May 7 - 23 wks

I had my weekly ultrasound and appointment with my MFM doctor today, and it has been another good week! :-) My cervix is still measuring very long and holding up very well. Every week that I go in and hear good news I feel less "fragile" and so much relief. My next appointment is Thursday May 15th at 8am. Now onto the other half of this battle...

Next week will be that big 24 week mark. This is a milestone because for one it is considered the point at which the baby is "viable" and everything could be done to give him the best chance at life if he were born, and number two, it is the point at which we really start to follow this antibody issue a lot more closely and possibly start to see more changes than we have in the past. Over the next week we will be getting the results of two different blood tests, one from Andy and one from me. Depending on the results of those tests, I could POSSIBLY be having an amniocentesis perfomed at next week's appointment. For you medical nerds (like me, lol) we are looking at Andy's blood to see if he is heterozygous or homogygous (called phenotyping) to determine if the baby has any chance at all of not being positive for the antigen (which is what we want, for the baby to be NEGATIVE). We already know Andy is positive for the antigen (called Duffy), and if he is HOMOzygous then he will undoubtedly pass on the positive to the baby, but if he is HETEROzygous, then the baby has a 50/50 chance of being positive or negative. Since I am negative for it, then we want the baby to be negative so there is not an incompatibility between my blood and the baby's, and therefore my blood would not attack the baby's blood. If there is a chance that the baby is negative, then there is only one way to find out and that is through amnio. However, we are also looking at the level of defense my blood has built up (called a titer) to see how necessary it is to find out more information about the baby's blood type. So far my titers have not gotten too high with the highest result to date being 1:16 (or 16). Depending on the results of my next titer draw, if it rises and by how much, then that will determine the level of need for the amnio. One other aside: Although amnio will give us the baby's blood type and give us other useful information on how well the baby's blood is tolerating being in an oppositional environment (if that is indeed the case), there is another less-invasive way of monitoring any affects on the baby's blood. It is called an MCA (middle cerebral artery) and is done by transabdominal ultrasound, where the blood flow in the baby's brain is measured. This number is called a PSV (peak systolic velocity) and is input into a calculator that measures it against the median (I'm assuming average) number for that gestational age (weeks of pregnancy). I am putting a link into the sidebar for this calculator. Anyway, however far off from the median the PSV is, called MoM (Multiples of Median), is the key number we are looking for. We want for it to stay under a MoM of 1.5. Just FYI, the baby's PSV today was 35.4, giving us a MoM of 1.2. So, as a means of having a less invasive way of testing the baby, we are continuing to do the MCA's every week, and could possibly not need to resort to the amnio if that's what the doctor decides. It will all depend on my titer numbers for the most part, but knowing if the baby has a chance of being negative/is negative for the antigen is very useful, too. I think after this week I will start having my titer drawn every 2 weeks instead of every 4 weeks, as well. Probably way more information than you ever wanted to know about all of that, but I enjoy getting it out there. If I can explain it to someone esle, then I have a better grip on it myself!