4D Growth Scan

Yesterday we decided to do something particularly special and we had a 4D scan at This Is My London Screening Centre in Harley Street. We were a bit sceptical regarding whether to have one done as some clinics don't have trained professionals but my other half being a radiographer, his protective daddy instincts and his connections- we knew they were experts here and we were in good hands. The past six weeks have been pretty up and down so yesterday was, for lack of a better word, AMAZING! Seeing the little nugget did make me feel like the crazy hormonal pregnant lady who will cry at anything but I can honestly say nothing really compares to seeing him and having these videos and pictures. It was also very reassuring that they estimate he now weighs approximately 2lbs (916g) with super long legs (which he definitely didn't get from his daddy).

Looking at his little face, all I can see is a mini version of my other half. I am completely in love. The little nugget was in quite a mood and kept refusing to move his hands away from his face. It was almost like he knew that everyone was watching him. We did manage to get some really adorable pictures though. He had decided to bury his head in the most awkward position but we had the most lovely lady scanning us who was really determined to get us some pictures of his face.

The scan didn't just include getting to see the little nugget being grumpy just like his daddy when he gets woken up. They did a little MOT, checked his growth and the blood supply within the placenta and his estimated weight. They really put us at ease and it has lifted my mood immensely knowing he's okay and getting to see him. Seems like his head circumference and long legs are coming from my side of the family. His abdominal circumference was the only measurement that was below average, which is surprising considering how much I eat and how little fat I've actually put on, saying that I can't really turn to see if my bottom has gotten much bigger in the mirror. So I am sure it is all going to nugget and I just finished a slice of toast with nuttella after having granola for breakfast.

The one thing that did concern me a little was the umbilical artery pulsatility index reading was a little on the low side showing 0.94 where the average is 1.08 (Radiology Key). I think Radiology Key explains it in the best way I have seen so far online. As far as my research has taken me, it is only when reading is above average that this is a sign of possible pre-eclampsia and other possible problems regarding the placenta. 'A low pulsatility waveform is indicative of low distal resistance and high pulsatility waveforms occur in high resistance vascular beds' - Fetal Medicine. So this doesn't seem to be a problem with nugget but I might be picking my consultants brain at the next antenatal appointment!

In the mean time I just can't stop looking at him...

26 weeks today!!!

We have made it to the 26 week mark! That means it's time to reset the countdown and aim for 28 weeks. I was pretty happy today that I also managed to get a sneaky peak at our little nugget again as I had to have a kidney scan following another UTI. He's looking pretty squished in there, he's definitely getting bigger. I did pop into the hospital gift shop, they have really sweet knitted cardigans and jumpers in there. So nugget did get another present today... a little cardigan so he can look stylish next to his daddy.

Nugget did have me a little worried yesterday as he was pretty quiet but it turns out that feeling a bit plugged up, thanks to all the progesterone, didn't make him particularly happy. He was back to his cheeky self today trying to punch through my cervix on numerous occasions after I had several trips to the ladies. I am on the verge of buying a doppler so I can keep track of him. He has been a little jumping bean today though.

To celebrate reaching this far I have decided to treat myself to a little outing with the two special men in my life. I'll be taking nugget and his daddy to the Real Greek this weekend to get some seriously yummy food! The Real Greek is one of my favourite restaurants and just happens to have the most comfortable chairs. It is going to be the first time I'll be going out that isn't a trip to the hospital or twice weekly short walk to the end of the road, so I am pretty excited to be spending some quality time with my boys!

Third Premature Clinic Appointment & Glucose Tolerance Test

Usually I get pretty excited about knowing I'll be seeing the little nugget but today I had the dreaded glucose tolerance test too. Thinking about it, you wouldn't find it too difficult; have a fasting blood test, drink a glucose drink and have another blood test two hours later. Unfortunately for me that involves two things I severely dislike- being hungry and needles. So that meant my 3am snacks were a big no-no, but a good thing for the rest of my household who apparently can hear a cookie packet opening a mile away.

Plitvice Lakes National Park, Croatia with my other half

I did spend most of yesterday wondering how I could get out of the blood test and if it was really necessary. My mum constantly reminds me that all four of her children (including myself) were 10lbs or bigger, considering I'm 5'6 and my siblings are all 6ft and over, I still find it hard to believe I was that big. So the midwife was pretty insistent on me having the test even though my other half is a questionable height which apparently is the optimum; gestational diabetes can result in big babies making for difficult births, heart/lung problems and premature birth (Made For Mums).

I have to say that the blood test wasn't anywhere near as bad as I thought it was going to be considering I was on the verge of a panic attack about it yesterday. They managed to find a vein a few minutes after looking and the needle was in and out before I knew what was happening. I'm so used to them struggling to find a vein and having two or three attempts, I really can't praise the nurses today enough. They did give me lucozade afterwards as the glucose drink, I was pretty happy with myself. I'm a big fan of lucozade and I haven't had a fizzy drink in months. My other half constantly tells me off about my small addiction to fizzy drinks so I was very chuffed when I was given one by a medical professional.

Nuggets presents today

I had my premature clinic appointment in between the two blood tests. The clinic was very busy today because of the bank holidays (the clinic only runs on a Monday). There was good news today, there's been no change in the length of my cervix so we're all quite happy so my next appointment will be in three weeks. I got to see a quick peak at nugget, considering I felt like I was getting punched and kicked all over I was quiet curious to see what position he was in. The little trouble maker has his head down, hands above his head punching my cervix whilst trying to kick my stomach. As the doctor put it the 'superman' position, the doctor could even see his little hand when he was trying to measure my cervix which seems to be staying at about 1.7-1.9cm. So to celebrate a good result we bought nugget a little Elmer teddy and bear hat.

So being 25 and a half weeks today, my best friend has broached the topic of the baby shower! I have to say I'm pretty excited and I have a feeling she has secretly been plotting what she wants to do for a while now. So we're aiming to do it at the end of next month, I'm feeling pretty confident that the little one will hopefully stay in until after then. I should be about 30 weeks by that point. I did find an interesting website about premature births and cervical length. During my 20 week scan I had a cervix of 0.4cm so according to the chart below it would estimate giving birth at less than 32 weeks. The doctors did believe I was about to give birth at any moment at that stage but it's more reassuring to see higher gestational ages. Now that my cervix is about 1.7-1.9 I would be very happy with a gestational birth age of 34 weeks! Only a few more days until we are 26 weeks!

25 weeks + 4 days transvaginal scan of cervix length

Cervical length at 20-24wks (cm)	Mean birth gestational age
1.0	32
1.5	33
2.0	34
2.5	36.5
Source: American Journal of Obstetrics & Gynaecology, June 2000 cited in: http://www.keepemcookin.com

Obstetrics Appointment

As I write this my little nugget is kicking and punching away. Today would have been the day I would be going back to work at college after Spring Break but instead I'm on bed rest and having my first Obstetrics appointment. I did manage a walk around my block yesterday, I was pretty proud of myself and it did feel amazing to get some Sun. The other half practised his photography skills whilst I waddled down the road.




We also watched the episode of Friends where Rachel gives birth. Even though my partner is a Radiographer and can handle all sorts of blood and guts... childbirth is his kryptonite which he's told me repeatedly even before we found out about this little one. I think he might be slowly trying to desensitise himself to the whole process, I'm sure his addiction to youtube documentaries is also helping and he's not just relying on episodes of friends.

It wasn't particularly all fun though, having visited the ladies (maybe for the 12th time?!?) I noticed blood in my urine... having a cervical stitch you know any kind of infection within that area just turns on your panic button. Thankfully my partner is amazing at calming me down. At the obstetrics appointment today there was only +1 leukocytes which is normal in pregnancy. But due to me having some pain around my bladder, some blood and having just recovered from another UTI a couple of weeks ago, they'll be sending a sample to be cultured anyway.

Besides what could possibly be a UTI I have been discharged from Obstetrics! Having a family history of heart problems they wanted to keep an eye on me but my echo and everything came back normal. Even my blood pressure is down, typically I would see 140/90 whereas today I had a reading of 101/61. Apparently, progesterone can assist with vasodilation and it makes sense that could bring down blood pressure. So everything is looking good at the moment, 24 weeks and 5 days, which means it's only a few more days until we're 25 weeks!

I have brought myself to look at the 20 week scan, with everything that surrounded that day I've found it pretty difficult. I am less emotional now but even looking at babies of instagram can set me off. Seeing him just makes me want a video of what he gets up to in there. I know my hospital does DVD's and 4D imaging but I think just having a video that I can see is quite priceless.

Nugget at his 20 week scan

24 weeks today!

I woke up this morning to see this!
Along with quite a few messages of support
and love

So we have made it to 24 weeks today! The past four weeks have been full of lots of fears, tears and hospital appointments. I'm really proud of my little family for what we're managed to get through together and how amazing my other half has been driving me to and from the hospital at all times of the day and putting up with these crazy hormonal mood swings. So it's time to reset the countdown and see if this little nugget will be patient enough to reach the 26 week mark.

In babies born preterm, the chance of survival at less than 23 weeks is close to zero, while at 23 weeks it is 15%, at 24 weeks 55% and at 25 weeks about 80% (Tommy's Organisation). For every week that he decides to stay in there cooking his chances look better and better. So I am quite happy to just try and plump him up as much as possible until then, however much his also impatient daddy wants to meet him (I say this whilst eating a Viennese swirl after finishing a bowl of grapes). I am starting to wonder if I am just producing a new improved version of my other half.

One of the things that has bothered me since having my cervical stitch placed was the fact that they kept referring to a 'miscarriage' if anything were to happen. That means that no birth certificate would be given. Now that we have reached 24 weeks my little one is now considered 'viable'. I know these are technical terms and the reasoning behind them but it is comforting to know that his birth will now be recognised. Not all ladies are this lucky. Scrolling through the internet this morning I did find this petition-

https://www.change.org/p/department-of-health-uk-allow-registered-birth-certificates-for-children-born-from-20-weeks

Even though the likelihood of a baby born before 23 weeks surviving is greatly reduced, I think it is important that these births from 20 weeks are acknowledged. Especially with babies born much earlier than 24 weeks surviving. During week 24, according to the baby center, the little ones taste buds are forming and the brain is growing quickly. So that means whatever I'm eating, those chemicals and theoretically tastes are being passed to the amniotic fluid for the little nugget to take in. Now if my other half figures this out I feel he'll be force feeding me chicken so he can have a food buddy and also an excuse to bring home buckets of chicken wings.

Last night I visited the ladies two or three times... I believe my bladder is now the size of a walnut!

Second Premature Clinic Appointment

Yesterday was my second appointment at the Premature Clinic. The clinic is only run on Mondays so it is pretty busy but it's reassuring seeing other woman who have had a stitch placed and have had similar problems. The clinic also has a board of photos and thank you cards, it's really nice to see how many ladies have kept in contact years later and how many babies have made it through.

I am lucky enough to have my mum who came to the appointment with me, my partner was literally messaging every few minutes from work to check on his little boy. Thankfully my mum is a lady who tries to lift the mood in all circumstances. The atmosphere isn't great in the department however much effort the staff put in to make it welcoming and calm, a bunch of pregnant ladies worrying about their babies doesn't really do much for morale. Especially when not many of us can sit down comfortably for more than 10mins due to the stitch.

I did find myself comparing bump sizes with every lady that walked in. You do find yourself empathising with bumps that don't look much over 20 weeks. Thinking about how I felt 4 weeks ago, this is definitely the hardest and most emotional thing I have ever done. One of the consultants had also put out a new little booklet about success stories of babies born at 24 to 26 weeks. It did make me feel more confident especially as I'm 23 weeks + 5 days today! I'm pretty sure I need to buy a big present once I reach 24 weeks.

So the news... Previously I had 15mm of cervix below the stitch and 21mm above the stitch. I now have 17mm of cervix below the stitch and above the stitch has opened with funnelling. Now the doctor wasn't concerned about this as the stitch was holding and I still had length below it. I felt like it was a step backwards especially when I heard the dreaded term- funnelling.

Little nugget is happy though, kicking away as usual, completely oblivious to how stressed he makes his mummy. He decided to move head down for the scan which is unusual for him as he really takes great enjoyment in kicking my cervix as hard as possible. I am actually starting to think he uses it as target practice, the similarity between him and his father is funny.

Even though I wasn't particularly happy with the length of my cervix, the doctor did an estimate of how big our little nugget is. Considering all my family were big babies- my mum is constantly reminding us of how we were all over 10lbs. I was quite curious to know how nugget was doing knowing how the bigger he is the better his chances are. His measurements gave an accurate 23-24 week gestational age but he weighs approximately 1.5lbs (660g) which puts him at the weight of a baby at 24-25 week gestation.

So the little one still has some way to go. I'll be back in the Premature Clinic in a fortnight again to check if there's any difference. If things get worse there is talk of starting to get ready for baby making an early appearance, in that case we'll be admitted into hospital and will start on the steroids to get his lungs ready. Until then the focus is going to be on what to name the little trouble maker.

My Incompetent Cervix Symptoms

Considering this is my first pregnancy I didn't really know what to expect in terms of all the changes that were happening. As the Bump website states there aren't many symptoms with an incompetent cervix. I did however question some of these changes- mainly that I did feel a lot of pressure pushing down on my cervix and I did have a lot of very sticky clear discharge which I felt was quite unusual. I had read lots of websites that this type of discharge was completely normal and that you would expect to have an increase in the amount of discharge over the course of pregnancy. Since having the cervical stitch there has been very little of this clear sticky mucous compared to before when it was very noticeable. I didn't experience any bleeding, cramping or back pain.

Date nights have been replaced by giving my pregnancy pillow some serious TLC

The causes of cervical weakness can be put down to having an abnormal smear, cervical trauma with a previous pregnancy, previous operations that require a D&C or congenital conditions. Thankfully none of these apply to me besides the last category. The Mayo Clinic includes a really good connection between genetic conditions and cervical incompetence 'genetic disorders affecting a fibrous type of protein that makes up your body's connective tissues (collagen) might cause an incompetent cervix' which I feel having read a number of websites none really address. Ehlers Danlos Syndrome (EDS) is a condition that affects the production of collagen. It is also the condition my family suffers from.

Some facts about EDS...

I do alternate between feeling quite confident in the stitch to quite angry that my cervical length wasn't monitored as soon as I mentioned my EDS. During my first midwife's appointment it didn't take long before it was decided I needed to see a consultant. To be fair when seeing the consultant they were too preoccupied worrying about a heart condition developing, issues with my kidneys and a history of gestational diabetes in my family. I did raise my concerns of my cervix due to my EDS with the consultant, she said she would liaise with the premature clinic and it wasn't something to worry about until after 6 months. It has now been 17 days since my cervical stitch and I am 22 weeks + 4 days today.

22 weeks + 4 days today!