August 20- Anatomy Scan

     This morning was our 18 Week Anatomy Scan with Maternal Fetal Medicine at Winnie Palmer. We are always so excited to see the babies again! (For those of you who don't know, the Anatomy scan is done between weeks 18-22 and measures the head, body, four chambers of the heart, kidneys, bladder, stomach, brain, spine, and sex organs. They also do a survey of the organs, including the umbilical cord, to ensure that they are developing normally (or identifies any potential problems as soon as possible). The sonographer also looks at the amniotic fluid levels, the location of the placenta, and the fetal heart rate.)

     While Baby Girl was cooperative as usual, Baby Boy was being difficult as he always is during ultrasounds. He flips around and moves into positions that make it tough for the ultrasound tech to collect the data needed for testing. It is always so amazing to see them in there. No matter how many times we see them, we are still blown away that there are TWO in there! So while the nurse was working on the ultrasound, our MFM doctor came in. It was the first time getting to meet him so we weren't really sure what to expect. He was very nice and took his time answering all the questions I had for him. I first filled him in on the background story of me being diagnosed with Premature Ovarian Failure earlier this year and how four different doctors told me I couldn't have children because my ovaries weren't working and my hormone levels were post menopausal. And that after only three months of taking herbs and doing acupuncture I was naturally pregnant with twins. He said I am not the first person he's heard of that became pregnant after being given that diagnosis and questioned whether or not using hormone levels to make such a diagnosis was viable in the grand scheme of things. I was about to say my usual catch phrase when discussing that topic, "just goes to show you that doctors don't know everything," but I decided against it as I didn't want to insult him and his profession!

     I had a list of questions to ask and he did a good job of answering them thoroughly. He brought up that I am considered high-risk because I'm carrying twins and I said that I did know that, but was curious as to what is high-risk about it. He went on to say that humans are made to carry only one baby at a time, so when there are multiples in there it is more taxing on the body, which is why they will be monitoring me more frequently. Labor is the body's response to stress (I did not know that!) and usually happens when the uterus is expanded to its maximum and the body can't take anymore. So because there are two in there, the body is being effected twice as much as having a singleton pregnancy and therefore can go into preterm labor more easily. He also said there is a higher risk of birth defects with multiples, but frequent monitoring watches out for things like that. He said some things I already knew... like that they won't let me go past 38 weeks and that the babies should be fully developed and not need to be in the NNICU if delivered from 35 weeks on.

     This led to me asking about delivery and what percentage of twins have to be delivered via c-section. He said at Winnie Palmer about 2/3 of twins are c-section and I expressed how I would much rather go the vaginal route if possible, but that I understand it's ultimately not up to me. That I know it would be a lot more pain during the birth, but I would rather get it over with than have a long and challenging recovery. He did say that mothers who really want to go the vaginal route stand a better chance of it happening that way. I told him my concern about delivering one vaginally and then the other one stressing out and having to be c-sectioned out. That's a big nooo thank you! He explained that doesn't necessarily have to happen if you have a skilled OB because even if the other baby is breech, it is easier to go in and pull the baby out by her feet than to cut me open to get her out. While that makes me feel better, the whole thought of someone reaching up there and yanking a baby out conjures up images of a construction crew in hard hats and some sort of bulldozer scooper being involved. 
Although I am sure at that point in time I won't care how the hell they get the baby out!

     I moved on to the topic of weight gain and exercise. As of today, since getting pregnant I have gained 24 pounds. Granted, I lost a lot of weight this past year. I was pretty fit and skinny when I found out I was pregnant (for the first time in my life, go figure!). I told him I eat healthy and workout 6 days a week and he said while I am on the high side of the recommended weight gain for twin pregnancy, I am still within range and to just keep exercising and eating right. I've gained 4 pounds since I was there last, which was a month ago. But... I was on a different type of scale so I would really like to see what it says on the regular doctor scale (that I have always felt was a big fat liar!) but just to have an accurate comparison. I mentioned how I've read about bed rest being a common thing to happen to those carrying twins and to my relief he said he doesn't like to put women on bed rest unless it's absolutely necessary- meaning either having cervix issues or high blood pressure. That is wonderful news because that is a HUGE fear of mine. I am way too active to ever be confined to lying in bed 24/7! 

     He also brought up the test results from the Modified Sequential Screening I had last month. The babies have a 1 in 6000 chance of Down's Syndrome and a 1 in 10,000 chance of Trisomy. Those are some REALLY good odds compared to others I have heard. So because they were so good, no further testing is needed. YAY! That is definitely comforting.

   After the Q & A session the doctor turned his attention to all the ultrasound pics that were taken and he said everything looked good. That they are still small so he will look again in a month. And BTW, Baby Girl weighs a half a pound and Baby Boy is a half pound plus one ounce! Pretty cool! The Girl is on top and is currently laying sideways across my belly button area (I didn't realize they were so high up there now!) and the Boy is at the bottom with his head facing down. So they look like the number 7 the way they are laying. I asked the doctor when I should start feeling them and he said within the next couple of weeks I should definitely start feeling them move and kick. I still haven't even had flutters yet! Of course, be careful what I wish for, right? LOL. Oh and cervix is holding steady, so no concerns there. An excellent bill of health for all three of us!

     So that's about it. We made another appointment for a month from now so they will be a little bigger then. After that I'll either have one more visit with MFM or skip it and be released back to my OB. Then at 32 weeks I will be back at MFM for weekly monitoring until birth.

    Super happy everything is going well. It is always a little nerve-wracking going to these appointments, but at the same time it eases our minds to see the little buggers again.

Here are the pics from today's ultrasound. They aren't all that great, really. But these are the best ones out of the bunch...

Baby Girl's Head

Baby Girl Money Shot

 Baby Boy's Head (not very clear!)

                                                    Baby Boy Money Shot