Monday, January 26, 2009

Week 9: Scans and fears

"Your baby's taste buds are developing. There are distinct fingers and toes and the inner ear and eyes are formed, but the eyelids are still sealed. The little heart is pumping blood around the body and can be seen on an ultrasound scan. Wrist and ankle joints begin to develop. Organs continue to grow and more bone and muscle tissue continues to be laid down and the external sex organs have begun to form. Your baby is still less than the length of your little finger. " -

So that's what Blobkin has been up to. I'm still keeping my fingers crossed that they stick and stay, and get a little bit paranoid every single time I hear someone tell a story about a 10 week miscarriage, or going to their nuchal translucency scan and finding no heartbeat. Obviously, that's my worst fear at this point. I will be really glad to get this trimester over with, and start pushing some serious foetal development. Come on, kiddo. Hang in there!

The husbug and I are due to take a little trip to see the scan-folk soon. My midwife has sent out the forms and we're all ready to go. I plan to ring them as soon as I post this to make an appointment. The first scan is called a nuchal translucency screening, and it basically constitutes a check for birth defects. They take an ultrasound and some blood tests and combine them to give you a "risk factor" for things like Down's Syndrome. The "general population" score is 1 in 3500 (from memory) so if you get a risk score that is significantly high - say, 1 in 150 - you will be offerred further rounds of testing.

Two of those rounds include amniocentesis, and CVS (chorionic villus sampling). Amniocentesis is performed by inserting a hollow tubed needle through the abdomen (yeoooouch! I have needle phobia) and into the amniotic sac to extract amniotic fluid. They then spin the hoohah out of it in a centrifuge, and all the sloughed off cells from El Blobkin are separated out for testing. They can determine if the baby has any birth defects pretty definitively from this test, as well as the sex.

CVS is another fairly invasive test. I know I'm showing my bias there - let it be known that I'm not a fan of overtesting, partly because I hate needles and partly because I think many people are overzealous without merit when it comes to babies and medical stuff (which obviously does not include those with genuine, serious issues who need careful attention). CVS involves a tool being inserted into the cervix so that some of the placenta can be scraped away and tested.

All of these tests carry risk. From Wikipedia:

"Although the procedure is routine, possible complications include infection of the amniotic sac from the needle, and failure of the puncture to heal properly, which can result in leakage or infection. Serious complications can result in miscarriage. Other possible complications include preterm labor and delivery, respiratory distress, postural deformities, fetal trauma and alloimmunisation (rhesus disease). The risk of amniocentesis-related miscarriage is generally thought to be 1 in 200,[2] although a recent study has indicated this may actually be much lower, perhaps 1 in 1,600.[2] In contrast, the risk of miscarriage for chorionic villus sampling (CVS) is believed to be approximately 1 in 100, although CVS may be done up to four weeks earlier, and may be preferable if the possibility of genetic defects is thought to be higher [3]."

My midwife advised me that I did not actually need to attend my nuchal scan, and advised me that it can often be a "gateway" to worry and further, invasive, risky testing. Well, we're approaching it like this: we want the scan, so we can confirm that there's a heartbeat and everything is fine. We also would very much like a picture for our friends and families to oooh and ahhh over (trust me - I have a mother in law who would probably crawl over broken glass for an ultrasound picture, she gets *that* excited about grandkiddies). However, even if the results bring back a high risk score - which is incredibly unlikely, due to our age and health - we're not going forward with any further tests.

After all, what would we do with that information? If I knew my child would be born differently abled, of course I wouldn't terminate the pregnancy. As long as they were able to have some quality of life and engage with their world - even if that's in a different way to others - I'm on board as a parent. So, being advised that my child may have a birth defect is one thing, but having invasive tests that carry risks of miscarriage (among other things) is completely another.

All in all, I'm feeling pretty positive about the scan. I'm just trying to push out negative thoughts and replace them with positive ones. Even if the worst happens, there is little point in ruminating on it beforehand - I really need to cross my bridges when I come to them.

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