Tuesday, August 21, 2012

Ultrasound and Perinatology Appointment

Today Aaron and I had another level 2 ultrasound to get another look at Natalie's NTD and check on the hydrochphelus. Everything looked good with Natalie. The fluid is still building up in hear head, which is to be expected and the cerebellum is pulled down further into her spinal column, which is also normal. Last time Natalie was still so little that it was hard to get much of a look at her spine. Today they were able to view it really well. Last time they did not view much of a menengocele (sack of fluid at the point of the defect) and today they were. The perinatologist said it is not a huge protruding sack, but it is noticeable now. Everything else still looks great with all her other organs.

Here are a couple shots from the ultrasound:



After the ultrasound we were able to talk with the perinatologist about the delivery and how this is all going to come together. This is what we discussed:

What date are we looking at for the c-section? What time of day? When will it be scheduled?
It looks like October 31st is the best date right now. The perinatologist who I have been seeing is the head of the department and apparently either wants herself or one other doctor to deliver Natalie. She doesn’t want to schedule the section until after I am 39 weeks along but not too close to my due date and the neurosurgeon wants it to be in the beginning of the week, so this leaves very few options. I guess she is schedueled for l&d for Nov. 4th which is a Sunday and too close to my due date. The other doctor is on schedule for the 31st… so that is when she prefers. The genetics counselor who handles our case sent a message to the neurosurgeon to see if the dates are okay for him (since he will need to come evaluate Natalie on the 31st and then do her surgery the following day.) If he is not okay with this date, then it goes back to the perinatologist who will give a couple other dates, back to him for approval until we have everything scheduled. I was really not expecting to hear that she would be delivered on Halloween, so I am a bit shocked and disappointed at the moment. We won’t know the time of day until everyone agrees on the day and then it will be in the books. I am supposed to hear back tomorrow. We’ll see.

How long will I have to be admitted?
It depends on how my recovery goes. She said some women get discharged 2 days after surgery others need to stay longer. It just depends.

How much will I be able to be in the NICU with Natalie?
Because I will be a patient, I will have to have my vitals checked multiple times a day, be in my room for rounds, and all that stuff. So, I may not be able to be with her as much as I would like until I am discharged.

Will we need to do an amnio to check lung function before delivery?
No. The plan is to not deliver until 39 weeks so Natalie should be fully developed. If, for some reason, she is going to have to be delivered early and it was before 37 weeks, then they may do the amnio to check her lungs. Otherwise, no.

What is the contingency plan if she starts to come early or if I develop complications?
If I go into active labor I am to go to a local Kaiser to be checked. Then, if there is enough time, they will transfer me via ambulance to Roseville.

How often will we need to be back here for monitoring?
Not at all. There is nothing that could happen with Natalie in utero that will change their plan, so there is no more need for monitoring from the perinatologist.

We talked to Dr. McNatt about delayed cord cutting and he said it is fine with him. How do we accomplish this with a c-section?
It is fine for us to do delayed cord cutting provided there are no complications with Natalie or my health that require them to cut the cord earlier. The example she gave was if the placenta was cut or something like that. She said they will allow only 1 minute before cutting the cord, which I guess is better than nothing. I believe she said they will actually lay her on my tummy.

Can Aaron cut the cord?
No. It is a sterile field that he will not be allowed to go into.

Can I have Aaron and my mother in the OR? Or when Aaron leaves to go with Natalie can my mother then take his place?
Only one person can be in the room at a time. So, when Aaron leaves for the NICU with Natalie my mom can come in, but they cannot be in the OR at the same time.


  1. Oh Robin, I have such a burden for your precious little girl! Sitting here reading your post and just crying and praying for her. I just wanted to let you know that I am believing for God to totally touch and heal her and repair the neural defect! So be encouraged and have faith: nothing is impossible with our God!!! Love, Sharilyn :)

  2. Robin - It's Janelle from APA. I have been thinking of you and Natalie a lot. I just wanted to let you know a little of my experience with Tyler. I had a c-section with him and I was usually able to get up to the PCTU (heart kids NICU) about 2 or 3 times a day while I was still admitted. I did have c-section complications & I was on magnesium so it made it harder for me to go up there. I hope that things go much smoother and you will be able to be with Natalie more often. Sending lots of love your way. *hugs*

  3. Hi Robin! You don't know me but I have been following your story on APA for years and I just realized that you and I live in the same area. I am not sure if you are delivering at Sutter Roseville but I just want to share with you that they have an EXCELLENT NICU. My youngest was in there a few days after my c-section and the care was stellar. My oldest was in the NICU up in Washington State and it was awful so this was a welcome surprise. Praying for all of you and knowing that God's grace and mercy will continue to rain down:)