When I found out my Level II ultrasound was scheduled the week before Christmas, Matt and I had the idea to have the gender written down, have a friend wrap up either a "Little Brother" or "Little Sister" sleeper, and open it on Christmas Day with Emmett and our family. So arrangements were made, sleepers were bought, we go through the entire ultrasound and... nothing. Not a peak, not a hint... just firmly crossed legs. Not to be deterred, I managed to book a last-minute appointment at a 3D ultrasound clinic the next week, driving all the way across the city on my first day of holidays for it... oh, and did I mention it was 2 days before Christmas and total chaos? Like I said... should have been a hint.
Having gone through a relatively uneventful pregnancy two years ago with Emmett, I was expecting much of the same the second time around. My diabetes was well controlled, I had started all my prenatal supplements a few months in advance, and I was being followed by the same fabulous high-risk team as before. The first 20 weeks were smooth sailing -- and life with a 2-year-old sure made it seem to fly by a lot quicker.
During our follow up from the Level II ultrasound, the doctor mentioned that I had a two-vessel cord. Most umbilical cords have one vein and two arteries, however some (approximately 1 in 100) only have a single artery. Nobody really knows why, and most of the time it doesn't really mean much. We were told that sometimes it can impact baby's growth in the third trimester, but they would just keep a little closer eye on it.
We returned a few weeks later for the next routine ultrasound. Baby was measuring a little small, but still within normal range. They spent a lot of time looking at the blood flow through the cord, but everything looked just fine. Fast forward two weeks later and things had started to change. Baby's growth had slowed enough to be diagnosed with IUGR (intrauterine growth restriction), and they had started to notice abnormal blood flow patterns through the umbilical cord. The doctor booked us for a follow up 3 days later and mentioned that if it didn't look any better he would look at transferring my care to the Ottawa General. When I realized it was because they are a Level III neonatal care facility and can take premature babies under 32 weeks, things got a little more scary. At this point I was only 29 weeks pregnant.
Friday came and the follow up was not great. The ultrasound now showed absent end diastolic blood flow, meaning instead of continually flowing forward like it should, it was starting to pause between pulses. A clear sign that my placenta was simply not doing it's job anymore. The doctor contacted the General, and they asked that we come in for their own assessment. I received a shot of Celestone (a steroid to help baby's lungs mature faster), and off we went.
We arrived at the General, and checked in at triage. Turns out it was one of the craziest afternoons they had in a long time, go figure. At least it gave us some time to make arrangements to have Emmett picked up from daycare, and cancel our hotel for the weekend. Had I mentioned that Matt and I were scheduled to leave the next day for a nice relaxing weekend away in New York? Like I said, she has a flair for the dramatic.
The doctors reviewed my chart and ultrasounds, and came to the same conclusion. Baby was not getting enough of what she needed anymore, and weighing the risks on both sides, was going to be better off coming out than staying in. The plan was to keep her in another 48 hours in order to get the maximum benefits from the course of steroid injections, as well as start 24 hours of magnesium sulfate for neuroprotection. In the meantime, I would be admitted on bed rest and constant fetal monitoring. If at anytime she showed undue stress, they would be prepared to act quickly.
Not expecting the situation to have escalated so quickly, we were quite obviously unprepared for a hospital stay, let alone having a baby. So Matt went home to gather some things together, and I got settled into my room. Despite it being my worst case scenario, it really wasn't. The doctors and nurses were amazing, and knowing that everyone just had the baby's best interest at heart made it ok.
Aside from a few heart rate decelerations overnight that would bring a whole whack of people into the room to assess, the weekend was calm and relaxed. I was able to complete the full 48-hours of steroids and MgSO4, and my C-section proceeded as planned on Sunday afternoon after only 29 weeks and 4 days of pregnancy. Elyse Catherine Brearey made her grand appearance on March 2nd at exactly 4:00pm. She weighed 860 grams (1lb 14oz) and 36cm long. She was born "en caul" (still enclosed in the amniotic sac) which the nurses all thought was really special, and is supposed to bring good luck.
The team from the NICU (neonatal intensive care unit) took her right away to assess and stabilize, and Matt was able to see her. She needed a bit of help to start breathing, but all her vital signs were stable and strong. She was put on a CPAP machine (room air, no extra oxygen) to help keep her lungs slightly inflated so she wouldn't have to work quite so hard for each breath. Once she was stable, she was transferred to the NICU nursery and I was taken to my recovery room. We were able to visit later that night, and so began our next big adventure...
Welcome to the world sweet baby girl
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