I have a lot to update on, but I thought I should at least post the news from today's visit to the OB's office. I go twice a week now to the office to do something called "NST" which is nonstress testing. They hook my belly up to two monitors: one for baby's heart rate and one for my uterus activity (baby's movement, contractions, etc.). They want to see the heart rate rise by ten beats per minute (BPM) at least twice in twenty minutes. This indicates that as baby moves around and needs more oxygen to support the movement, that the placenta produces more oxygen in the blood flow to baby. Thus the placenta is healthy and continues to support baby. They do the NST for all women over the age of 35 in this office, starting about week 34. I go in on Mondays and Thursdays for this testing.
Baby has been passing the NSTs without trouble. Heartbeat has averaged 145 or 150 BPM. Today, baby was so active, they had to move the heart rate monitor to find a better spot to measure it from! Baby's heart rate did drop once to 120 BPM today and when I asked if that was of concern, the nurse told me that baby had probably hit the umbillical cord.
On Thursdays, they add a second test, this one is a small ultrasound scan used to measure the pockets of amniotic fluid that surrounds baby. They can't count pockets that have baby parts in them, like the cord or a foot. So the first week, the fluid level was 9.8, but there was one pocket with the cord in it. They look for levels between 5 and 20. The second week, fluid level was 16. Today, they measured it at 14.6. Having a nice amount of fluid makes it easier for baby to move around.
After this test, I was brought in for our Week 36 growth ultrasound. A student nurse was at the controls in the beginning, and she was supposed to be measuring things like the length of the forearm. She focused in on the heart and said, "And there is baby's heart with all four quadrants showing." I smiled and said, "I tend to think of it as a two chamber heart." But I'm sure she didn't know what I meant. (Later when I laughingly mentioned it to the doctor, she agreed that the student had probably no idea why the heart appeared a little different from the ones she is used to seeing.) She showed me baby's full bladder and the bean shaped kidney. After a few minutes, she left and the regular nurse technician took over. She finished up the measuring, and did some scanning. She was videotaping this on our tape, too. As she was scanning, she pointed out an area on the back of baby's head and announced, "
Your baby has a little patch of hair here, just above the neck." She told me to avert my eyes at another point, then too late realized she had videotaped baby's gender! She had to stop and rewind the tape until all was clear. Pretty funny. Baby is still head down, with the back running up along the right side, butt near the top, feet sticking out the left side.
So baby is 6 pounds 11 ounces! (Weights can be up to a pound off in either direction.) This places baby smack in the middle (50th) percentile. Not too big, not too small. What an awesome, healthy size! Baby will now continue to grow one ounce a day until birth. In other terms of measuring, baby measures at 37 weeks 2 days, with an estimated delivery date of 18 November.
I asked the tech if the office had one of those 3D u/s machines and she said yes, but that they did not use it very often. She thought about it then added, "But your baby is in the right position, so we can probably get a good scan." She finished up with the ultrasound, wiped the goo off my belly, then brought me into another room. She got me situated again and this time we got to see three dimensional views of baby's head. It was so amazing. I have never liked 3D scans of babies since I think they look pretty scary, so wasn't really interested in getting one done. I had hoped to do one near the end of this pregnancy just to see if we could pick up some signs of a chromosomal disorder like a cleft palate. The tech said they rarely show, though. But she did mention that with downs babies, they do tend to see the longer tongues sticking out. She took about ten pictures. Here is the last one she took, the only one in "color":
You can see baby's hand covering up the right side of his or her face. Baby's eyes are closed and lips were a bit pouty. I thought the baby resembled my father-in-law, Tom!
The doctor came in to do a quick scan of her own. She said there was no fluid collecting around the lungs or heart, so no signs of heart disease. She said everything looked very good. She said baby was adorable. They say that to all the moms, don't they?!
Lastly, I headed off to my prenatal appointment. My blood pressure was 103/64, nice and low. I've gained 3/4 pound in past two weeks. I had a small amount of protein in my urine, but still in the normal range, so nothing that concerns them. But they will keep an eye on it, as elevated levels can be a sign of preeclampsia (hypertension). I also had to do a Group B strep test (with a swab) to see if I am one of 30% of women who carry this bacteria on the skin. If I am, then I will require two rounds of antibiotics via IV when I go into labor to protect baby during birth. The nurse practitioner (NP) checked me for swelling and said I have very little. Overall, I am still having a very healthy pregnancy and doing well. I will start having weekly prenatal appointments now.
I asked what their policy was for induction, since in my first trimester one of the OBs had said to me that they do not let women over the age of 40 go past their due dates. The NP made me very happy by telling me that they prefer their healthy mothers-to-be to go into labor naturally, even allowing them to go seven to ten days past their due dates. By trying to do an induction when the mother and baby haven't shown any signs of labor, they are increasing the woman's risk of having a c-section, she admitted. So they will continue to monitor the placenta twice a week (with those NSTs) and my overall health.
I was at the office for two hours. But I just loved the things I learned today! What a great day!
Nurse also mentioned that baby appears to by laying in an optimal position, Right Occiput Anterior, where baby's back is on my right side. Here is a neat website showing baby's head in the pelvis (scroll down): Fetal Position within the Birth Canal. [Other info from the appointment: blood pressure nice and low at 104/66, I passed the Strep B test, so no need for antibiotics at birth, baby passed the NST as usual, and fluid level was 13.8.]
