Pregnancy Complications, Questions, & Still No Answers...One Year Later

"It's not that we've never seen this before, most of us have never heard of it before." Those words, from my doctor, will forever ring in my head. It was exactly one year ago today when my husband and I went for what was supposed to be a routine weekly checkup at my Baltimore-area OBGYN. I was 32 weeks pregnant with my first baby. Little did I know that day would change everything... certainly the rest of my pregnancy and perhaps the rest of my life.

As I sit here trying to figure out how to describe what I was feeling that day I am getting chocked up. Even knowing my precious baby girl is perfectly happy and healthy it's still very emotional. So, as I tear up over what could have been, I'd like to finally share the story that I've considered blogging about for a year, but never known exactly how to put it into words.

As I mentioned, I was 32 weeks pregnant. It was July and our baby was due September 2. My husband, Bob and I waited in the exam room at my OBGYN just as we did every other check up. I distinctly remember saying to Bob about how we waited for so long in the waiting room and then every appointment was the same: the doctor came in, he or she (they rotate through doctors in this practice) would listen to the baby's heart beat, take my blood pressure, and say they'd see us the following week. Five minutes later we'd be were on our way: Bob back to work, me back home to sleep since, at the time I was working the overnight shift. But that's not how it went last July 15th.

Last July 15 Dr. Guidice (the sole male doctor in the practice and the one I hoped upon hope would not be on call when I went into labor) came into the exam room. I'll never forget: I was sitting on the table my husband was across the room in a chair. Dr. Giudace put my patient folder down next to him and leaned against the counter. He looked at both of us and said "we have some things we need to talk about."

I had recently had my third ultrasound (I was getting more than normal because I have chronic high blood pressure.) He told us the results of the ultrasound came back with what he described as a very rare find. From there everything is pretty much a blur. All I can remember is "rare." Somewhere along the way I also picked up "umbilical cord" "clot" and "induced at 36 weeks, if everything went well" (it might have to be earlier). The condition, which he called an "umbilical vein varix" was so rare, he said, that he reiterated none of the six doctors in the practice had ever even heard of the condition and they were working closely with the Perinatal Center at St. Joseph's Hospital to learn more about it. He then warned me not to Google it. Google is my homepage. Dr. Guidice told me there was little known about the condition and what I would read on the Internet would basically scare me into labor. I never did Google it, but from what I came to understand is that my daughter had a kink in the one and only vein in her umbilical cord which posed a risk for a clot. A blood clot in the vein could be fatal to her. The kink was in the part of the cord after it entered her abdomen. This, I was told, was the good news. Since the kink was in her abdomen, and not in the large section of cord that ran from the placenta to her, there was less of a chance of it being disturbed by her movements in my womb. What it also meant was the doctors needed to keep a very close eye on the varix. I would have to have two ultrasounds a week, for the remainder of my pregnancy, to measure its size and make sure it was not limiting the amount of blood flow to my precious baby girl. I was told I would also have an amnio at 36 weeks to test my daughter's lung development. If it was positive, I'd be induced on 8/8/08. (As the doctor looked at the calendar he realized that wouldn't work, too many women had scheduled to have c-sections that day. This is another blog post in and of itself..but seriously????)

I knew the size of that varix better than any tech, nurse, or doctor. I knew if it grew by a fraction of a millimeter. I knew what to look for on the ultrasound monitor and I knew which techs were the best and which I needed to steer clear of. I had to protect my daughter. But for as much as I knew about this varix-thing, there were 10 times as many things I (and the doctors) didn't know. There had to be a reason she got this, but what was it? Was I taking the wrong kind of medication when I got pregnant, did I have a drink and not realize, did I sleep on my stomach and cause too much pressure...there had to be a reason. Then I'd wonder if there were going to be permanent side effects after she was born? "No," I was told, once the umbilical cord is cut it's useless, the vein dries up and is no longer needed. But how could they know for sure if they hadn't even heard of the condition. The most frustrating part was that all the doctors just kept saying they couldn't explain it...but they kept discussing my case in their weekly "problem child" meeting. Great! I was told it was likely more common than doctor's realized and most often went undiagnosed because most expectant women don't have so many ultrasounds. But the fact that there were so few answers was frustrating. And it made for a long three or four weeks.

Finally, I was able to get an amnio. They would test to make sure my daughter's lungs were ready and I'd be induced the next day. The last month of my pregnancy, the longest, the most stressful (and the non-stop itching on my feet) was about to come to an end. But my daughter had other plans. The amnio came back negative. I was devastated. Not only would she not be born the next day, I'd have to wait at least another week. Two more stress-tests, two more ultrasounds, another amnio and another week of itchy pregnancy feet. A week later, the amnio had a different result. Olivia's lungs were mature and ready to take on the world. The next day I was to report to the hospital at 6am. I became a mom, the happiest, most proud new mama in the world at 8:50pm Friday, August 15, 2008.

Note: My doctors did special testing on the placenta and found nothing out of the ordinary. They also did an ultrasound of Olivia's abdomen and found it to be perfectly normal. So while I still have very few answers, I will forever to be grateful to all the Baltimore-area doctors and staff who spent so much time on my case. By the way, I, the woman who was in no way ever having a male OB, was so grateful for the time and dedication Dr. Michael Guidice spent on my case I made him my routine OBGYN.

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