I could. Everytime one of my students referenced my baby I had to hold back tears. It was so hard. I am showing now, there is no hiding it. And all I want to do is protect myself and this little baby.

On Friday I called my OB's office again and asked to speak to her. She called me back within a half hour and after breaking down yet again, she agreed it would be best if I came in for a quick check of the heartbeat to calm my nerves. I couldn't fight this feeling that this baby inside of me had died. Luckily, she was able to find the heartbeat right away which put my mind at ease, even if for a few minutes.

Upon pulling myself together over these last 48 hours I have done some of my own research. It seems out of 1,000 women, 50 will get the same phone call I got on Wednesday night. That is only 5%, but it doesn't matter how small, I am part of that 5%. Of those 50 women, 1 or 2 will go on to have children with a severe neural tube defect.

We have an appt. with a genetic counselor on the 26th followed by a Level II ultrasound. If everything looks good, close monitoring will be the next step. If abnormalities are picked up, we will need to decide about an amniocentesis, which would be performed that same day.

I don't know how we are are going to get through this next week...

I need to keep reminding myself, I have wonderful doctors and they are doing everything they can to assure everything is okay with both me and the baby, and they will continue to do so for the remainder of this pregnancy...but I am so scared. I hope everything is okay.