Wednesday, April 04, 2007

Still Three

I'm still here. Still pregnant. Still triplets. I saw the perinatologist on Monday, but then had to hurry up and get finished with all the details before Passover started, so I couldn't post. Anywhozit, my husband was able to be at this appointment with me, which is a good thing, and we had a long, detailed ultrasound done, so there was lots to see. There are still three. Three heartbeats measuring 171, 171, and 168 beats per minute. On the day of the appointment, I was 8weeks, 5 days. Baby A was measuring 8 weeks, 5 days. Baby B measured 8 weeks 4 days. And Baby C measured 8 weeks, 2 days.

The perinatologist was obviously hugely in favor of reduction, but failed to give me any compelling reasons why it should be my primary option. While she gave me the general information about how twins are lower risk than triplets, I didn't hear anything truly compelling... no specifics. She admitted that the triplets they deliver do very well. She certainly didn't suggest that reduction was my only option, but she did say that it was probably my BEST option for a positive outcome. Still, when pressed about specific medical concerns, she didn't have a lot to say.

She did, however, suggest that the bleeding that I was experiencing (oh, hey, it seems to have stopped!) was probably completely normal. She says she sees a lot more bleeding with higher order multiples and it's probably because there's so much placenta-action going on. This makes sense to me. She said that the cramping I've been having is probably actually a good sign, because it's probably just normal pregnancy cramping resulting from the placentas embedding in the uterine wall, but of course the cramping is three times as great as it would be with a singleton, but that's completely fine.

What she recommended we do is the Nuchal Translucency Screening and go from there. If the Nuchal Fold comes back looking fishy, we can do a CVS and then make a decision about reduction. She recommended that I go ahead and schedule the reduction and I can always cancel it if I change my mind, so it's scheduled, but I don't expect to keep that appointment. Nuchal fold is 4/20, reduction (likely to cancel) is 4/27. I seriously doubt that the nuchal fold scan will show anything compelling enough to suggest to me that reduction is worth considering. Reduction comes along with its own risks and I'm not sure it's worth it. Halachically, I probably do have grounds to pursue reduction within the bounds of Jewish law, but I don't feel sufficiently compelled personally to consider it yet.

And that's that. I have bunches of ultrasound pictures, but I'm rather lazy right now. Maybe I'll take care of it later. I've been offline for a couple days, but hopefully will catch up with all of your blogs soon. Not tonight though, it's my bedtime. Past my bedtime, actually.

11 comments:

Anonymous said...

I don't think you have to consider anything you aren't comfortable with, be it a reduction or even carrying all 3 babies. I think you have done a great job of getting all of your bases covered and seeking out as much info as you can.

Anonymous said...

Glad to hear that things are well. Take care and get some rest!

Anonymous said...

Yup, definitely get some rest. It sounds like a sensible plan to me and I hope nothing goes wrong at the nuchal scan and that you get to keep all three :)

Thalia said...

I'm surprised she didn't give you specific risks, the docs here are full of them. Like preterm labour leading to death of all three babies; or extreme prematurity leading to death of one or more plus cerebral palsy, deafness and blindness, etc.

As everyone else has said, you need to make the decision which is right for you, and no one else can tell you what that is, although the docs should be able to help you make sure you are well informed.

Hope Pesach is going ok, I am already sick of matzah!

Rachel Inbar said...

I think each case is so different that it's hard to hear the statistics and understand what it means for you specifically. I was told with my twins that I would definitely have them early, but I ended up being induced at the end of my 39th week, just because my doctor felt both twins were big enough (over 2.5kg). My SIL then went on to have 2 sets of twins, each born during the 40th week... I'm sure that with triplets, it's similar - some people have bad experiences and others have good ones. Good luck with the nuchal scan! Happy Passover from Israel :-)

Anonymous said...

I'm so glad that all three are still doing well, and that your husband was able to come to the appointment too. I hope you had nice seders and were able to get some rest.

I must say, it bothers me that this specialist didn't offer much information to support the claim that reduction was the best option for you. It's one thing for the RE to jump to that conclusion and push for it, but the specialist should offer an informed opinion, should support the opinion with reasons. You should be given both general statistics and specific-to-you assessments of the risks either way.

That the specialist was able to give you information about the bleeding and cramping makes me feel a bit better, but if you feel you aren't getting a reliable assessment from this specialist, please see whether you can get a second opinion.

You might want to look at http://raisingweg.typepad.com/raising_weg/2004/12/selective_reduc.html
and at http://raisingweg.typepad.com/raising_weg/2005/09/res_sr_and_bad_.html
for information, statistics, and advice that might be helpful in getting good care and choosing the best options.

I'd be interested to know where the halakhic line between reduction being permitted and being required lies.

Moadim l'simcha.

Marie-Baguette said...

the cramping is normal, but so tiring! I can't believe the specialist did not rattle off some stats! Did you discuss your health issues? Anyway I completely recommend the CVS even though it is not a piece of cake. There are things they don't see on those scans (see the story of my friend J that I posted). I am thinking about you a lot and hoping for the best.

Erin said...

I agree with My Reality. It sounds like you're doing everything you can to be as well-informed about all the possibilities as possible.

I hope you get some rest!

Watson said...

I'm glad things are going well and that the bleeding seems to have stopped.

PHEW!

It sounds like you're comfortable following your heart on this one, so I think your plan to do the NT and the CVS testing is a good one.

Take care of yourself!

Leah Goodman said...

Best wishes. I had such awful cramping early on (I'm 6 months with a singleton) that I was afraid to go to the bathroom, b/c I was sure that I'd see that I was bleeding. It felt like period cramps on steroids.

megan said...

glad to hear that the bleedings has stopped and that it was normal to begin with. my reality is so right -- you don't have to consider anything you're uncomfortable with -- either way. i hope you get some good rest!