36 weeks 4 days

This will, most likely, be my last post here before our little runt arrives. That is his new nickname. Runt. I'll get to that, trust me.

My blood pressure is doing okay. I guess I would call it stable-ly elevated. I've pretty much stayed in the 149/90 range for the last few weeks without many problems. The persistent headaches continue, and swelling has increased drastically, but the perinatologist has assured me that it's fine.

My blood sugars, which have been elevated recently, have dipped back down to acceptable levels, which makes me wonder if the placenta's integrity isn't an issue now, but that doesn't even really matter now, because our baby will be here Tuesday. His eviction noticed was signed nearly a week and a half ago.

He's repositioned himself back head down, and I have dilated to 2cms thus far, so we are continuing with our induction, rather than a Cesarean at this point in time. However, given baby's current condition, that could still be our end result, unfortunately.

Amnio fluids are still measuring high. Higher, in fact, than they have been. Initial levels that I was aware of were 18cm. A week later, those levels were down to 16cm. They have since increased to 21cm. Too much further beyond where we are now is dangerous and calls for immediate delivery at this point in pregnancy, however, his eviction notice has already been singed, so it's moot at this point.

As of my last posting, at 34 weeks, our baby was measuring 4lbs 3oz and was just under the 10th percentile (9th) for his gestational age.

As of yesterday, 36 weeks 3 days, our baby's growth curve has dropped even further than where it was previously. His estimated weight is between 4lbs 8oz and 4lbs 11oz. His abdominal measuring puts him below the fifth percentile (4.85th percentile). His head measurement was in the 6th percentile and his femur measuring was just below the 3rd percentile. Overall, they consider the abdominal measurement the one to watch. At the 3rd percentile on an abdominal measurement, they would want to deliver immediately. At this point in time, our baby will most likely NOT be breaking the 5lb mark. He is truly the 'runt' of my children, who have all weighed in at greater than 8lbs 6oz.

This particular ultrasound was done in the OB's office, and in my experience, they have a tendency to give 'extra' and over project compared to the ultrasounds that I get at the peri's office. Anyway, after my OB got the report, she literally dropped everything and walked out to go do a phone consult with my perinatologist. He is going to see me tomorrow (Friday) for my regular visit, where I will have another growth ultrasound to basically do the BPP we always do, and to confirm the accuracy of the ultrasound that I had Wednesday with the OB. The perinatologist assured us that it was safe to wait until my already scheduled induction on Tuesday morning. He said he actually prefers to wait until 37 weeks gestation strictly for lung maturity's sake if at all possible. As long as I am stable, and baby is scoring 8/8 on his BPP's and NST's it's okay to wait. The OB said, she'd have LIKED to take him Wednesday, and absolutely would have, had the Peri not assured her that it was fine to let me go a few more days, at the very least, to my appointment with him Friday. At which point we will be re-evaluated with the new ultrasounds and tests, to make sure that we can make it through the weekend. He will let her know if someone needs to see me on Monday or not, or if my induction needs to be bumped up to Monday morning instead of Tuesday morning. Unfortunately, inductions are not done at hospitals around here on the weekends, otherwise I would be going in on Saturday night. My mom flies in from Seattle and arrives in Austin on Saturday at 4:30, so that is the earliest that I would be comfortable doing it, unless it was an emergency. Technically, it's not emergent, but it is a very fine line that we are walking right now....and dare I say, my balance is not that great!!!!

I think the only GOOD news we got this week was that my Group B Strep test came back negative, so I do not need to spend four hours hanging out getting IV antibiotics.

I have been advised, that in the event that my water breaks between now and Tuesday morning, at 5am, that I am to immediately go to the ER so they can take me up to labor and delivery. I am not allowed to wait around and see what happens due to the fact that baby is so small, that he could, quite literally, arrive in one unintentional push. Scary to think, due to the fact that if my water DOES break, I'm going to be pretty well dilated at that point, and without the epidural to slow my labor, and his size, I could very likely have a delivery even more rapid than my third was. From the time my water broke with him, until he was out, it was an hour and 46 minutes. I have to get down three flights of stairs and make it the 20 minute drive across town without delivering in the suburban LOL

Currently, we have about a 90% chance of needing to be transferred to another hospital upon delivery. Our hospital does not have a NICU, but they are equipped to care for babies at 35 weeks with no issues. The neonatal pediatricians and nurses that work in our hospital actually circulate between the local LEVEL 2 and LEVEL 3 NICUs in our area. With our hospital though babies having lung problems have to be transported. At 37 weeks, we won't know until he's here without an amniocentesis, what his lung development looks like. Also, babies having low blood sugar issues also have to be transported. Given my diabetes, he most likely WILL have blood sugar issues.

Babies needing transportation, go to one of two hospitals. Dell Children's, meaning he would have to go by himself until I'm discharged, due to the fact that they do not have maternity suites for moms, or Seton NW, meaning we BOTH would be transported together, because they DO have maternity suites for moms. My OB assured me that she would do everything in her power to have us sent to Seton NW in the event that we have to transport so that we can stay together. Especially since I breastfeed exclusively and we both agree that breastmilk for babies is THE BEST thing, especially in premature infants and infants with issues such as our baby has.

Overall, I'm absolutely terrified. I wish it was Tuesday evening already. That our baby was here. That all the hard decisions had already happened and we could just get the show on the road already. I have thrown myself into researching IUGR and have read everything that I possibly can so far, something that I continue to do. IUGR babies struggle for YEARS to catch up with their peers, which is discouraging. The only encouraging thing that I've read so far is that IUGR babies tend to thrive REALLY well once they are born. They are used to living in a hostile environment and once the strain is off of them, they just do really well!

We will not know until after delivery what the actual cause of the IUGR is, and we really might never know. The most targetable thing we can settle on right now is the fact that my diabetes and my pregnancy induced high blood pressure are both known causes of IUGR. Other possible causes in my case are thing like chromosomal abnormalities, something that we did not test for. Or placental abnormalities, something that we will not know until we see the placenta and possibly have it analyzed.

Anyhow, one way, or another, the newest addition to our family will arrive some time on Tuesday at the latest.

I'll leave you with this....it's a side by side picture of my youngest son, and the new baby. They look so much alike, at this point, that they could be twins! I can't wait to see how the runt compares to his brother once he's here.