20 Week Ultrasound Results

We are having a baby girl! A mother always knows. Lydia Rae, weighs approximately 11 ounces, and has all the appropriate body parts. Apparently, she looks great! Our estimated due date remains January 31st. Her heartbeat is still strong, the heart anatomy looks solid, her brain looks good (the doctor said he predicts an IQ of 215), everything looks as it should. Also, my first and second trimester integrated prenatal screening results have come back and are within normal limits (Lydia is low risk for down syndrome and a few other conditions). She was in the breech position on the ultrasound, but of course this does not matter in the slightest right now – fetuses are continually changing positions at this stage of pregnancy. She was sucking her hand and appeared to be sleeping for most of the ultrasound. She looks adorable. We’ll post some pictures when I get James to scan them. (I’m sick with food poisoning at the moment and can’t move from the couch.) Dorian, who has been saying he wants a sister all along, of course said, "But I want a brother" when the ultrasound tech said it was a girl. Kids, eh? I think he's happy about it now and has been making reference to her by name.

We did have a little scare during our appointment though. The ultrasound technician performed the approximately 20 minute ultrasound, taking all the measurements, clicking away on her computer, making comments like “That looks good,” “Perfect,” etc, etc, etc. When she finished, she told us she would go print us some pictures to take home and then we could go. She never returned. We were waiting approximately 15 minutes when a doctor (whom I recognize from the hospital I work at) came in. He said he had reviewed the images from another computer and that he just needed to check a few things. James and I exchanged a look and started to worry. He basically went through all the anatomy again and delved further into the heart and brain, which was actually pretty cool to see. He talked about this valve and that valve and the blood flow, and it was awesome (he also knew I was a postpartum nurse at his hospital so I think he went into more detail for my benefit). He confirmed it is definitely a baby girl and pointed out her female anatomy (and not just the lack of a penis, which sometimes results in parents finding out their supposed baby girl is actually a boy when the baby is born). Then, at the very end, he proceeded to tell me I had a low-lying placenta. Of course, my immediate thought was, “Oh no, I have placenta previa!” (For those of you who need a refresher, the placenta is an organ that connects the fetus - via the umbilical cord- to the uterine wall to allow nutrient uptake, waste elimination, and gas exchange via the mother's blood supply. Placenta previa is when the placenta covers the cervix, which is the opening of the uterus - where the baby eventually needs to exit.) He assured me my placenta is not currently covering any part of the cervix. It is approximately 1.5 centimeters from the cervix, and they like it to be at least 2cm away. Usually the placenta implants on the upper part of the uterus, where the nutrient supply is the most dense. It's possible I have scarring in my uterus from the D&C procedure I had after my miscarriage, hence, the lower-uterine attachment instead. But who knows? Sometimes, these things just happen. I don't have any of the other risk factors for placenta previa. He told me, at this point, I do not have an increased risk of preterm birth and do not have to modify any of my activity. I do have to go in for a follow-up ultrasound in 6 weeks. If the placenta is still low-lying (or worse, covering the cervix), then at that point, they will continue to monitor me via ultrasound every couple weeks and possibly restrict my activity a bit. He told me that 9 times out of 10, a low-lying placenta resolves on its own and tends to move upward in the uterus as the uterus grows. He said my placenta looked nice and big, and the cord to the baby looked how it should, so he wasn’t too concerned. I have a few friends who told me they too, had a low-lying placenta at their 20 week ultrasound, and the issue resolved itself later for them.

The doctor told me if the issue does not resolve itself (even if it just remains low-lying, and does not develop into placenta previa), I will most likely have to have a c-section at the end, something I obviously don’t want but of course, would accept in this case. There is no way I would risk Lydia’s life or my life for the sake of having a vaginal birth. A c-section would not be a huge deal. It would be a huge deal if this developed into placenta previa, however, because then you are at risk for heavy bleeding and preterm birth and usually have to restrict your activity (and I have a very active job and am hoping to work up until I go into labor). Sometimes, you even have to go on bedrest or be admitted to an antepartum unit. However, as the doctor said, chances are less than 10% in my case, and I am just taking this as yet another experience I can use to learn more about prenatal health and conditions and become a better nurse! If anyone else would care to share their experiences with a low-lying placenta or placenta previa, I’d love to hear about them. Thanks!