There are 2 parts to this screen, the first is a blood draw where they look at the levels of hCG and PAPP-A that the baby is making (abnormally high or low levels are typically scene when the baby has a chromosome anomoly) and then they do an ultrasound to measure the gap in the back of the baby’s developing neck and also look to see if the baby has a nasal bone. Babies who have a larger gap in the back of the neck and no nasal bone present at week 12 might have a chromosome issue. If something appears out of the norm in either portion of this screen, the doctors will give you what they are guesstimating from these 2 portions are your “odds” of having a baby with a chromosome issue and encourage you to have an amniocentesis to find out, with much higher accuracy, if this is the case.
On our first meeting with the MFM doctor we informed her that we had done CGH testing on our embryos which gives a full report of all 23 pairs of chromosomes on every one of our embryos (unlike PGD and PGS which only looks at a handful of pairs so you could still have a baby with a chromosome issue using those forms of tests). Since we know what we transferred was 46xy (23 complete sets of chromosomes) there was no reason to fret that our baby would have a chromosome issue which is the main thing this first trimester screen is looking for. When we told her this last month she had suggested skipping the blood work portion of the first tri screen (why subject yourself to odds and stress when you know your baby’s chromosome count already) and had suggested instead to just do the ultrasound portion where SHE PERSONALLY would do an indepth look at the brain, spinal cord and heart to help set our mind at ease about congenital defects and especially neural tube defects due to what happened with Ava.
We of course thought this was a fabulous idea. However between that appointment and friday’s appointment all of that shit was clearly forgotten. When we arrived, the tech NOT THE MFM DOCTOR) was an hour late doing our ultrasound and then spent 20 minutes of what I thought was her looking at the brain but then realized it was just her trying to get a good angle to measure the gap in his neck-before saying “I’m not sure of this measurement, let me grab the doctor” and left the room. I looked at my husband like “what the fuck is going on in here” when the MFM doc walked in. She then proceeded to immediately take 3 measurements of the gap in his neck (roughly 60 seconds) and then turned the machine off and said “he looks super, has someone already taken your blood today?”
At this point I wanted to punch her in the face, but being half naked kinda takes all of your authority away. I angrily remind her of our first meeting, and what her plan was for today and told her we were here to have YOU look at our baby to see if YOU could spot any early signs of NTD’s. She then said “he looks healthy, I don’t see anything”-not because she went back in to look again-merely to placate me. She then asked if I had any questions-and even though I had a half a dozen about the tapering off of progesterone and steriods, as well as the glucose in my urine test from my OB’s that I had them send to her to see if I needed to do a 3 hour glucose tolerance test or if she thought the steriods might be the cause, and monitoring of my cervix over the next 3 weeks to rule out incompetence-I quickly said “no, I need nothing further from you” and got up to get dressed.
Our baby has a nasal bone. Our baby has a gap in the back of his neck measuring 1.2mm. Our baby doesn’t have downs syndrome-but I knew that before I even knew I was pregnant. He is measuring a couple days ahead-coming in at 12 weeks and 3 days with a heart beat of 172bpm. It didn’t look as if there was anything wrong with him so for now we’ll have to say he’s perfect.
I am keeping EVERYTHING crossed that on Tuesday, when I meet with my local OB who had to do my D & E with Ava 2 years ago and tell her what has happened since then, that she might find it somewhere in her soul to dig out a little compassion and perhaps treat me with the care that I deserve. Her nurse didn’t bother wasting an hour of my time last week while doing my intake interview telling me how to behave while pregnant and just said “I’m sure you know all of this, I will put all of this in this folder and you can look at it, or throw it away if it stresses you out.”
Now I am not sure if that is because after I handed her my printed out pregnancy history and detailed medications list and she stared at me in disbelief so I simply stated-“when you have seen so many doctors and nurses and no one remembers your history and can’t seem to locate my files regardless of how many times I’ve sat in front of them, it gets emotionally exhausting having to talk about my dead babies over and over again so I find it easier to just print this out every time I meet with one of you.”
Her response was “I can’t imagine, but it must be hard”-to which I responded “yes it is, especially when your front desk just DEMANDED that I pay the 10% deductible TODAY for a global delivery fee of a baby that isn’t due to come until July-when I honestly believe right now I have a better chance of waking up in July with my face sewn to the carpet than walking out of here with a live healthy baby. I am taking this pregnancy 1 day at a time and just hoping to find a doctor who will listen to my concerns, and remember who I am, even if that means they just have to read my file before walking into the room with me. I’m not like everyone else in your waiting room, I dare say I am probably unlike anyone else in your current practice-all I ask is that I am treated that way and not like the masses.” The nurse didn’t say much, which is fine, I would prefer that. Now let’s see if she communicated any of this to the OB. Here’s to hoping that Tuesday’s appointment will be unlike any that I have gone through thus far.