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06/15/2002 Archived Entry: "Sonograms, Neo-Natologists, and moving up the Schedule"
Geoff again - I was not at the hospital when all of the following happened, so I am relating it second-hand from Chrissy and Judy's retelling. Hopefully all the important details are right. :-)
At 3:30, our buddies Dr. Lewis and Dr. Deering appeared with the portable sonogram unit to check on the baby. They started with the lungs, and there is little fluid left around the lungs. The C-CAMs are very visible now (this did not appear to concern them), the lung development probably means the steroids have done their job.
The baby's femur is measuring at 34 weeks (even though Friday started week 32), and she is (still) breech.
They then looked at the ascites in the baby's abdomen, and the amount of fluid has GROWN. The Drs also saw soft-tissue build up all over her body, and they said she would look "puffy" were she to be delivered now (the comparison they used was the Michelin Man). The likely explanation for this is that her kidneys are not functioning. Chrissy's AFI (Amniotic Fluid Index) has also gone DOWN. It is now around 5 (remember from the last post that it should be in the 8-25 range).
At this point Dr. Lewis looked pretty worried and unhappy. He said he needed to talk to a neo-natologist about our case, and would return shortly. The feeling that Chrissy and Judy got was that he might want to deliver her VERY shortly via Caesarean Section.
Some uncomfortable time passed.
He returned with two of Georgetown University Hospital's neo-natologists. Neither was Dr. Keszler that we had met with before, and neither Chrissy nor Judy can remember their names. They went through the full sonogram again. The female neo-natologist pointed out that the baby's heart was still displaced and that one of the C-CAMs in her lung was pressing up against the heart (for those that are worried, I will note here that we have been VERY aware of the baby's heart rate while we have been at the hospital, since it is the back-beat of Chrissy's room, and it has not varied significantly since the first procedure -- it is still in the 135-160 range).
Overall, the neo-natologists were much more reassuring than Dr. Lewis expected them to be. They have successfully treated babies that have much more severe ascites, and they felt there was no immediate danger that would require her to be delivered in the very-near future.
The current plan is to try to keep Chrissy pregnant for two more weeks, monitoring the baby throughout, and then deliver her via Caesarean.
PS: Somebody pointed out that the link I gave for Nifedipine (Procardia) in the last update was buggy. The correct link is here.
