13-Week Appointment–with Ultrasound

Having undergone in vitro fertilization (IVF) to conceive—and having a high-risk pregnancy—I had one or two appointments with my IVF clinic and/or the Center for Maternal and Fetal Health, the high-risk pregnancy group at the local hospital, each week, for the first six weeks of my pregnancy.  The reassurance of ultrasound after ultrasound, measurement after measurement, showing that my twins were developing properly, was addictive.  And, after my ninth week ultrasound showed that we’d lost Baby B, the following ultrasound, done in my 10th week, which proved that Baby A was still thriving, assured my sanity.

However, at the 10-week mark, I’d already been “closed out” by the IVF clinic because the staff’s job—getting me pregnant—had been completed, and the head of the Maternal-Fetal Health group determined that I could go three weeks between appointments—unless I needed to get a peek at Baby A to calm my nerves. 

Not wanting to look like a crazy person, I waited until my scheduled appointment this morning.  I waited the full 3 ½ weeks between appointments—and ultrasounds. 

And, it wasn’t easy. 

I’m not nauseated anymore.  Not starving.  I have more energy.  And, while I recognized that this lessening of symptoms could be tied to my exit from my first trimester, I worried that it might mean that Baby A had died too. 

While we did pre-implantation genetic diagnosis (PGD) to assure the chromosomal health of our embryos prior to implantation, and while chromosomal abnormalities are the primary reason for first-trimester pregnancy loss, we still lost Baby B.  No explanation, just speculation. 

His gestational sac had been separating from my uterine lining during the fifth week of pregnancy, so I believe that his development was stifled during those early days, that, although he was a fighter whose sac reattached itself properly, he couldn’t make up for the lost nutrients and the stunted growth of critical parts of his teeny-tiny body.

My uterine abnormality—an underdeveloped, one-third normal size T-shaped uterus that my 4½-year-old son stretched out while he was in utero, making it now a slightly larger arcuate uterus—has too-thin uterine lining.  I’ve lost several babies as a result, including, in my opinion, Baby B.  So, I will always worry about Baby A.   It’s impossible to suffer from recurrent pregnancy loss without feeling constant, underlying fear until delivery.

So, I was nervous today. 

I was especially stressed because every subsequent period of visitation with my stepsons is harder for my son.  (Since early September, my 15-year-old stepson has been away at school, so my son only sees his 13-year-old brother until the holidays.) 

Saturday night, my son had the meltdown of his life when I insisted he stop playing the Lego Star Wars video game with his brother because it was time for bed.  (See my “You’re Such a Bitch” blog, dated October 17.)  Sunday night, he cried at bedtime, when he had to separate from his brother.  Yesterday morning, he was teary-eyed when we dropped his brother off at school.  Last night, he bawled, knowing it was our last night together, that this morning would bring a week’s separation.  He cried, “I don’t want him to have to go back to his mean mom.  I love him.”

And, this morning, after the school drop-off, he cried again.  And, every time, I think, “Please, God, make sure this baby is OK.”

Because my son needs him, needs to become attached to a sibling who will still live with us when his older brothers leave again and again, a sibling on whom he can focus when he’s feeling abandoned and lonely.

And, as of today’s ultrasound, our baby boy is perfect.  He’s now 8.3cm from the top of his head, his “crown,” to his “rump.”  His heart is beating 150 times a minute, which the ultrasound technician deemed “good.”  I saw him moving for the first time, waving his little arms. 

The technician zoomed in on his face, showing me his nasal bone. 

I asked why she was measuring it. 

She said, “Oh, we don’t measure it.  We just check for its presence because most Down’s babies don’t have a nasal bone.”

She said she also was going to check his neck because Down’s babies have thicker necks, which I knew.  She measured his neck several times, coming up with the same number, showing its reliability.  She said his neck is normal, but I already knew that would be the case—because of PGD.

Last, I asked her about Baby B, for I saw his gestational sac and body, both of which looked miniscule sitting on top of Baby A’s.  She said he is being absorbed, outlining all that is left of him in his sac.  At this point, 4 ½ weeks after learning of his death, I am focused on the future, on the health of Baby A, so I primarily felt relief that my body is doing its job.

I still feel sad, especially because I started carpooling with twin boys, who are so damned cute together that, every time I’m around them, I feel a sense of loss for my baby, for my son, for my stepsons, for my entire family.

It know it will be easier for me when I can’t see him anymore.  Three and a half weeks ago, during my 10-week ultrasound, he looked so normal that I was looking for his heartbeat, although I knew he was dead.  Today, Baby A’s development was so stunningly significant, next to Baby B’s shrinking body, that I experienced full acceptance.

Baby A (bottom).Baby B (top) in his gestational sac, bo being reabsorbed by my body

Baby A (bottom), 8.3cm from crown to rump. Baby B (top) in his gestational sac, both of which are being reabsorbed by my body.

When I met with the doctor, a brand-new one this time—and one who mentioned his twin sons, of course, for I’m tormented by twins these days—he said that he wants me back during my 16th week for a transvaginal ultrasound to determine if my cervix is closed.  When I was pregnant with my son, my premature dilation wasn’t evident until the 27th week, but he wants to be safe, which I appreciate.

So, I need to wait three more weeks for another ultrasound fix.

I can do it. 

But, I will hate it.

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