The First Ultrasound

Last spring my (then) 2 year-old was praying nightly for a "girl baby for my birthday." As providence would have it, I confirmed my current pregnancy shortly before his birthday. I've felt that this baby was a boy. My intuition had served me well in past pregnancies concerning gender. But I figured that if my son got the baby he prayed for, he may have gotten the gender too, so I doubted myself. Whatever the case, we had purchased 2 doelings shortly before his birthday, so he had 2 female babies of the goat variety for his birthday at least.

Last Wednesday I received the first ultrasound scan of this pregnancy. I had a blood draw scheduled after the ultrasound, and only 15 minutes was allotted for the scan. That's standard practice at my OB. The ultrasound tech only comes in one afternoon a week, and they schedule her tightly. I've never had an ultrasound longer than 10 minutes. My husband missed attending one once because he got delayed for a few minutes at work. They even have signs up in the office saying that if you are more than 10 minutes late for an ultrasound you have to reschedule, as there isn't enough time to get you in before the next patient. So I shouldn't have been surprised when our ultrasound lasted only about 8 minutes. And I wasn't I guess, but I couldn't help being disappointed. 

Never before have I had an exam where toes and fingers weren't visualize, kidneys weren't inspected, the palate wasn't looked at, the nuchal cord wasn't examined, a frontal facial shot wasn't done, blood flow through the cord and heart wasn't watched, an amniotic fluid index didn't take place, etc. During the exam, the technician pointed out to me a cyst on the baby's brain, saying that they often resolve themselves. She also used the doppler to look at my placenta in a way that I hadn't witnessed before, but I couldn't tell what she was seeing.

Then, after confirming that we wanted to know the gender, our tech informed us that I was carrying a boy. My youngest was with us, and immediately he cried out softly in anguish that he didn't want a boy, "I want a girl baby." But I smiled. He'll benefit from a same-gender playmate, seeing as his 2 older siblings are girls and his brother is 13 years older than he is.

I left the short exam without being comforted and with questions. I almost wished that I had opted not to have a scan. My husband just seemed relieved that there was no indication of the same birth defect that caused our first daughter's death. I was stewing over the cyst and the placenta thing, and figured that since she had spent time inspecting the cyst in my son's brain and the blood flow in my placenta, that she had taken up the time she usually would have spent imaging the things I mentioned earlier.

Six days later, a nurse from my doctor's office called to inform me that the doctor had reviewed my ultrasound.  "Everything looks good except that the baby has a cyst on the brain. Did the tech mention that?" she asked. I responded yes. Then she said, "Oh, and you have maternal lakes." She didn't offer an explanation, so I asked her what they are- just to be sure. She said, "pools of fluid in the placenta." Then she went on to say that I'm to come back in 4 weeks for a follow-up ultrasound to monitor both of these things. No more information... no nothing. I was immediately transferred to scheduling. Sigh.

Having worked for Acuson, and having been pregnant 7 times in the last 13.5 years, I know a little about ultrasounds. I know that placental lakes are pockets of (usually) maternal blood in the placenta. They can mean poor blood flow to the child (impeding growth) or the increased likelihood of postpartum hemorrhage. They can mean nothing. I've even had a maternal lake in the past with no negative outcome. In fact, my kids have been huge. (My last one was over 11 lbs. when he was born!) Like the cyst (which I think is choroid plexus) placental lakes sometimes just self-resolve.

However, I also know that cysts in the fetal brain are thought by some to be "soft markers" for chromosomal disorders such as Trisomy 18. So the phrase, "everything looks good except..." when so many things (including other soft markers) weren't imaged is insanely frustrating. (Several soft markers increase the odds of a chromosomal disorder.) You see, Trisomy 18 is often fatal, and so my peace has been shattered. My hormonal pregnant self is succumbing to worry, despite my best efforts and my rational mind knowing that I shouldn't.  I have a lot of emotional baggage from a past miscarriage, as well as a still birth. And I have felt extra rotten during this pregnancy. I'm sure that doesn't help.

(FYI: I turned down the quadruple screen as it in not a definitive diagnosis and often causes unnecessary worry. The only real diagnosis is via amniocentesis. I'm not interested in that. For one thing, it substantially increases your risk of miscarriage. For another, a woman I used to work with told me about a disturbing thing that she witnessed as it occurred during her amnio. As everyone watched the monitor of the ultrasound machine, her pre-born daughter reached up and grabbed the needle shortly after it was inserted! Everyone in the room gasped and then held their breath until she let go and the needle was quickly removed. If her arm had been but a little bit off, she may have damaged or lost her hand, etc. Besides, I would never abort an "imperfect" baby. And what good would the knowledge of an untreatable chromosomal disorder like Down's Syndrome do me before birth? It would just hang like a pall over the rest of the pregnancy.)

Anyway, my littlest is now cool with a baby brother. My sweet, sweet nephew just spent the weekend with us, and my youngest son was smitten. Now he thinks that we should name the baby with the same name we gave him. I think it's because he wants to share his personalized baby blanket with him. That's pretty endearing. But in the mean time, our newest son's in utero name is still Zebo. :)