A little bit of peak-a-boo going on!
Baby is weighing in like a champ, at 16oz and measuring a week and a head ahead. Always reassuring!
Sadly, because of COVID restrictions, I had to go alone to the appointment. And it was a military facility, so there was no recording or video calling.
Even more sadly, they found a couple of concerns during the scan.
I missed most of the scan because she made me keep my eyes closed since I didn't want to know if it was a boy or girl. Who knew that was visible in so much of the scan?! I saw the baby's face at the very beginning, and then the heart at the end. That was it. And the tech was silent the whole time. Agonizing.
At the end, she handed me some photos, including this one of the feet.
And then she said she needed to show some things to the doc and then he would be in to talk to me.
Eek.
So I sat there for FOURTY-FIVE minutes wondering what was wrong. I assumed it was the heart since that is what I saw her looking at intensely. I started googling heart defects and it was depressing and scary.
Well, the doc finally came in and said they found a couple of things. The first was the feet. You shouldn't see the top of the foot when you see the side of the leg. The baby has bilateral club foot.
Not a huge deal. They can fix that these days.
The other is that the baby has too much fluid in the kidneys. Also, the ureters are distended, full of fluid as well. Normally, they aren't visible at all on an ultrasound, but they were very clear. He said the bladder was prominent, but not for sure that it was too large.
The biggest concern is whether or not baby can keep producing amniotic fluid. If the fluid gets too low, the lungs cannot properly develop. This leads to death in utero or at birth. If the fluid is fine, there isn't much else we can do for now.
He offered to do an amniocentesis, to test the fluid for chromosomal abnormalities. I declined until I could research and discuss with Bryan. The risk is too high to me, given that labor at this point would result in the baby's certain death.
The doctor basically gave very grim facts. He said the potential for stillbirth is much higher, as is preterm labor. But there isn't anything that we can do until we have a better idea of what is wrong.
He scheduled an echocardiogram for tomorrow, just to make sure the heart looks good. He also suggested a meeting with the genetic counselor.
He threw out some possible diagnoses, with Prune Belly Sydrome being the most likely because it correlates the bilateral club foot and the urinary tract malformations. But the abdominal wall appeared normal, so that was reassuring.
Other possibilities he mentioned were-
Bilateral vesicoureteral junction obstruction
Vesiocoureteral reflux
Megatcystis microcolon intestinal hypoperistalsis syndrome
What's this all mean?
Well, we got way more info from Google.
Hydronephrosis (too much fluid in the kidneys) is THE mostly commonly found defect on 20 week ultrasounds. And more than half the time it resolves by birth or shortly after. Rarely does it mean death or even kidney failure. Most of the time, if not outgrown, it leads to a lot of UTIs and may need surgery at some point. In the worst cases, it requires dialysis or a kidney transplant.
Prune Belly is pretty serious. It has a high rate of death in utero and at birth. But since the abdominal wall seemed to be intact, we are hoping it's just a slowly developing urinary tract system. We have yet to research the other possibilities.
The feet will require casting and then braces at least at night until age 5. A bit more lengthy of a process than I would have thought, but it's pretty straightforward and commonly dealt with.
So, a whole lot of praying that things resolve and we bring home a healthy little one in January!
