Ellen's pregnancy with Clara was initially uneventful. At 19 weeks, we were referred to a perinatologist for a Level II ultrasound due to risks associated with Ellen's hypothyroidism and associated medications. Our OB had made the same precautionary referral during Ellen's pregnancy with Owen, so we were not unreasonably concerned.
The ultrasound technician asked if we wanted to know the gender of the baby. During the pregnancy with Owen, Ellen and I decided not to find out his gender prior to birth. No such patience was in order during the pregnancy with Clara. The technician directed our attention to an image of three short, parallel lines and indicated that it appeared that we would be having a girl. I think that Ellen did a little happy dance right there on the examination bed upon hearing that news.
Unfortunately, Clara was in a bad position during the January 14 ultrasound - as she would be for almost all subsequent ultrasounds - and the technician could not obtain all of the required views of the heart. Therefore, we were scheduled for another ultrasound four weeks later.
Ellen and I had planned on having lunch after the ultrasound appointment at our favorite Greek restaurant, the site of our first date. Instead, we grabbed a sandwich from a chain restaurant located in the lobby of the hospital and ate in the car on the way to Children's Hospital. Due to construction at Children's Hospital, there was a long walk from the parking garage to the cardiology department. After completing requisite paperwork, we once again found ourselves in an ultrasound room. Clara, of course, was not cooperating. The technician managed to get the views that she needed and confirmed to us that the baby appeared to be a girl. The technician left to make sure she had sufficient images, then returned to escort us to a consultation room. After a short wait, a young pediatric cardiologist sat down to chat with us. He explained that the heart appeared to be structurally sound and that it was functioning properly. We then discussed possible causes of the effusion, which consisted of a refresher on the list of possibilities previously discussed with the perinatologist. He then took the time to listen to our concerns and attempted to answer our questions. We were instructed to schedule a follow-up appointment with the perinatologist, and we were scheduled for another echocardiogram at Children's one month later.
On February 25, 2008 we had another ultrasound appointment with the perinatologist. The ultrasound indicated that the fluid was still present, but had not increased. The ultrasound also indicated that there was no fluid in the lungs or abdomen, and confirmed that growth and development were on track. Following the ultrasound, the perinatologist discussed the plan of attack. We planned to continue to monitor the situation closely to make sure that the fluid was not increasing and that other problems were not developing. We were scheduled for a second fetal echocardigram at Children's Hospital on March 12, 2008. If that scan indicated that there was no decrease of fluid, the perinatologist planned to admit Ellen to the hospital for more frequent monitoring and in preparation of a possible preterm birth. Ellen and I decided that if the fluid did not decrease by 30 weeks (March 28) or if other problems developed, we would consent to an amniocentesis to give the medical professionals as much information as possible prior to the birth. Our ultimate goal was to keep the baby in utero as long as possible.
We left the March 17th appointment with a significantly reduced sense of concern, feeling like the pregnancy had resumed a "normal" track. Over the course of a month we had mentally prepared ourselves for the possibility of hospital bedrest, preterm birth, and medical complications; therefore, we happily drank from this pool of good news that had been laid out before us.
On May 14, 2008, three weeks prior to the scheduled c-section, we returned to Children's Hospital and made the long walk for the final fetal echocardiogram. Everything appeared to be consistent with the April 9 echocardiogram. In response to our question about whether continued monitoring would be needed after birth, the cardiologist stated that he would write an order for her to have an echocardigram shortly after birth.
As we inched closer to the due date, we continued to drink heavily from the pool of good news, pushing to the back of our minds the possibility that there might be complications that could not be determined in utero. At the end of the day, I am glad that we did not spend those last few weeks worrying about the "what ifs". We spent the time preparing ourselves and our home for the newest member of our family, while enjoying the time we had remaining as a family of three.
TO BE CONTINUED IN PART II - IN THE HOSPITAL