May 2004 Special Report
This note is only being sent to a subset of the regular baby list who know about our recent "blip" on the otherwise smooth and boring pregnancy road to this point. We didn't share this with everyone because there was no reason to alarm anyone unnecessarily. As most of you know, my doctor called me last week to say that my alpha-feta protein test results came back higher than normal, which can indicate a birth defect with the baby. I was cleared for two of the three pieces of the test, but not for the spina bifida part. She recommended a level two ultrasound with a perinatologist (special training for high-risk pregnancies and fetal birth defects) just to be sure, but she assured me that there was no reason to panic (easier said than done with a hormonal pregnant lady!).
My level two ultrasound was today. As far as they can tell (which is pretty well), everything is fine. We were in the ultrasound room for about an hour. The tech did a very detailed analysis to determine fetal age. She put my due date about 5 days earlier than the one that my doctor gave me, but she did say that it's a numbers game and some babies are just bigger than others (i.e. don't get my heart set on an earlier date, LOL). Oh, and it's *definitely* a boy. Both she and the doctor said so, and I have the picture to prove it. (I promise to get new ultrasound photos scanned soon.) The doctor even laughed and said that, although dad's don't like to hear this, sometimes their little, er, parts are not big enough to be seen at this point, "but that's not a problem for your little guy." :p
Anyway, after doing her analysis, the doctor came in to have her own look around inside. I like her a lot, she was very very nice, and very careful to explain everything she was doing and seeing (something I like in a doctor, but I know some people don't). She asked if this was our first, and when we said yes, she said "oh, so they got you all freaked out about this for probably no reason." She said that the absolute number one most common reason that AFP tests come back high is "just because they do, with nothing to ever explain why." She went over a few other "normal" reasons, including twins ("we'd definitely know if that were the case by now") and fetal demise ("clearly not a problem with your little wiggle worm here"). She also said that my readings were not that high. A reading of 2.5 is considered normal, and mine was 2.87.
Then she went over the defects that could cause it. Missing the top of the skull: everything is perfectly intact as it should be, the brain is developing well. Intestines developing on the outside of the body or the lower abdominal cavity not completely covered in skin: no evidence of that, and it is very easy to detect via ultrasound. Lack of skin covering the spine: she did a "cross section" view of the spine all the way down for as much of it as she could see, and there is skin covering all of it. She did say that it is hard to detect if the very ends of the spine are exposed. The very bottom portion is hard to see because it curls into the "butt crack" (her words), but she seemed unconcerned about that one. The very top portion, where it joins the brain, is also hard to check directly via ultrasound, but if that is the case, it usually causes a clearly visible problem in the cerebellum, and she found no evidence of any such problem. So, as best we can tell, all is well.
Ultrasounds are not 100%, of course. The only way to be absolutely sure is to do an amnio. Then she said almost the same words, verbatim, that I said to my mother last night. Having seen no evidence of a defect of any kind (including a cleft lip, which doesn't show up on the AFP test, but since I was there they decided to check), the likelyhood of him having an undetected defect after four ultrasounds, two in the past two weeks that have been looked at by three people, including a doctor, is so much less than the chance of miscarriage due to an amnio, they really discourage the test unless the parents are practically hysterical and absolutely demand to have difinitive proof. The worst possible outcome would be to do an amnio, have it come back perfectly normal, and then to miscarry a perfectly healthy baby. I was in absolute agreement, so we will just assume all is well, since we are as sure as we can be at this point. She also said that unless something else shows up strange at my regular doctor, she has no reason to see me back. Yay! :D
Thank you all for your concern, well wishes, prayers, and love. All three of us are very appreciative.
Love, Erin and Steve and Baby G
