~ A Long, Scary Week
In one week the babies have progressed in size, changing from red to green cabbages. A singleton should measure just over 16 inches and weigh 3.5 pounds at week 31. At this point in a twin pregnancy, the babies growth rates may begin to slow compared to singleton growth rates as space becomes more limited in utero.
And here's this week's belly picture. It's definitely not taken at home in the nursery. I'll explain more in the next section. (And there's a lot of detail . . . you can read it or not.)
Oh, Right. A High-Risk Pregnancy.
Week 31 began with me going to my OB's office for a routine growth ultrasound. Baby B weighed in at 4.09 pounds and Baby A was 3.45 pounds. Both babies were active with great heart rates.
While at the doctor's office, I discovered I failed my 3-hour glucose tolerance test from the day before and was diagnosed with gestational diabetes. I was really disappointed with this news. Having to change my eating habits and to monitor my glucose levels four times a day sounded like torture. But I had to keep telling myself that this would be a temporary situation. And I would do anything for the health of these babies. That evening, I began having frequent Braxton-Hicks contractions, at least 5 an hour if not more. I decided to go to bed and rest to see if they would ease up.
The next day I was on my feet for most of the morning. I took a break for lunch and then was on my feet again for grocery shopping. By the time I got home I told Karl that my contractions were back, this time with more frequency and intensity.
My OB told me to go the Birthing Center to get monitored. "It's probably nothing but we want to be safe." So off we went. A cervical exam showed no signs of dilation or softening. I was hooked up to heart rate and contraction monitors (as seen in above picture) and given some medication, procardia, to slow/stop the contractions. Two rounds of oral medication later and the contractions showed no signs of slowing.
Another cervical exam showed that my cervix was "fingertip" and softening. I was then given an intravenous magnesium drip to delay preterm labor so I could receive steroids over 48 hours to aid in fetal lung development in case the babies had to be delivered this early. Receiving the initial "mag" drip dose was an unpleasant experience. And because the drug affects your muscles, I was unable to eat solid foods or leave my bed. I did get to wear some nifty compression boots. And I watched a lot of bad television.
Still on the mag drip and contractions appear to have stopped. I was also receiving penicillin because I never had my Group B strep test, usually given during weeks 35-37, to determine if I was positive for this bacterium. The antibiotic was given as a precaution in case the babies had to be delivered early. Another growth ultrasound was performed to examine the differences in twin growth (yet another concern). The babies were active with normal heart rates. I was given my second shot of steroids -- did I mention this was a 2 ml injection administered with a VERY LARGE needle in the rear end? -- and left alone for the night.
No more mag drip! I could get up and walk around and eat solid food! I didn't even care about having to eat diabetic food -- I could CHEW! I was in serious need of a shower around this time.
And the contractions came back. Another cervical check showed that I had dilated to 1 cm and my cervix was starting to thin. I was given procardia again, every 4 hours, to try and slow the contractions.
Still having contractions. I was given a shot of terbutaline to help slow them down. After discussing details with the OB on call, Karl and I decided to be transferred to Roanoke where there's a Level III NICU and maternal-fetal medicine specialists in case these twins wanted to make an early appearance. I got to take a bouncy ride in the ambulance.
When I got to Roanoke, it was about 7:30 or 8pm. I didn't have anything to eat since lunch at 1:30 or anything to drink since leaving the Birthing Center. But I couldn't receive anything until I was checked out by several groups of doctors and in case a C-section surgery was in my future. Once again, I was put on a mag drip. This time, the initial dosage seemed 100 x worse than the first one. I felt like my entire body was on fire. Karl put ice cold compresses on my forehead and chest and it felt like steam could rise from them.
An ultrasound technician came into the room to get detailed measurements for the specialists. She began her scans at 11:30 and didn't wrap up for two more hours. I slept through a lot of this.
No more mag drip! Food + water + shower = feeling human again! And I woke up to this great view from my hospital room window.
Still, I'm not to be released for at least another 24 hours. Doctors wanted to monitor me and the babies off of the medications. The results from the latest ultrasound showed Baby A at 2.8 pounds and Baby B: 3.6 pounds, or a 22% discordant growth difference. The specialist didn't think this difference was cause for concern. Baby A is now breech and Baby B is vertex. Looks like a C-section is in my future. Also, my cervix was still 1 cm dialated and now 50% effaced. Let's hope I stay this way for weeks and weeks!
Home! I'm on limited movement. For all of my complaining about being practically tied to a hospital bed, I was scared to leave in case something happened again. But nothing beats having the comforts of home. Karl took great care of me. He forbade me from cleaning or doing much of anything except resting. I'm still having contractions but not with any regularity. And I'll have more doctor visits and non-stress tests in the weeks to come. Here's hoping for no more complications!
Babies, you did an AMAZING job this past week! One of the Roanoke doctors said it was remarkable how well you two did throughout all of the poking, prodding, medications, stress, etc. Every nurse commented on how active you both were. Baby B, you need to make sure you give Baby A some room. We know you love the limelight but Baby A needs room to grow. And Baby A, now that you've moved lower . . . your little kicks and punches aren't so cute anymore but I still love you. Both of you, please feel free to hang out in the uterus for several more weeks. Dad and I love you both.