I have now officially reached the 32 week mark.  32 weeks + 4 days to be exact!  I was a little worried we wouldn’t make it to this point.  At 26 weeks I began experiencing horrible braxton hicks contractions.  Some days they were coming as frequently as every 3-5 minutes lasting over a minute for hours at a time.  But my cervix stayed strong and true.  And my irritable uterus became nothing more than a mere nuisance as opposed to a preterm labour threat.  I did, however, begin taking magnesium supplements as a means to curb the contractions. Whether or not that has been helpful is debatable.  While the frequency of the bouts of regular contractions has decreased the intensity of the contractions when these episodes occur has increased.  Thank goodness I know how to check my own cervix.  I couldn’t imagine the stress I would be in if I were not able to.

Despite my cervix remaining closed, it was still decided to have an ultrasound at 30 weeks to check on cervical length.

 

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Baby at 30 weeks


The Results:  
Cervix was wonderfully long measuring at 4.5cm.  The baby, on the other hand, was measuring small.  Small!!

A rather bizarre finding given that I don’t make small babies.  I make whopping 8 to 9 pound babies.  Babies so tall and scrumptious that they don’t fit into newborn clothes babies!  But this little one was measuring as being in the 6th percentile.  I cannot say that I was totally surprised by the fact that this one was smaller, but I was surprised by the degree of the size difference.  Since about 20 weeks I felt smaller than I did in my previous pregnancies and I look significantly smaller as well.  Usually by this point I have strangers asking me if I’m overdue and am receiving twin comments on day to day basis.  But not this time.

30 Weeks Pregnant

But I just thought that was an indication that I was likely to have a normal newborn sized baby, I never even contemplated for a moment that this one could be itty bitty.  I charted the measurements using numerous different sources and there was only one based on studies conducted in the 1980′s which agreed with the assessment of 1237g equating to the 6th percentile.  All of the others depicted that measurement as landing somewhere between the 15th and 20th percentile though BPD and FL were found to be consistently low.  At this point in time I am not overly concerned as ultrasounds have such a large margin of error and I really have no other risk factors for having an IUGR baby.  The one thing that does concern me,  however, is the fact that there was a very obvious error written on this ultrasound report.  Baby was NOT cephalic at the time of the ultrasound, but was actually oblique frank breech.  While position generally has little clinical significance at 30 weeks, I find the fact that they reported it incorrectly quite troubling.  If they reported the position wrong, perhaps the measurements could be wrong as well?

I did bring up the error to the diagnostic imaging department and they said that they will ‘definitely be looking into it’.

 

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Ultrasound Lab Report

I had a subsequent ultrasound two days ago (at 32 weeks) and I am still waiting for the results.  The ultrasound technicians here are not permitted to divulge any information regarding measurements, findings, etc during the ultrasounds so I have been forced to play the waiting game.  If there are any urgent concerns regarding fetal well being you are sent to L&D to speak to someone right away, so I do have the peace of mind of knowing that despite being small, baby is still doing A-Okay in there.  And I am still clinging to hope that maybe, just maybe, baby hit a growth spurt and isn’t even in the ‘too small’ category anymore.  It happens.  Given that my midwives have yet to call me with the results, the likelihood that that has happened keeps growing higher and higher.  Though it is plausible that even they won’t receive the results until Monday.  I could call… But it always annoyed me when clients called me in regards to non-urgent matters when their appointments were just days away….  And I don’t want to be one of those clients.
In terms of baby’s position.  I THINK we’re now head down.  Baby was still frank breech at my last ultrasound two days ago, so I decided to get on top of that and I did the Forward Leaning Inversion and Breech Tilt yesterday evening.  Then through the night baby woke me up with some big movements and this morning my belly felt strangely tender where it’s head usually sits, only now what’s there no longer feels like a ballotable head.  The location of the movements has changed as well. Admittedly, due to the tenderness, I haven’t actually been able to get a real good feel, but I’m optimistic :)
While I am very much in favor of the normalization of vaginal breech deliveries given the new information and research we now have on them, unfortunately both my having Von Willebrand’s Disease and the baby potentially being IUGR are contraindications to a vaginal breech birth.  Von Willebrands disease, because there is a 50% chance of baby having it and breech deliveries are associated with a very slight increased incidence of intracranial hemorrhage (which unfortunately is more than slight when you factor a bleeding disorder into it…) and IUGR because oftentimes IUGR babies will be born with heads slightly larger/out of proportion to their bodies which can increase the chance of head entraption.  To confound matters further, I highly suspect that finding an obstetrician who is willing to perform an ECV on a IUGR fetus with potential Von Willebrands Disease would be quite the challenging task!  So this baby NEEDS to be head down and it needs to stay that way!