MFM Appointment: Legitimately Good News

Despite a super-long wait, my Maternal-Fetal Medicine appointment yielded a host of good news. There continues to be no new bleeding, I'm not contracting, the baby is very active, etc. Here were the main talking points:

- The baby's fine, looking ever-so-slightly larger than average in most measurements, which is good because if he does have to come early we want him to be as big as possible.

- My cervix is still long and closed. They were baffled that I was worried about a measurement of 35mm and said that there was absolutely no reason to be concerned.

- There are still no placental abruptions or sub-chorionic hemorrhages. Thank goodness!

- They did a fetal echocardiogram just for funsies and it was very normal and very boring.

- Are you sitting down? :::pause::: How about now? Okay, so get this: on their very detailed ultrasound machine, looking transvaginally for the most accurate view possible, my placenta is 1 cm away from my cervix. That means it's not a previa anymore.

Whoohoo! Break out the sparkling cider, everybody! Except that means we don't have a good reason for the bleed anymore. I was really leaning toward my OB's guess that it was just the usual previa complication and staying as quiet as possible would help avoid it happening again, but now we're back to square one in terms of unraveling the mystery. My MFM doctor said that he would bet it was somehow related to the original hemorrhage, but also said that there are a million reasons that women bleed in pregnancy and the important thing is that we don't see anything worrisome on the scan right now. This doesn't mean I can start doing back handsprings in celebration (ha! Back handsprings, that's a good one. I think the last time I did a cartwheel was in 1996, and I didn't exactly stick the landing) but it's all good news. It also means that I'm back on the lowest dose possible of Lovenox effective tomorrow morning, yippee.

One more thing. You know how I had unexpectedly lost five pounds as of Monday? On MFM's scale, I had actually only lost two. The nurse said that it was probably just normal variation and I should keep doing what I'm doing. In other words, perhaps I shouldn't have made this Mocha Icebox Cake yesterday? Oh well. I make no apologies. It's delicious!

OB Appointment: Still Hanging On

Yesterday's OB appointment went about as well as expected. Overall, I'm not experiencing any new bleeding, my cervix remains long and closed, I am not contracting, and the baby (yes, everyone needs to say this as soon as they start the ultrasound) is "very active." My OB's best guess about what happened is that it was related to the placenta previa - after all, painless bright red bleeding is the classic presentation and in the pre-ultrasound days it was evidently how they found out about previas. She thinks that the placenta probably bled a few days ago internally, it formed a clot, and then the clot made its dramatic escape on Friday night. She also said that stopping the Lovenox was the best thing I could have done right now.

So it was a good report, overall. However, there were still some things that were ever-so-slightly worrisome:

- Finally, someone did a transvaginal ultrasound to measure my cervical length. They could see it pretty well transabdominally, but I knew it wasn't an accurate measurement, and even though I have no risk factors for Incompetent Cervix, of course I'm worried about it. The good news is that the transvaginal ultrasound confirmed that my cervix is "long and closed." The bad news, according to this chart, is that my 35mm long cervix is still below the 10th percentile for singleton pregnancies at 21 weeks. I know, I know, it could be so much worse. And it seems like most OBs consider anything above 25mm to be fine. But now I've got that on my mind, too.

- The transvaginal ultrasound, even though it was as gentle and noninvasive as possible, dislodged enough of the bleed that it started up again. (That's why you apparently never want to touch a cervix with placenta previa - even a small amount of activity can disrupt the fragile blood vessels right above it.) It was pinkish-brown and I actually showed some of it to a nurse on a tissue after they told me to clean myself off and she said it was nothing to worry about. Still, for the rest of the day, every time I went to the bathroom, there it was. The mental torture of seeing more blood was the worst part of yesterday, because I just kept waiting for it to turn into a full-on hemorrhage... even though it didn't.

- Finally, here's one for you to puzzle over. Yesterday the intake nurse who did my blood pressure and my weight (and obviously hadn't looked at my chart) said "Oh, looks like you've lost five pounds since your last visit, congratulations!" To which I replied, "Um, I'm actually pregnant... aren't I supposed to be gaining weight?" Awkward pause. I then had two separate nurses as well as my doctor ask me, all polite concern, "Are you eating?" And my response was yes! Yes, I am eating! I had a burger for dinner last night! I haven't had any morning sickness in weeks! I'm lying around on the couch all the time doing as little exercise as possible! My bottom should be the size of Brazil! How entirely bizarre. I mean, at any other time in my life, my reaction would have been - unexpected weight loss, score! But now I'm just baffled more than anything. Why on earth would I be losing weight? My doctor didn't seem terribly worried and said that it was more important to just watch the trend, and Dr. Google doesn't seem to have many resources on this particular problem. I mean, I want to gain weight in the healthiest way possible, so noshing on a tube of chocolate chip cookie dough seems like rather an immature response, but I will admit it's tempting. How often am I going to have this opportunity, really?

That's all for now - hopefully today will be quiet, and then tomorrow it's off to see the Maternal-Fetal Medicine doctor. There's no Yellow Brick Road leading the way there, but fingers crossed for at least one wizard who can make all of this better.