27-Week Appointment: No Exam, No Ultrasound

Yesterday, I had my pre-scheduled 27-week appointment with the Center for Maternal and Fetal Health, my high-risk pregnancy practice—my first appointment since being released from the hospital after a 1 ½-day episode of pre-term bleeding. 

My weight was 193.7, so I’d gained only two pounds in two weeks, even though I’d been on bed rest for nine of those days.  My blood pressure was 110/62, which the nurse proclaimed “good.”   Another nurse checked my baby’s fetal heart tones, and his heart rate was consistently around 148, which is normal.

When Dr. E came in, she said she was happy to see me outside of the hospital and that I look great.  She measured the length of my ever-expanding uterus, saying it’s perfect for my son’s gestational age.  But, she recommended against a trans-vaginal ultrasound or vaginal exam—to check the position of my low-lying placenta and the condition of my cervix—because either could re-start my placental bleeding.

When I was pregnant with my son, now nearly 5, a doctor in my previous high-risk pregnancy practice found, at my 27-week appointment, that I was dilated—the curse of having a T-shaped uterus as a result of my exposure to diethylstilbestrol (DES) when I was in utero.  She immediately put me in a wheelchair and had a nurse push me over to the hospital, where I stayed for 48 hours, the time necessary to not only receive the steroid injections that advanced my son’s development, in case he was born pre-term, but also to monitor my dilation.  When my cervix didn’t dilate further, I was released and directed to spend my days at home on bed rest.

Yesterday, the first day of my 27th week of pregnancy, I was feeling nervous, because of my history, about whether my cervix is still long and closed, as it was at last check.  But, then I realized that, whether my cervix is thinning, dilating or funneling isn’t relevant at this point.  I’ve already received the two steroid injections to advance this baby boy’s brain, heart, lungs and stomach, and I’m already on bed rest.  Everything that would be done, if my cervix were becoming “incompetent,” is already covered.  Therefore, it’s not worth risking an exam that could irritate my placenta.

My next appointment is in two weeks, unless I have complications in the interim.  Dr. E told me to stay on bed rest, saying that, if I still haven’t bled by this next appointment, she may be able to lift some of my restrictions.

Today, it’s been 10 days since my initial bleed, 10 days of bed rest.  My baby boy is still inside of me, where he belongs, and he’s had 10 additional days to grow, to gain weight and strength.  Dr. O, the doctor who released me from the hospital last Sunday, said it’s rare for placental bleeding to necessitate pre-term delivery.  So, I will hold on to that thought, as I struggle to keep the bed-rest blues at bay.

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