In the Hospital

On May 10 we went in for a routine ultrasound and found out that my amniotic fluid levels were low (AFI was 5.5).  Low AFI can happen with gastroschisis pregnancies, especially in the third trimester, and mine had been fluctuating for weeks despite drinking tons of water.  My perinatologist told us that I needed to be admitted to the hospital immediately.  We knew things could be serious when he made a point to tell us to go straight to the hospital and not to go home first.  The main concern with low amniotic fluid is that the baby could compress her cord or go into distress during contractions since there is less fluid around her to act as a cushion.  When I got to the hospital, they inserted an IV and hooked me up to a fetal heart rate monitor to see if the baby was showing any signs of distress.  I was 30 weeks pregnant, so the neonatologist from the NICU came in to talk to us about what to expect if she was born early.  Knowing that I could be wheeled into the OR at any moment was nerve-racking, to say the least!  But we did our best to stay calm and roll with the punches.

Fortunately, the Littlest Warrior didn’t seem to understand what all the fuss was about.  She was quite stable and showed no signs of distress.  In fact, the nurses and doctors kept commenting on how “beautiful” her monitoring strips were and what a happy, active baby she is.  It was SUCH a relief to see that she was doing so well!  The next day brought even better news – my AFI had gone up to 8.0.  However, the doctors wanted to see it at a 10 or a 12 for several days in a row before they felt comfortable sending me home.  Three days later I had another ultrasound and my AFI was back down, this time at 4.9 (less than it was when I was admitted to the hospital!)  That was a rough day… I think that’s when it really hit me that I could be here for a while.  After that they measured my AFI every 2-3 days and got 4.7, 5.5, 5.9, and most recently, 7.4.  So… I continue to be at the hospital and, barring a miracle, will most likely be here until the Little Warrior makes her grand debut into this world.  

But that’s okay.  Although I’m really homesick and getting a little stir-crazy, there’s no denying that it’s a relief to be here because I know that I’m in the best place I can be if anything goes awry.  I feel like I can let go, relax, and enjoy my new full time job as an Incubator.  Gastroschisis babies have a slightly increased risk of stillbirth, so this is truly the best place for the Littlest Warrior to be right now.  I feel like if I were at home, I would be constantly worrying and wondering what’s going on in there. 

The best news throughout all of this is that that Littlest Warrior continues to perform like a champ during her monitoring sessions.  There are two primary indicators of fetal well-being that they look for: variability and accelerations.  A fetus’ heart rate is much faster than ours, ranging from about 120-170 bpm, and is constantly going up and down.  This variability is an indicator of neurological function, so the more ups and downs the better.  They also look for accelerations which show that the baby’s heart is reacting to her movements.  So basically, you want the heart rate tracing line to be super squiggly with a lot of humps.  As you can see, the Littlest Warrior is quite the overachiever in both categories.  She is also very active, especially late at night.  Apparently that’s when it gets craaaaaaazy down in Club Uterus.  

Fetal monitoring strip with baby's heart rate on the left and contractions on the right.

Right now the doctors and nurses couldn’t be happier with her monitoring results.  Every day they comment on how happy she is and how she doesn’t act like a baby with low fluids.  Usually babies with low fluids don’t move around that much, have frequent decelerations (bpm < 100 for an extended period of time), and have constant heart rates with little variability.  These are the most common indicators of fetal distress.  As long as the Littlest Warrior keeps up the good behavior, they’ll continue to allow her to cook, which is THE #1 priority right now.  She will already have a lot to face when she’s born, and we would like to avoid adding prematurity issues to that list.  The doctors would really like to see me get to 34 weeks, which they said is golden as far as prematurity is concerned.  We’ll hit that milestone this Saturday!!  Then they’ll see how much farther they can get me before I go into labor or they notice something that would warrant delivering me.  The next big milestone will be 36 weeks, when the baby would no longer be considered premature.  At 39 weeks she will have reached full lung maturity, so it is unlikely that they will let me go farther than that.  So… we play the waiting game, knowing that each and every day she’s inside makes her a bigger, stronger Littlest Warrior.

Day 1 in hospital

Day 4 in hospital

My favorite hospital buddy, always by my side. :)