Oligohydramnios

On Tuesday when we got our sonogram done my fluid was also measured and despite all of my efforts my fluid was still low. In fact I am no longer in the normal range because I have less fluid than I did before. We have been referred to a Perionatologist who will run some of their own tests and then come up with the next solution.
Until we can get more information I thought it would be good to post some information on low amniotic fluid to try to put off some worries.

Low amniotic fluid levels : Oligohydramnios

The amniotic fluid is part of the baby’s life support system. It protects your baby and aids in the development of muscles, limbs, lungs and digestive system. Amniotic fluid is produced soon after the amniotic sac forms at about 12 days after conception. It is first made up of water that is provided by the mother, and then around 20 weeks fetal urine becomes the primary substance. As the baby grows he or she will move and tumble in the womb with the help of the amniotic fluid. In the second trimester the baby will begin to breathe and swallow the amniotic fluid. In some cases the amniotic fluid may measure too low or too high. If the measurement of amniotic fluid is too low it is called oligohydramnios. If the measurement of amniotic fluid is too high it is called polyhydramnios.

What is oligohydramnios?

Oligohydramnios is the condition of having too little amniotic fluid. Doctors can measure the amount of fluid through a few different methods, most commonly through amniotic fluid index (AFI) evaluation or deep pocket measurements. If an AFI shows a fluid level of less than 5 centimeters (or less than the 5th percentile), the absence of a fluid pocket 2-3 cm in depth, or a fluid volume of less than 500mL at 32-36 weeks gestation, then a diagnosis of oligohydramnios would be suspected. About 8% of pregnant women can have low levels of amniotic fluid, with about 4% being diagnosed with oligohydramnios. It can occur at any time during pregnancy, but it is most common during the last trimester. If a woman is past her due date by two weeks or more, she may be at risk for low amniotic fluid levels since fluids can decrease by half once she reaches 42 weeks gestation. Oligohydramnios can cause complications in about 12% of pregnancies that go past 41 weeks.

What causes low amniotic fluid?

• Birth defects – Problems with the development of the kidneys or urinary tract which could cause little urine production, leading to low levels of amniotic fluid.
  Placental problems – If the placenta is not providing enough blood and nutrients to the baby, then the baby may stop recycling fluid.
• Leaking or rupture of membranes –This may be a gush of fluid or a slow constant trickle of fluid. This is due to a tear in the membrane. Premature rupture of membranes (PROM) can also result in low amniotic fluid levels.
• Post Date Pregnancy- A post date pregnancy (one that goes over 42 weeks) can have low levels of amniotic fluid, which could be a result of declining placental function.
  Maternal Complications- Factors such as maternal dehydration, hypertension, preeclampsia, diabetes, and chronic hypoxia can have an effect on amniotic fluid levels.
  

What are the risks of having low amniotic fluid?
The risks associated with oligohydramnios often depend on the gestation of the pregnancy. The amniotic fluid is essential for the development of muscles, limbs, lungs, and the digestive system. In the second trimester, the baby begins to breathe and swallow the fluid to help their lungs grow and mature. The amniotic fluid also helps the baby develop muscles and limbs by providing plenty of room to move around. If oligohydramnios is detected in the first half of pregnancy, the complications can be more serious and include:

• Compression of fetal organs resulting in birth defects
• Increased chance of miscarriage or stillbirth
• If oligohydramnios is detected in the second half of pregnancy, complications can include:
  Intrauterine Growth Restriction (IUGR)
• Preterm birth
• Labor complications such as cord compression, meconium stained fluid and cesarean delivery
  

What treatments are available if I am experiencing low amniotic fluid?
The treatment for low levels of amniotic fluid is based on gestational age. If you are not full tem yet, your doctor will monitor you and your levels very closely. Tests such as non-stress and contraction stress test may be done to monitor your baby’s activity. If you are close to full term, then delivery is usually what most doctors recommend in situations of low amniotic fluid levels. Other treatments that may be used include:

• Amnio-infusion during labor through an intrauterine catheter. This added fluid helps with padding around the umbilical cord during delivery and is reported to help lower the chances of a cesarean delivery.
• Injection of fluid prior to delivery through amniocentesis. The condition of oligohydramnios is reported to often return within one week of this procedure, but it can aid in helping doctors visualize fetal anatomy and make a diagnosis.
• Maternal re-hydration with oral fluids or IV fluids has shown to help increase amniotic fluid levels.

Yesterday's Scans

And the baby is...

First Kick Line

I have felt a little pushing from the inside which is really cool. The first kick was during the Avant Guarde meeting on July 10th. I was just quieting listening to the presentation and then I felt this pain on my side and like that 3 rapid kicks. It was so neat!! Then last week I was laying on the bed and baby Sug was on my belly and the baby was just kicking away. It was funny Sugar was just laying there and I kept feeling it one after another and that baby was getting a workout! Sugar couldn't feel anything though because it was a little too early for that. The baby is just kicking really softly at this point and only I can feel it for now. I can't wait until she can feel it though I just want to see what she thinks of all that.
Then the next time was today. I felt the baby kick just a few times while I was at lunch. I like it when the baby kicks its a nice reminder that the baby is there and is doing ok. Hopefully within the next week or so it will get more frequent and I will be able to feel it a little more often. (A downfall about being a Plus Sized Pregger is you don't get to feel all that stuff as early as the little ladies do because there is more "cushioning" there).
I am having a harder time bending over now since my uterus has now reached belly button height. It will get really stiff there everynow and then and then it makes it really impossible to bend over easily. The plus side of that is my stomach feels rock hard so I can feel it and pretend I am all ripped. I am like that's right I got bricks. (Self delusion has never been a problem for me).
Other than those few things it is all mellow right now. I am still trying to pump myself full of water and I must say I have been doing a great job. The bathroom trips seems to be slowing down over the past few days so I am glad about that. I have been going through some weird controlling issues. Like I feel like I am spirling out of control at random times and so I frantically start cleaning and organizing. I guess the whole neating instinct has set in a little early since I have such a long way to go to get ready.

Next Sonogram Appointment: July 29th at 2:30 Stan and I have invited our moms to come along and see how their little Grandchild is doing! I am so excited it is going to be a blast! And we will all keep our fingers crossed that the baby isn't keeping it's legs crossed!

Auntie's Bragging Rights

Today I am really feeling sore. It is nuts my stomach feels like I have done a million crunches (or at least I assume that is what my body would feel like after a workout.) and my calves hurt for some odd reason. I am just a big bundle of mess today. Luckfully, the day is drawing to a close and before I know it I will be fighting traffic to get home. I have been feeling recently like I am coming down with something and I know since there are like a million colds and flus going around I need to take it easy and rest whenever I can. Currently I am focusing on just relaxing at work since I have been very efficent and finished all my work in record time. These next few days the office will basically be empty and it will be blissfully quiet. I have to say there is a part of me that is grateful for the break in the action and it feels like perfect timing.
I just made all my OB appointments up through October so I am set for now and I only have to call one more time to get the appointments through December.
And we have really kicked some butt on putting our registrys together. It was suggested to me to have more than one registry since it usually is helpful for people to have a choice on where they go. Our main registry is with Babiesrus and then we have another registry through Target. I have really been looking forward to registering but there is so much to get that I have to admit Baby registries are in a whole different league than Wedding Registries. With the wedding registry it is more stuff that you would like to have but you could live without whatever it is. With the baby stuff it is things you assume you will use and hope that you know how to use when the time comes.
We are so fortunate to know many mommys and daddys who can guide us through the world of butt paste, nasal aspirators, exersaucers, and temporal thermometers. There are so many things you can easily overlook and I want to try to avoid (if at all possible) finding my baby with a fever at 3 am and there is nothing I can do about it until 8. I am just thinking the more we try to stock up on now the more ready we will be which I know sounds funny to all you mommy's out there who are thinking that we will never be ready no matter how much stuff we have to back us up. I am just happy to have so many wonderful resources because in the end their experiences, advice, stories will save us from a lot of chaos and Stan is fragile--he can't handle all that.
I have to say I am also really grateful for the time that I have gotten to spend with Annabelle, Sarah & Julia, and William. Anna taught me soooo much in the land of babies. Actually one of my biggest lessons from her was to trust in myself and my instincts the more confidence I had with her the more comfortable she was with me. Not to mention all the wonderful memories I have of my time with her. I was lucky enough to see her grow and evolve right before my eyes. It seemed like she was doing something new everytime I went over there. And I was just amazed at the person who she is now and I just always think about what a cool chic she was back then. Sarah has soooo much energy and I totally love it. I have to brag on her every chance I get because she is such a little teenager and I love listening to her talk. She sounds like Beth and I when she talks and I can't get enough of that. She has excellent fashion sense and totally keeps me on my toes. I think I learned quite a bit about how much energy is required for kids after spending a few days with Sarah I needed to nap for days but then after that I was totally ready to go hang out with her again. She makes you feel beautiful too I love that. She has such a huge imagination and she is so open and friendly that everyone is invited to come and play. Julia was very quiet for a long time and seemed to hang back a little which was such a strong contrast to Sarah. I have to say Julia is like that too cool girl. She is always really even tempered and although she approaches things with caution she is still a joiner. She seems to be really smart like she is always inspecting whatever the event is in its fullest before deciding to take part. She always has the cutest voice everytime she talks I can't help but laugh her voice is that cute. And she has this super cute smile that is sooo infectious. (Ahhh I miss my girls!!!)
William has this amazing smile and he is such a little love bug. He just really likes to include people in his fun. One thing that is super cool about William is he really likes to watch what you do and how you do it then he copies you. On top of that he has a really great memory and seems to be able to recall something you have done days or weeks in the past. What a little genious! He seems to be a lot more mellow than I am used to like he seems to enjoy working with you on an activity and has more of a laid back spirit. He just has an excellent heart and a really impressive mind. I think all the influence these wonderful kids have had on Stan and I will (hopefully) show in the way that we choose to interact with our own child.

Back to the Bathroom

One of the things that came up during our ultrasound on Wednesday was that I was on the lower side of normal in terms of my amniotic fluid. Of course the amniotic fluid is really important so now I have to up the input of water and I can't even tell you how hard that is! I have been focusing on drinking 10 bottles of water a day and of course I have really been trying to drink as much as I can during the day portion since the evening it is often colder and I am not losing as much water. I actually have assumed that all of this low water business has to do with the fact that it is the summer time so under doctor's advice we are doing nothing for this weekend. No outdoorsy things (as if I ever did that) and no overexertion (yeah never really did that either). Actually this would be a really good time to start focusing on our house and getting it ready for nursery stuff and everything.
Luckfully work is really light today so I can visit the commode in peace! Maybe I should just move my office in there!

Not Tonight Folks!

As you can see from the title we were unable to see the gender this time. The baby had it's legs comletely closed so we couldn't see anything and the onry little thing was not going to relinquish it's comfortable position for anything (a baby after my own heart!). Actually it was cute the baby was sleeping head down in the narrow part of the uterus and in order for us to get some better pictures the sonographer kept jiggling my stomach and all the baby did was just roll over on it's side--now if that is not Stan and I's baby I don't know what!
We were able to get some good pictures but we have to go back to get the baby's heart and brain. (Now it's starting to sound like it's in the Wizard of Oz). Since we couldn't get everything we are scheduled to go back on July 29th for our consolation prize (more pictures).

The Race Is On

There is only two more days until the big sonogram so people have until Thursday Morning to put their guess in on the baby poll. It's exciting we are so close to beating the people in the number one spot and I am having a ball seeing what everyone guesses.
Stan and I are getting all geared up for the nursery and have been talking about colors. I am thinking we will start decorating sometime this weekend.

Making Contact

I think--or at least I am pretty sure I felt the baby kick me during one of my meetings last week. It was really sudden I felt this pain in my side which I completely assumed was gas and then it was gone. The pain was replaced by this weird tapping feeling inside and it did it three times then I didn't feel it again. It was so weird it made me jump. I was thinking about how they must have felt in alien. It was really exciting. More and more the baby has become a reality. When I lay down I can feel the pressure inside from the uterus and the baby and Thursday I put Stan's hand on my belly so he could feel where the baby and all its accoturements are right now. It feels rock hard so you can totally tell compared to the usual bouncy belly. He was so happy to feel and I think it made him all excited. I can't wait until the baby gets big enough for Stan to feel the kicks (not until the beginning of the third trimester--roughly).
Other than that we are just looking forward to seeing the baby on the screen on Wednesday. All the organs that have developed and being actually baby looking will be nice. We will def. post the photos up here on Wednesday afternoon so everyone can take a look and see if they can tell one way or the other.

Thinking BabyMoon

I read about a this idea of taking a BabyMoon before your baby is born somewhere I think like a magazine or something and at first didn't give it too much thought but as I start to feel the baby reality really sinking in I have been leaning in the other direction. Perhaps it would be fun for Stan and I to take a romantic vacation away from everything before our lives become all diapers and demands. Plus we have both had a pretty tough year for the most part and in a way need a chance to get away somewhere. I just don't exactly know where to go when money is limited and time is (as always) an issue. I can't travel past September and I know I won't be able to handle too much heat the further along I get (us big girls are already well insulated I can't imagine what it's going to be like with more body heat) so I keep thinking end of July is really the time especially since my assignments should be complete by then and I will be just getting my new assignments. Where to go though? I keep thinking it should be somewhere special because it will be a last him and I vacation before we have our little baby bear. Suggestions welcome...(hint hint)

Preparations

I can't believe it, less than 2 weeks now and I will know the gender of the baby. I know I shouldn't be so sure since the baby has been very modest so far. We couldn't find the heartbeat for a while and on our first ultrasound it took a long time to even find the baby. I am thinking this baby will do all it can to hide it's gender. If we can't see it then I am pretty sure we will be able to go back in a week or so and see if anything has changed. Stan and I are still trying to pick out where we are going to have the dinner where we announce it. We are trying to find a place that is special. I wanted BDs since we all know my obsession with that but my mom suggested an Irish resterant in Glen Echo so Stan and I may go and check it out to see if it is a good find.

I am going to call Auntie Angie immediatly after we open it so she can be the next person to know after the families. I am excited to tell her and since we had to keep the number low of who we were taking to dinner I figure I can still let her know next.

In terms of the nursery, Stan and I decided since we have that whole Wibby and Boo-Boo thing we were going to do a "Nighty-Night Blankets and Bears theme." I actually bought my first nursery item which was this super cute mobile that has a star and moon with night-caps on and little bears holding their blankees. I thought it fit so well and wanted to get myself something special since I was now finished with the first trimester and now into the second I thought it would be cool to get a little baby something to help it feel more real. I haven't decided what color I going to paint the room. I am thinking either a light blue, Bluish-green, or maybe just buy a border and skip the paint all together. We will have to see what things we find. I know Stan loved wall paper so maybe we will go that route. I found this really nice crib set at BuyBuyBaby so I am thinking about using that for the room. It says cute things like "Goodnight babybear" and has these cute little hugging bears. We are still mixing in the celestial theme so we are looking a lot at bears with stars or moons that kind of a thing. The hard part is trying to find bears with blankets and stars and moon. I hit the jackpot with that mobile.

I started bin where we are keeping all the baby stuff until we are ready to start putting the nursery together (prob. around Sept. or Oct.). Everything is getting so exciting!!! Stan's mom knows all these great baby boutiques in Bethesda so we are talking about planning some shopping days with her so she can help us pick out things. Stan and I have been thinking of using lighter woods for the furniture and I know we both want to find sturdy furniture at a reasonable rate. I know there are a lot of businesses out there so I am not worried about finding something nice at a good cost. Once we get the nursery all together I will be sure to post some pics so everyone can have a sneek peek!

I have been really lucky because the SRO's here have been giving me so much helpful advice from daycare choices to "crying it out" options they have been a huge help. What is really nice is they know all these specialists in the field of pediatrics and child development so they can pass on the latest news as well. I love my job!