Lincoln's Begining

A home pregnancy test gave a positive result on Sept 27th, 2010. After trying for only two months, Dan and I were so excited to learn we were going to be parents. Since I didn't have a regular OB that I saw, I made an appt for an initial OB visit with Dr. M, who had delivered by sister’s children.

Dan went with me on Oct 29th to St. John's Medical offices to meet Dr. M and there we had our first ultrasound. It was so amazing to see our baby on the monitor! We saw the heart fluttering at only 8 weeks along! The baby's measurements according to the ultrasound were putting the baby at 7 weeks gestation, one week behind according to my last menstrual period. Dr. M said that this discrepancy could be due to the measurements being off (we had an external ultrasound, instead of internal which can be more accurate) or that my due date could be off, meaning that I ovulated late when the baby was conceived. I had the standard OB blood work done at this visit as well.

After meeting with Dr. M at St. John's, I was less than pleased about her practice and enthusiasm in general with our pregnancy. I had been thinking of trying a natural birth, with no medication and little medical intervention. In my search for alternative birthplaces, I found the Birth and Wellness Center in St. Charles, MO. Although the center was not open yet, I was able to get a referral for a Family doc who was open to natural births.

After a consult with Dr. P at her family practice a few weeks later, I knew that I had found the doctor for me. She was totally on board for me going natural and put my mind at ease. I had my 12-week appt with Dr. P on Nov 23rd, and Dan came along, too. Dr. P did another ultrasound to assess the baby's growth. Baby was still measuring around one week behind overall, but Dr. P was not worried. Every baby grows differently and they come when they are ready! We declined to have the 12-week screening done to for Down Syndrome etc. (Oh, and my blood work came back normal.)

At my 16wk check up on 17th of Dec, my blood pressure and weight were both good. Dr. P ordered an anatomy ultrasound at the perinatal center at St. John's Hospital to check growth and find out the baby's sex!

At 19 weeks, Dan, Kathi, Layla, my mom and I went for the ultrasound at the perinatal center on Jan 10th. We were all so excited to see how big the baby had grown and to find out the gender! The technician performed the test, which took about 40 minutes. Sometime in the middle of the session, the technician announced that we were having a little girl! Although Dan and I had been hoping for a boy, we were overjoyed non-the-less. Dan and I had talked about names before the appointment and had decided on Scarlett Hazel for a girl.

After the technician had finished, she said that she was having difficulty seeing some of the structures due to the baby’s position. Dr. B came in to talk to us about the placental cord placement. It is called “eccentric” when the cord enters the placenta on the outer edge, instead of the middle. This may cause restricted fetal growth that is usually seen later in pregnancy. Dr. B suggested we return in 4 weeks to look at the structures they were unable to see that day and to monitor baby’s growth due to the eccentric cord placement.

The following week, I had my 20wk check up with a resident at Dr. P’s office. While I didn’t care for the resident, everything seemed fine with baby and me. My fundal measurement was 19cm, concurrent with the ultrasound findings. Dr. P decided that we could just push back my due date a week to accommodate for the difference, since baby had been measuring about 1 wk behind since day 1. This meant I was back to 19wks gestation. Dr. P was not concerned that the eccentric cord placement would change our birth plan as long as baby grows consistently.

On Feb 7^th, Dan and I returned to the perinatal center at St. John’s for our follow-up ultrasound with Dr. B. They were able to see the heart this time and said that everything looked good with the function and structure, but that the placement of the heart in the baby's chest was extreme to the LEFT. Dr. B explained this probably meant that there was a mass in the chest pushing the heart to the side; most likely the liver was herniated into the baby's chest.

Congenital Diaphragmatic Hernia (CDH) is a condition where the diaphragm doesn't form completely (the large muscle separating the upper and lower cavities of the abdomen), leaving a hole that allows other organs to spill into the top. This can interfere with the growth of other structures, such as the lungs and heart. CDH is a life threatening condition that has a wide range of outcomes, depending on the severity of the condition. In the most severe cases where little hope is given, surgery can be performed on the baby in utero to try to help the lungs to develop. Dr. B did mention two other possible conditions that would cause the hear to be misplaced, but he thought CDH was the most likely. Further tests will need to be performed to be more certain.

Dr. B was not able to assess lung development at that time due to the baby's small size. Dr. B also noted that the long bones (upper leg and upper arm) were short for the gestational age, which can be a marker for Down Syndrome. We had an amniocenteses performed to check for abnormalities with the chromosomes that may explain the baby's anatomy. This test involves taking a small amount of amniotic fluid through a needle to retrieve genetic material from the baby. It didn’t hurt as much as it scared me to be going through this so suddenly. The results will take up to a week.

Dr. B asked us to return for another ultrasound in two weeks to check on the baby's growth. He also mentioned that a fetal MRI could be in the future to help him see the diaphragm more clearly, but that can only be done in the third trimester, which is 4-5 weeks away.

Needless to say, Dan and I are devistated by all of this unexpected news. All that we know for now is that our little one has a heart that is pushed to the extreme left due to unknown reasons.

No condition has been formally diagnosed. I have my 24 wk check up with Dr. P next week and will have my gestational diabetes test done. Since Dr. P is a family doc and doesn't specialize in high risk pregnancies, I fear that I may not be able to finish out this pregnancy under her care if the baby is diagnosed with CDH. We will have to wait and see. So many uncertainties.....