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.

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.

We just had our 17 week ultrasound on Friday. As usual, we were looking forward to seeing our babies again and catching up on their latest progress. The nurse walked us through each baby one at a time, explaining what she was looking at. At this point we measured overall length, arm and femur bones, head, cerebellum, thorax/abdomen and heart rates. There were probably a few other measurements in there we missed – I think they measured their noses and some other parts. Here’s the checklist:

• All three babies had four-chambered hearts beating at similar rates
• No signs of cleft lip/palate
• All extremities present and developing at appropriate rates relative to each baby
• All babies within 20% of each other in overall gestational size and within the standard curve
• No signs of common birth defects or Down Syndrome
• Cervix is still long and closed
• Good amount of amniotic fluid

We also learned they were able to determine gender for all three, but we are waiting until a later date to learn that information! Things seemed to be going very well, and we waited for the doctor to cover the information with us.

The doctor went through the information fairly quickly, reviewing some of what we already knew, but then pointed out some new information. At this point, there are a couple things that are concerning and we will keep a close eye on.

1. Baby B has a Single Umbilical Artery (SUA). The cause for this is unknown, but it happens more frequently in multiples. SUA means that instead of two arteries and a vein in the umbilical cord, there is just one artery and a vein. This could lead to malnourishment and underdevelopment of the baby unless the artery is able to expand and supply the nutrients needed. About 75% of the time the artery expands and there are no discernable effects. If this case falls in the 25% category, they may need to deliver early. We are still not sure if they would just deliver Baby B or all three and how early.
2. Baby C has an enlarged stomach. This could either mean the stomach is not emptying properly due to some sort of blockage or other condition, or it could simply be a stage of development. Because the stomach is still developing until week 25, we will keep an eye on this as well. If it does not resolve itself through development stages, it most likely will result in Baby C requiring corrective surgeries.

For now we can only hope and pray for the best and continue to watch their development. We went on with our day, extremely concerned for our babies. We know just enough to worry.

Over the weekend, we decided we should start registering, as people were starting to ask about that. We had been looking forward to this part quite a bit. On Sunday, we were registering at our third store and had just started the process. I felt a “leaking” sensation, and due to the scare we had at 12 weeks, needed to check it out immediately to be sure I wasn’t bleeding again. There was clear fluid, no blood this time, so I thought maybe it was just normal pregnancy stuff and we went back to registering. About an hour later, I started to feel the leaking sensation again, but it felt like it just kept flowing this time. Again, I went to check and the fluid was clear but there was a lot more of it, so I became more concerned. We cut our registering short and when we got to the car I called the on-call doctor at the clinic.

The doctor gave us the most likely scenario to the worst case. Most likely was that pressure on the bladder had caused some incontinence – fairly common in pregnancies with multiples. The worst case was that amniotic fluid was leaking. I had the choice to go in to the hospital, or wait until my next appointment. Going to the hospital presents a greater risk of infection, and the doctor said it would not change our course of action. I opted to go home and take it easy and wait it out.

On Monday morning, I noticed there was some more leaking, but not as much as Sunday. My gut was telling me that I should call the nurse line at the clinic again and see about moving my appointment up sooner. After describing what happened the day before and that morning to them, they advised me to come in and get checked out as soon as possible. I called Ryan, and he left work, picked me up and took me to triage.

The nurse there said they would first test for amniotic fluid and also test for urinary tract infection (UTI). The fluid test is similar to a pregnancy test, except it uses a swab instead of urine stream. There will be one line (control line) and a second line visible if the test is positive. The nurse examined the test strip and needed to consult with someone else. When she returned she said she could not be sure and it looked like it was negative but the doctor advised re-testing. The doctor came in to do an ultrasound too. He scanned around quickly as we closely watched. I wasn’t seeing any movement. I couldn’t see any heartbeats or the babies kicking around. Because the doctor wasn’t saying anything, I had to ask if there were heartbeats. “Oh yes, there are,” he said as he quickly showed us A, B and C’s heartbeats.

He was looking more at the fluid and membranes around each baby. From notes of previous ultrasounds, he knew the membranes were hard to see, but he was able to tell there was a normal amount of fluid around each baby and each had about the same amount of fluid. This was good news.

The second amniotic test was defective – the control strip did not even show up. So a third test was needed. Again the nurse left to check with someone else on the results. When she returned, she said this test was the same as the first, but according to the manufacturer’s instructions, even a very faint line should be considered a positive test result. The doctor explained that he suspected I had leaked some amniotic fluid. It could have been just a “high leak” as he called it. I’m not sure exactly what that means, but in that case, there is a chance that with rest it could re-seal itself and the membranes may not have ruptured. The pee test came back negative for UTI so there was nothing to worry about there.

So the good news is that there is still hope, although that is accompanied by a great deal of worry. The bad news is I will be on bed rest indefinitely. At my next regular appointment I will be re-examined and I hope to find out if I will need to remain on bed rest or can return to work. I knew that at some point of the pregnancy I would have to be on bed rest, I was just hoping it would not be this soon. I still have months to go, and there are so many things to do. There are parenting and nursing classes, showers and birthdays.

We ask for continued prayers and are appreciative of any help that people have to offer.