Thursday, February 17, 2011

Visit at University of Tennessee Medical Center - High Risk Obstetrics

So yesterday, Ryan and I went over to the University of Tennessee Medical Center to meet up with the High-Risk Obstetrician who is going to look through my case and assess if I have a high-risk pregnancy case.

You see, I have already gone through several tests, the major being the Thrombophilia Panel, where they found an abnormality in my blood consistency.  I was recommended by Dr. John McAcmis of the WCG at Blount Memorial Hospital to also have another consult with a high-risk obstetrician at UT Med tthrough the results of the tests with me and make recommendations based on his findings.

Before we went there I asked around about UT Medical Center and I got great feedback. Apparently, the hospital is known for it's reputation on medical education, research and producing some of the best surgeons and practitioners around the country.  I love hearing that!

I was pretty impressed with the hospital coz it's huge and the lobby looks like a hotel lobby haha.

I also learned from Dr. McAmis that UT Medical is known for their High-Risk Obstetrics group, which specializes in dealing with difficult pregnancies and high-risk prenatal care.  And that's what I am there for.

Anyhow, when we got there, as usual they got my vitals, take my urine sample, then I was headed for my ultrasound....

The Ultrasound Trauma - 

I remember it was exactly February 5 2010 at 7PM, when Ryan and I went to get an ultrasound at Makati Medical Center in the Philippines during my first pregnancy.  It was not a pleasant experience because that was the time we discovered we are losing our Joaquin. So yesterday, when we were inside the sonograph room to get my 2nd ultrasound, we are bloth clutching each other's hands, our hearts pounding.  At the back of our minds is the memory of the sonographer from Makati Medical saying that she cannot appreciate the baby's heartbeat.

So the moment that the transducer of the ultrasound landed on my belly, we are holding back our breathe until we heard that most awesome sound of our little bube's heartbeat!  I swear Ryan drained the blood from my hands while he was waiting for the sonographer to say something bad.  It was amazing.

The sonographer did not introduce herself and Ryan said she did not have bedside manners hahaha.  Well I think she is a teacher coz there is another medical student with us observing the proceedings, and she just kept on talking to the student and answering questions for us when we only ask.  Nevertheless, we found out some great things yesterday

Our baby grew by 2 ounces.  It is now 8 ounces at 18 weeks and 3 days.  We saw the legs, feet, 10 toes, arms, 2 hands, 10 fingers, face, heart beating, brain, skull, spine, bladder, liver, kidney, oh and we saw the balls! haha.  It's great to know we are gonna have a little Ryan again :)

Meeting Dr. Mark Hennesy -

After my ultrasound, Ryan and I get to spend time with Dr. Mark Hennnesy, OB-Gyn for maternal and fetal-medicine.  He went through my case as submitted by Dr. McAmis and he delivered several news to me -

  • Based on the thrombophilia panel results, I am categorized at the lowest risk of the high-risk pregnancy.  He said he was quite happy with what he saw, and surprised too because it was not as bad as he thought it was.  He said that my blood abnormality is just right on the edge of being normal but at the same time, Dr. McAmis is exercising extra precaution by giving me Lovenox to help regulate my blood consistency.
  • My ultrasound looks great - the baby is in good shape.  
  • Mommy's vital stats looks good too.
  • There was a minor discovery found in my ultrasound that he said we should not concern ourselves about too much.  In my placenta, there were only 2 vessel cords instead of 3.  The 3 vessels are attached to the umbilical cord.  one vein (which carries oxygen and nutrients from you to the baby) and two arteries (which shuttle that waste back to you, to be processed and disposed of by your kidneys). Instead of those three vessels, our baby's cord has only two: one vein and one artery.  Two-vessel cord — also known as single umbilical artery (SUA).  Dr. Hennesy said that 5% of pregnant women has SUA.  He said he will recommend to Dr. McAmis to keep a close monitor of the baby's development.  He said that some of the risks associated with having only 2 vessel cords is the ability of the placenta to provide all the baby's needs. 
  • I was recommended to do Quad Screening as a result of the discovery of the 2 vessel cords.  The Quad screen is a chromosomal analysis to rule out any genetic abnormalities or other congenital problems. 

The Quad Screen test -

I took the liberty of going through some literature of the Quad screen test.
  • The quad screen test is a maternal blood screening test that looks for four specific substances: AFP, hCG, Estriol, and Inhibin-A.
    • AFP: alpha-fetoprotein is a protein that is produced by the fetus
    • hCG: human chorionic gonadotropin is a hormone produced within the placenta
    • Estriol: estriol is an estrogen produced by both the fetus and the placenta
    • Inhibin-A: inhibin-A is a protein produced by the placenta and ovaries
  • The quad screen measures high and low levels of AFP, abnormal levels of hCG and estriol, and high levels of Inhibin-A. The results are combined with the mother's age and ethnicity in order to assess probabilities of potential genetic disorders.
  • High levels of AFP may suggest that the developing baby has a neural tube defect such as spina bifida
    or anencephaly. However, the most common reason for elevated AFP levels is inaccurate dating of the pregnancy.
  • Low levels of AFP and abnormal levels of hCG and estriol may indicate that the developing baby has Trisomy 21(Down syndrome), Trisomy 18 (Edwards Syndrome) or another type of chromosome abnormality.

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