Month: April 2014

Anderson Triplets - Parents at 21 weeks

21 Weeks

by Julie

I just had the “Level 2” full anatomy ultrasound this last week. Going into it, I was a bit nervous. More than anything, I wanted to know that all three were still thriving and had strong heartbeats. Baby A has had us so worried with the lack of amniotic fluid and leaking that recurs occasionally. Still, we were excited for another chance to see the babies.

We weren’t sure what to expect, and if we would have to wait through each measurement before learning the gender of each baby. They quickly went through the positioning and identification of each, and then they went on to the gender determination.

21 week ultrasound of Anderson Triplets Baby C
Ultrasound of Baby C at 21 weeks (Face)

Baby C: This one has the “penthouse” and has been measuring larger than A & B. With the positioning, the nurse was fairly quickly able to identify. A boy! She marked down “….Blue: on the ultrasound and printed the image.

21 week ultrasound of Anderson Triplets Baby B
Ultrasound of Baby B at 21 weeks (Profile)

Baby B: In the middle, Baby B needed a little bit of nudging to move into positon, but again we were able to see. The nurse said, “and this one…” and continued to type on the ultrasound screen “…..PINK.” A girl!

No matter what our babies were going to be, all boys, all girls or a mix; we knew that we would be happy to grow our family. Still, we were hoping we would be able to experience raising both boy(s) and girl(s). We were so thrilled that our wish is coming true.

21 week ultrasound of Anderson Triplets Baby A
Ultrasound of Baby A at 21 weeks (pike position)

Baby A: Fluid creates dark areas in the ultrasound, which helps the nurses and doctors to see contrast against the babies. With the amniotic fluid drained to less than could be measured, there was little contrast. Making matters more difficult, Baby A was in the pike position (legs extended with head by the knees) and not in a good position to determine the gender. From this ultrasound we could not see anything.

We knew that at 17 weeks they were able to determine genders for all three, but had not told us, so we asked the nurse to check if anyone had made a note in our charts about this. When the nurse returned at the end of the ultrasound, she had a small piece of paper, which she unfolded to reveal the handwritten note: “Triplet A – probable girl.” A girl! Well, at least “probably.” We’re not sure what level of confidence there was at 17 weeks, so it is possible that is not 100% accurate. For the time being, that is the best information we have so we are going to say that we are expecting two girls and a boy!

The rest of the ultrasound was mostly routine. However, there is one piece of great news: when they looked at Baby C, they found his stomach is now ‘normal’ size! One less worry, and we are so thankful that he won’t face multiple corrective surgeries for the stomach. Our prayers have been answered!

The doctor came into the room to go over the results with us. She said she “is pleased.” Baby C measures in the 52nd percentile, Baby A in the 23rd percentile, and Baby B in the 15th percentile. She explained that triplets do not have a separate percentile scale from singletons, but a 52nd percentile triplet is actually pretty large. Regarding the smaller size of A and B, she said that they are less concerned about smaller babies, as long as their growth has been consistent and they are healthy. They look healthy and measurements are all basically in line with their past measurements and growth rates.

We asked about Baby B being smaller than Baby A, wondering if that was perhaps because she had the single umbilical artery (SUA). The doctor said blood flow looked good, but with B she was more concerned about the umbilical cord attachment at the placenta. The cord is attached to the periphery of the placenta, which has less blood distribution. This could be a concern, so it sounds like they will keep an eye on this as well. I guess we trade one concern for another at this point.

Anderson Triplets - Parents at 21 weeks
Parents (Julie and Ryan) at 21 week ultrasound

I expressed my concern about Baby A and the lack of amniotic fluid. The doctor told us how amniotic fluid is not needed for much, and the lung development happens at some unknown critical point between 16 and 22 weeks. Since there was still measurable fluid until about 19 weeks, the doctor is hopeful that the critical lung development occurred before then. Unfortunately, there is no way to know for sure until the “breathe” test when they are born. Once I am hospitalized, I will receive a steroid shot that will help all babies’ lungs develop. We remain concerned yet hopeful at this point.

Kicks

by Ryan

Many times, Julie has felt the babies kicking. When I am around, she calls me over to try to feel it. I rush over, place my hands on her belly and… nothing. I always miss it.

Until today. Julie asked if my hands were full, and I noticed she had her own hands on her belly. I went over, hopeful as always but without high expectations. Then there were two taps! Another moment later, a much stronger kick. It was such an incredible experience for me. I had a big smile on my face, and it really made my day. After all the recent worries about the babies and Julie being placed on bed rest, this was a happy moment that we both needed.

Bed Rest Continues

by Julie
Julie on bed rest - 20 weeks
Julie on bed rest – 20 weeks

Well, I went back to the clinic to follow up on my progress, see if Baby A had regained amniotic fluid and if there would be any chance of coming off bed rest. The good news is, all babies have good strong heartbeats and good umbilical blood flow. Unfortunately, Baby A still has so little amniotic fluid that they weren’t even able to measure it.

The doctor says the membrane must be ruptured, even though it is still there and largely in tact. I need to be very careful of signs of infection and avoid sick people. I am on bed rest for the remainder of the pregnancy, and at 24 weeks I will be hospitalized. At that time they will give me antibiotics by IV for a couple days and steroids to help Baby A’s lung development. In the meantime, I’ll need weekly doctor visits to continue monitoring the babies.

I was really disappointed at this news. I was just hoping so badly that I would see the fluid regenerated and things would look better for the babies.

Appreciation

by Ryan and Julie
Ryan and Julie
Ryan and Julie

We wanted to take a moment to publicly thank everyone for all the support we have received. Those who have called, stopped by to visit, helped with chores, brought us groceries or meals, sent us mail and supported us in other ways have been a huge blessing. The calls and visits with Julie really help the time pass and make the bed rest much less lonely.

Potted flowers

Back on Bed Rest

by Julie

At 19 weeks, I went in to a routine doctor appointment to have my cervix checked. The good news is my cervix is still long (4.5cm) and closed, so they were pleased with that. The doctor decided to take a quick look at the babies on ultrasound because of being on bed rest the week before and losing some amniotic fluid. She thought it would be good to check the fluid around the babies. I was relieved to hear she wanted to take a quick peek because I also wanted to be sure they were all doing well.

This was a doctor that I had not been seen by before, so she started out with getting her bearings on where all the babies were located on the ultrasound. She was scanning around and trying to determine which baby was A, B and C. As she moved the transducer around, I saw one of the babies on the screen looked pretty scrunched up, like it didn’t have very much room to move around. I said something about it, which the doctor acknowledged. After looking around a bit more, she started to tell me what she was seeing. She asked if I could see how the two babies had a certain amount of dark area around them, which is fluid, but the one baby did not. It was pretty clear to see this, and she said that it meant that one of the babies did not have as much amniotic fluid, and in fact it was a very low amount. I asked her which baby it was, and she said it was Baby A.

The doctor explained the importance of the amniotic fluid, and how it is essential to have the right amount for lung development. I basically knew what she was getting at, and I didn’t even have to ask what would happen if the baby didn’t continue to get amniotic fluid for proper lung development. I knew that if the lungs do not develop properly, the baby may not be able to breathe and could be lost. She then told me that she was sorry to say that I would have to be put back on bed rest and to drink plenty of fluids. She wants me to come in a week later for another ultrasound to check the babies and their fluid levels. I asked about the bed rest and if it would be temporary or until the babies are born. She said there is a very high possibility this could be throughout the pregnancy.

At this point, my mind was racing. Being there alone, unsure of what would happen, feeling a bit in shock, I couldn’t think of any other questions to ask. I just felt really scared and concerned for our babies. I don’t want to lose any of them, and at this point we have a concern for all three babies. Baby A has low amniotic fluid, Baby B has SUA (single umbilical artery) and Baby C has an enlarged stomach. I did my best to keep it together and proceeded to the front desk for my follow-up appointment.

While I was at the front desk, the nurse returned with my paperwork and recognized my name. She realized that she had spoken to me previously when I had been leaking amniotic fluid and I called in asking what I should do. She put her arm around me, asking, “are you doing okay?” I was barely keeping it together as I shook my head no. I couldn’t hold back the tears anymore and she asked if I wanted to step into a room and talk. I couldn’t form the words to say yes, so I just nodded and we made our way into a room.

The nurse handed me some Kleenex and asked what was going on. All I could see in my mind was the image of Baby A, the lack of fluid, and how tight and scrunched up they were in their sac. The only thing that gave me comfort in that image was seeing their tiny heart was still beating. I told her I was really scared and explained what I had just learned and how concerned I was for all babies. I am scared about them being born too early and having to struggle so much. There are all the additional concerns about not being able to work, do household chores, attend parenting and nursing classes, and the other events like showers that I could miss. The nurse tried to reassure me that being on bed rest, Baby A will hopefully regenerate enough amniotic fluid and that I would be coming back in a week to be rechecked.

Potted flowers
Flowers from Ryan’s mom

Back at home, we’ve already gotten such wonderful support. My mom stopped by that same night, brought us dinner, helped with some chores and kept us company. The next day my mother-in-law dropped by with some beautiful potted flowers and some treats. I know right now is very emotional and scary for us, but we have amazing people who are being so supportive, and we greatly appreciate how much more bearable that makes these tough times.

If you could keep us in your thoughts and prayers, we would greatly appreciate it.

Update to 17 Weeks

by Julie
Hope napping
Hope – Julie’s bed rest buddy.

We have some good news that I am no longer on bed rest! After a week of watching Netflix and laying on my side, I will be able to return to work, but with restricted activity.

I went to the doctor for my scheduled appointment and to be re-evaluated after leaking amniotic fluid (see 17 Weeks). At the clinic, they knew that I was in the birth center triage on Monday and was on bed rest for the week, so they asked me to hop up on the bed for an exam. They asked if I had any additional leaking since Monday, which I had not, so that was good. The nurse did a quick ultrasound to check on the babies and the amount of amniotic fluid they had. We listened to each of their heartbeats, and all three had great heart rates (167-170bpm). Everything looked good from the nurse’s perspective.

The doctor came in later to confirm that all three babies were doing well, and that each had an even amount of amniotic fluid surrounding them. The doctor was pleased with my blood pressure and my weight gain so far. Aside from prior amniotic fluid leakage, this was a great update visit. I was happy when she told me that I could come off bed rest and return to work. She looked at me seriously and said, “Now, this doesn’t mean you leave here and go shopping for two hours!” She continued to lay out the restrictions. I should limit my activity – maybe do just one thing for a little bit standing and then go back to sitting or lying down. I can’t lift more than 20 pounds, and she recommended some kind of maternity brace to offload the weight to my shoulders. When I go to work, I should try to stay off my feet, and when I get home from work I should try to take it easy. She also said that if I see any leaking again, it will mean going right to bed rest, most likely for the rest of the pregnancy.