24 week u/s

I’m definitely not a practicing catholic – nor am I really sure what I believe in – but there’s something to thank for the success we’ve been having with this pregnancy. Now I’m not normally superstitious but im touching wood after that comment!

Our ultrasound showed 3 very healthy babies – so healthy in fact they are in the 60th percentile for weight – that’s pretty big for triplets. Given that an average baby born at 7lbs something oz. is in the 50th percentile – these are BIG BIG babies, they are currently each about 1lbs 10oz which is quite big for 24 weeks 2 days – but bigger for triplets is BETTER because they dont get enough time in utero…so everyone is super mega pleased with that, they all measure within an oz of each other too – so that couldn’t be any better.

 

They have however taken to some strange “sorting” of placements… Now Im not going to break out my fancy art skills and draw another picture –  but I’ll let your imagination figure things out Benjamin is lying transverese – which is a rare position, which means he’s neither up nor down he’s sideways across not my abdomin but my RIBS…so he’s up super high across my ribs, his head is on me left which meets up with laurens head ALSO on my left  rib ( yes my ribs are KILLING me) anyways Laurens head is up and she’s in the breach position lying a little sidways – her bum is in Alannas face who is the directly in the center and is head down. …. So do the math with me Ben’s transverese with head on left, Lauren head on left breech and Alanna center — NOTHING on my right – nothing. so that’s why my left side hurts sooo much – !!!

 

My cervix is still the sexiest one they’ve seen – it’s measuring at 5.1 it isn’t actually possible to get any better than that – and at 24 weeks with a cervix of 5.1 things are really on my side!… This can change at any given point – but for the next 2 weeks- I’m free – no bed rest – WOW!…Likely I may not even need bed rest.

 

OB thinks I’ll make it between 32-34 weeks, he wont let me go much beyond that because of their size – at 34 weeks if they continue the same growth pattern that they’re on now ( which they should under ideal circumstances) that’ll but the babes over 5.5lbs which means very little – IF any NICU time – wouldn’t that be something!… Remember that medal I talked about a few blogs back – Im serious. I want it. LOL…

My blood pressure is still perfect – showing a little bit of toximia signs but nothing alarming – I did gain 6lbs in 2 weeks – ooops!!

So VERY good report!! 🙂

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Comments
2 Responses to “24 week u/s”
  1. Kate says:

    Hi – just had to jump in to babble about C/S and respond to a bunch of your listed fears. I haven’t had one myself, but have given loads of anesthetics for them. (Since I’m not an OB or your anesthesiologist, take it all with a grain of salt!)

    – I’m afraid I’ll die – Extremely unlikely. You’re a healthy young woman. The risk is never zero, but chances are overwhelmingly in your favour that all will go smoothly. I think the only sorts of things that could cause death in a C/S would be a major allergic reaction to the antibiotic, if you had an epidural in place that had migrated into the spinal fluid (super rare) and the anesthesiologist was dumb enough to give the whole epidural dose at once (and then not recognize it soon enough, which would be tough), or if you had a major postpartum hemorrhage and the surgeons didn’t move to a hysterectomy if necessary to save your life. Having some kind of embolus go to your lungs and do you in that way would be totally shocking. So don’t worry. I’ve done hundreds of C/S, and haven’t had anyone die yet!

    -I’m afraid the epidural is going to leave me paralized – If you’re having a booked C/S, chances are that you’ll have a spinal instead, unless the surgeons thought it would take more than 2 hours to get the babies out and close you up. That’s a tiny tiny needle that pops the freezing right into the cerebrospinal fluid. Both the spinal and an epidural are done below the level that the spinal cord ends at, so the needles themselves should not cause trauma. It’s remotely possible to have the needle go off midline and bump into a nerve, which might cause a numb patch that could stick around a little while. To be paralyzed from either would mean that you’d either have to have disorder where you don’t clot properly (causing you to get a huge hematoma that would put pressure on the cord), or you’d have to get an infection and develop a gigantic abscess that would have the same effect. Both are extremely unlikely – I’d say maybe less than 1:200000 in the general sugical population (who are on average less healthy than the obstetrics population). We tell people they’re at more risk of dying in a car crash on the way to the hospital to have their baby, than of having any serious complication from a spinal or epidural.

    -I’m afraid of having a repeat C-Section and the scaring being very bad and hard to cut through – OK, it’s possible that the scarring might make life a little harder for the surgeons, but it will just mean they need a little more time to carefully dissect the scar tissue. The only super tough thing is if a placenta implants where the previous C/S scar is, and ends up growing into/through the wall of the uterus. That can lead to massive bleeding, and can usually be picked up by ultrasound or MRI before delivery. If your placentas aren’t on the lower uterine segment where your old scar is, you’ll be fine. Just because you had a previous C/S doesn’t mean you’ll have any problems or scar tissue. I did a C/S for a woman having her 9th baby by C/S (for the 9th time). We were sure the OR would take forever, that she’d have tons of scar tissue. There was nothing, and it didn’t take any longer than usual.

    -I’m afraid that since one baby is practically under my rib that the delivering OB’s ARM wont be able to reach up that high – Shouldn’t be a problem. There’s less distance to reach through a C/S scar than there is when they have to reach up vaginally to pull out the second twin! Plus, the uterus will shrink down as the other two babies get pulled out, and there’ll be plenty of room to grab the third (who will also have been brought closer to the incision).

    -I’m afraid of being alone in the recovery room worried about my triplets – The policies depend on the hospital, and depend on how old your babies are and how much help they need after they are born. Twins usually stayed in the C/S room with the parents in my experience. Triplets usually were taken next door to the “resus room” where they each had their own team and own baby warmer for careful care and monitoring. The OBs and pediatricians were pretty good about checking on them and giving updates to the parents, though for the first little bit things are hectic, and they won’t have much time to tell you what’s going on. I’m sure you’ll worry, but hopefully if you meet with the neonatologists beforehand, you’ll be able to develop some degree of trust, and also establish some sort of expectations about how often you’ll get updates. It’s pretty rare for things to be super touch-and-go, unless the babies are incredibly small and immature.

    -I’m worried that my IV will fall out (again) and I wont get enough fluids/meds – I’m sure they’ll tape it in really well, but if you’re concerned, just ask your anesthesiologist if they would mind starting a second IV for you as a backup, based on a previous bad experience. I doubt they’d say no.

    -I’m afraid that I’ll have to get a blood transfusion or hysterectomy – Very remote possibilities, I’d think. If they make sure your hemoglobin level is reasonable beforehand, it’s rare to lose more than 1L of blood during a C/S. You might lose a little more with triplets, but I’d be surprised if it were enough to need a transfusion. Your hemoglobin could safely fall to 70 before they’d need to transfuse (Canadian units here). If you start at 120, you’d need to lose over 2 litres of your approximately 5 liters of blood to require transfusion. Blood transfusions are extremely safe these days. The most common reaction is a little fever. They’ll crossmatch your blood carefully ahead of time to make sure the units on hold for you are totally compatible with your own blood. And the likelihood of needing a hysterectomy is exceedingly low, unless you had the weird kind of placenta I told you about earlier.

    -I’m not liking the ideas of having staples in my belly and Im hoping there’s an alternative – you should be able to ask the surgeon to use a suture to close the skin incision instead.

    -I shake like mad when Im nervous ( like REALLY nervous) and I hate that feeling and I dont want to feel it – you’ll probably have the shakes a little from the spinal/epidural anyhow. There’s not much that can be done to prevent it. They’ll try to avoid giving you IV medication ahead of the babies delivery, but I have had to give something like ativan to one woman before to get her into the OR and to have her spinal without her passing out from nerves. Demerol will also help with the shakes, and they ought to be able to give you that sort of stuff after the babies are born. The only thing with versed (the short-acting activan) is that it can prevent you from remember what happens for a while after you get it, which you may not want when you’ve just had your babies.

    Sorry for the long-winded comment. I hope I didn’t scare you! I’m always of the philosophy that knowledge is power, and find that the more facts I have at hand, the less anxious I am. Have a chat with your OB to discuss your fears. And you can ask to be referred to see an anesthesiologist in consult clinic well before your C/S in order to get any of those questions answered. It’s not just unhealthy patients who get consults, but those who are very worried about things, or have lots of questions.

    Take care, and keep on growing those babies!

    • 4under4 says:

      Kate –

      I just wanted to thank you SO MUCH for this awesome comment!…It honestly has made me feel much more comfortable.

      I really read it like twice a week everytime I start to feel fear I read – and I feel better 🙂 Knowledge is power and it makes me much more calm understanding what’s going to happen, it gives me a sense of control…

      Thank you so much for taking the time to write this
      xo

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