Went to our 8 am appointment with Dr. S. today. Arrived at 7:30 as traffic was light. Found out he wasn't there until at least 9am. (Why schedule so early if he isn't even there?) Sat in the chairs outside his office for over an hour and a half. Lots of happy preggos showed up as this was his "low risk" clinic day. Fun times.
When we walked in the door to see him he was reviewing my chart. He asked how I was and I answered "devastated, how are you". He didn't answer, but launched right into my 16 week blood work results that they had drawn just over a week ago. My AFP (alpha fetoprotein levels, also known as the spina bifida marker) were extremely elevated, giving us a 1 in 5 risk of spina bifida. From my last pregnancy, and research on the Internet, I know that these levels can also be increased when something is wrong with the placenta or amniotic sac, so I questioned "could that have anything to do with my water breaking, again?"
He looked at me and asked "Your water broke??! When did this happen?"
He obviously hadn't gotten the memo. It was almost comical.
Here he thought I was devastated because I had somehow found out my blood work results and was afraid my baby had a 1 in 5 shot of having spina bifida (with an 80% chance of NOT having it). HA HA HA. No, no, no Dr. S. I'm devastated because my kid has a ridiculously low chance of being born alive and/or able to survive, and even if he (or she, although I'm convinced it's a he so we'll just go with that now shall we) does live, we'll be in the NICU forever with all of those potential complications. Plus every moment I remain pregnant I'm at a high risk of contracting a potentially deadly infection which will not only most certainly kill my baby, but places my own weakened heart at high risk of no longer being able to function, possibly also killing me.
Oh and did I mention AGAIN...cuz oh yeah, we did this LAST YEAR.
Honestly ONLY having 1 in 5 risk of spina bifidia with no other problems would considerably brighten my day.
It only got darker from this point.
He reiterated that placenta complications were not known to reoccur, but admitted that since it seems to now have happened again, it puts more weight on the genetic/some cause other than just random bad luck pile. My thrombophilia (blood clotting factor) panel was checked last time and found to be fine, although when I'm not pregnant again we might want to redo that test. He added very little else to the small pile of information that we have so far, but assured me it was NOT an incompetent cervix. He felt that there was NO WAY my cervix was the culprit despite the recurrent pPROM. He states that the way in which my membranes rupture and then I go days (in Aidan's case literally months) without delivering was not typical of an incompetent cervix. I was super disappointed with that as I wanted something, ANYTHING, to be fixable or treatable or at fault. Anything other than an unknown.
We were immediately sent us for an ultrasound to check for fluid volumes. Even to the untrained eye the scan was so different than it was just over a week ago. It was heart breaking to see our poor little Acorn all scrunched up, when just over a week ago he was bouncing and kicking in his little womb room. And it was immediately evident that the placenta looked very much like Aidan's with clots throughout. I was measured to have very, very little fluid termed "oligohydramnious". The tech found one 3cm x 2.2cm pocket of fluid. I'm not even sure if this translates into an AFI for all you other pPROM moms out there. I did remember to ask for a picture and what they handed me is so grainy and so without black you can barely tell it's a baby. Doubtful if they could even scan for spina bifida as you can barely see the baby's outline.
At this point we are waiting until next Thursday when I'll have a follow up ultrasound to see if any 'significant' fluid has built up (sadly, doubtful), and see Dr. K. the placenta specialist that we all know and love, to find out if he has any fun facts to add to our little pile of knowledge. Then we will, of course, be counselled by my OB to terminate the pregnancy and 'try again' if we so wish, hoping for a better outcome.
I don't even have a closing statement that adequately sums up how absolutely depressing and devastating this is. Insert something poetically bleak here.