19 Week Ultrasound Update

On Wednesday, September 1, we had our 19 week ultrasound. First of all, IT'S A GIRL! It's nice to start referring to the baby with she and her pronouns instead of it. We're privately trying out our top choice for name and once we're certain, we'll tell everyone. So onto the details (boys may want to skip the next paragraph about lady stuff although it's all very clinical).

The first part of the ultrasound was a trans-vaginal ultrasound to measure my cervix to make sure I'm not having any issues with cervical insufficiency. As I had a LEEP procedure done about 8 or 10 years ago, this can be an issue. Good news in that area - measurements were good and there was no dilation with pressure. Hopefully I'll continue to hold up well on that front. She also looked at the placenta and umbilical cord. Everything looked good although she did see some extra placental tissue (I forget what she called it), but as the cord flow was good and the extra tissue is not in a bad location (i.e. not over the cervix) she didn't seem concerned.

The bulk of the ultrasound was measuring and looking at all of baby's major organs and parts. This ultrasound was done with the perinatologist so I believe it is what they call a Level II Ultrasound although I never really asked. It is amazing what all we could see, especially when you think that right now the baby is only about the size of my palm and weighs a mere 9 ounces. We also got a DVD of the ultrasound which is really cool.

The heart looked good - all 4 chambers pumping away with all the appropriate separating walls and portals. It's totally amazing and crazy to think that inside my body is a second little bitty heart pounding away at 147 bpm even as I type this. The bladder and kidneys were next; the left kidney was a little enlarged and seemed to have a bit of a "back-up" (I forget the medical term she used), but the doctor didn't seem very concerned about this and told us not to worry either. We saw our baby's spine, ribs, and arm and leg bones. Those all looked good and measured fine. Her little hands were amazing; 4 fingers and a thumb on each hand and we got to watch her make a fist and then spread her little hand out (good measurements here as well). The doctor measured the transnuchal fold (a marker for Down’s syndrome) and it measured fine and looked normal. Last, but not least, is baby's little brain. This is where we had a couple anomalies. Basic structure was okay - two hemispheres, different lobes present, and correct size for gestational age. She found a couple of choroid plexus cysts (fluid filled sacks on the brain). These are not completely uncommon and usually resolve themselves by the third trimester; however they are considered a soft marker of Down’s syndrome. This actually doesn't tell you a lot because it basically means that it can be present or not present in fetuses with chromosomal abnormalities and it can be present in completely normal healthy fetuses and mean absolutely nothing. Helpful, huh? The other anomaly the doctor saw was the shape of baby’s head. There were a couple of spots where it was a little concave. I'm still not sure what to make of that one, but I'm hoping it all works itself out.

The end result of all the measurements and inspection was that our risk of down’s went up a bit more to somewhere around 1 in 82ish which is still only about 1.2%. So, then we had the conversation with the doctor about how we wanted to proceed - i.e. amniocentesis or not. She asked us what we would do if we had a baby with down’s to which Brian said (and I nodded in agreement), "We'd have a baby with down’s syndrome". Do I want that for my child? Of course not, but we'll love the baby God gives us, period. She then gave us her completely unscientific (but based on years of experience, etc) gut feeling about our baby. She doesn't really get the feeling that our baby has down’s although of course there is no way to be certain of that other than amnio and she can't point to any specific medical evidence. I did get this impression from her throughout the ultrasound though - she would find a little something here or there and never seemed overly concerned about it and she didn't find anything "lethal". We discussed amnio, the risks, benefits, etc. Bottom line, Brian and I elected not to do an amnio. We don't want to mess with baby's happy little home since medically nothing would be done differently either way.

We go back to the perinatologist in a month to see if the cysts have resolved. Please pray that the cysts resolve, the brain continues developing normally, the head becomes less concave, the left kidney gets cleaned out, and that baby stays healthy overall. That's all for now. :)