Pregnancy Timeline

12/11/13- +HPT (7dp5dt)

12/13/13- hCG = 280 (4 wks)
                 progesterone = 30
                 estradiol = 1,617

12/16/13- hCG = 797 (4 wks + 3 days)
                progesterone = 31
                estradiol = 1,235

12/23/13- Early u/s done after minor freak out... Right pelvic area became swollen & sore over weekend. One sided pain in front right pelvic area/inguinal crease & also wrapping around right buttock. Woke up to spotting.

RE determined pregnancy was in uterus (not ectopic). Sees two sparks of life in uterus, but one measuring smaller than the other (6 mm & 3 mm I think?). Only one has beginnings of yolk sac visible....still extremely early and time will tell if one or two develop.

RE says sensitive pelvic area is "not connected to my lady parts" but instead a swollen lymph node/possible hernia. Sore hip/buttock attributed to PEO injection 2 days prior...delayed soreness & pain radiating much further around hip than normal. RE says spotting is perfectly normal. Everything is on track.

               hCG = 6,808 (5 wks + 3 days)
               progesterone = 26
               estradiol = 2,059

12/27/13- hCG = 16,764 (6 wks)
                 progesterone = 33
                 estradiol = 2,169

Still light spotting randomly. Acupuncturist left acu beads on Spleen 1 point on medial side of big toe to hopefully help with this. Worth a try!  All in all, things continue to go smoothly. Doubling time for hCG has slowed, but this is normal once passing level of 3,000-5,000.

Continuing same regimen of 1 mL PEO daily, 0.3 mL delestrogen every 3 days, 40 mg Lovenox & baby aspirin daily, 1 mg dexamethasone daily.

1/2/14- Apt. with perinatologist: Ultrasound revealed 2 gestational sacs, both with heartbeats

Baby A = Measuring 6 wks + 4 days
                 Heartbeat @ 138 bpm
Baby B= Measuring 6 wks....lagging in size noticeably
                Heartbeat @ 107...rather low

Currently we have twins, but realistically this may end up being a case of vanishing twin at some point. Measurements can be +-7-10 days in either direction for healthy pregnancies. Of course, we are hopeful for both babies. However, low heart rate coupled with measuring behind makes us a little wary about Baby B. Baby B is lagging, but in the words of the doc "Baby A looks awesome!" We just want the best outcome for a healthy mom and healthy baby(ies)....whatever is meant to be will be.

Discussed dexamethasone safety during pregnancy. MFM reassured us it's safe at such a low dose and recommended continuing through entire first tri....no need to rock the boat by changing anything right now.

Will continue 40 mg Lovenox daily until 2nd trimester, upon which time we'll increase to 60 mg daily (1 mg/1 kg body weight) and continue throughout pregnancy.

Spotting has slowed down to almost nothing, although still happening randomly. Coincidentally, I've noticed a pattern; It re-starts the AM following my PM delestrogen shot every 3 days? Hmmmm. MFM reassured me that spotting is normal, especially during the first trimester, and occurs in up to 50% of pregnancies. I will bring up this delestrogen/spotting pattern with RE if it continues after my next delestrogen shot. It's considered abnormal if there is red blood flow + cramping + clots all at the same time. Otherwise, I'm told no need to worry.

1/3/14- hCG = 44,678 (7 wks)
             progesterone = 29
             estradiol = 1430

hCG has leveled off. No more hCG blood draws necessary. Everything looks good. Continue with current progesterone & estrogen supplementation.

1/10/14- progesterone = 21 (8 wks)
               estradiol = 2241

Looks good. Continue current progesterone & estrogen supplementation. Have been "semi-graduated" to OB. Will continue monitoring blood levels with RE, but all other care transfers to OB.


1/16/14- apt. with perinatologist/ultrasound (8wks + 6 days)

Bittersweet goodbye to Baby B. Showing almost empty sac, which measured only 6wks & barely a fetal pole even visible anymore. We are sad to lose Baby B but always had realistic expectations regarding possibility of a vanishing twin. This was indeed the case.

We are focused on the positive though; Baby A is doing fantastic!

Baby A = Measuring 8 wks + 5 days
                Heartbeat @ 180

1/17/14- progesterone = 32 (9 wks)
               estradiol = 1906

Instructions to reduce delestrogen injections to 0.15mL every 3 days (1/2 of normal dose) and reduce daily PEO injections to 0.75mL (37.5 mg) beginning on 1/19 (1/4 reduction from normal dose).

Full disclosure: I am paranoid about tapering off of progesterone, and I chose to only reduce by 1/5 of normal dose, 0.8mL (40mg), but I did tell my RE the true dosage I've actually been injecting.

1/24/14- 1st apt. with new OB (10 wks)
              **OB apt. cancelled due to icy roads. Boooooo
              
              progesterone = 28
              estradiol = 1443

Instructions to do today's delestrogen injection and then discontinue completely...no more need for estrogen supplementation. Continue current progesterone dosage of 0.8mL PEO daily.

1/28/14- Apt. with new OB (10 wks + 4 days)
              **OB apt. cancelled due to icy roads AGAIN. Seriously?!

1/31/14- progesterone = 34  (11 wks)
              estradiol = 1163

Dare I say, it seems my body might sloooowly but surely be producing a little progesterone on it's own? Instructions to continue 0.8mL (40mg) PEO next 4 doses, then reduce down to 0.5mL (25mg) beginning 2/4. So far so good being off all estradiol supplementation as well. Re-test levels on 2/7/14.

2/3/14- Apt. w/perinatologist for NT scan (11 wks + 3 days)

Passed NT scan with flying colors. Nuchal fold less than 1, and nasal bone looks perfect, as do all other visible body parts. Opting out of additional bloodwork that many times accompanies NT scan, because chromosomal matter from vanishing twin would make results inconclusive anyways. Risk assessment for chromosomal abnormalities with this baby is roughly 0.33% chance of any abnormalities (even without additional bloodwork).

Instructions to continue Lovenox 40 mg until script runs out (right about time entering 2nd tri.) Then increase to 60 mg/daily.

Continue 1 mg dexamethasone daily. MFM believes benefits of continuing low dose steroid to reduce possible risk of 1st/2nd trimester loss far outweigh any reasoning behind discontinuing it.

Baby A = measuring 11 wks + 4 days
             = heartbeat @ 167 bpm

....everything looks perfect!

2/7/14- progesterone = 32 (12 wks)
             estradiol = 1216

Looks like body is continuing to take over progesterone production. Final dose of PEO on 2/9/14. Re-test progesterone & estradiol on 2/14/14.

2/10/14- Apt. with new OB (12 wks + 3 days)

Love our new OB and nurse. Full gyn exam & u/s which revealed gender of Baby A; We're waiting for one more u/s to confirm this before revealing. Baby was moving around like crazy! So cool to see so much movement and also learn the gender. Everything just became exponentially more exciting!

OB also recommended BRCA testing to me since my mom died from ovarian cancer at age 52 and great aunt died from breast cancer at 46....about the tenth doctor to recommend this to me at this point. Can you tell I'm stalling?

2/14/14- progesterone = 29 (13 wks)
              estradiol = 1216

Praise God, no more progesterone shots, and no more weekly blood draws to monitor P4 & E2. Still doing daily Lovenox injections (which will increase next week to 60mg) and 1 mg dexamethasone, but 1 shot daily is better than 3.


2/21/14- Phone call check-in with perinatologist (14 wks)

Increased daily Lovenox injections to 60 mg. Given clearance to begin weaning off of steroid. Yay! Reduce to 0.5 mg dexamethasone for 1 week, then .25 mg dexamethasone for 1 week, then completely stop. 


2/25/14- Apt. with OB (14 wks + 4 days)

IT'S A BOY! We've named him Preston Alexander.

Preston = Measuring 14 wks + 6 days
             = Heartbeat @ 157 bpm


3/19/14- Apt. with perinatologist for full anatomy scan (17 wks + 5 days)

Preston = Measuring 18 wks + 1 day
             = Heartbeat @ 147 bpm

Passed full anatomy scan with flying colors. Everything looks perfect for baby and mom. 3rd confirmation that it's definitely a boy. Madly in love with this little guy. Pretty sure I felt him kicking for the first time early this morning too!

4/4/14- Apt. with OB (20 wks)

We've reached the 1/2 way mark! OB apt. with long wait time (OB ran next door to deliver a baby) resulted in a 3D u/s for us "just for fun." Preston is doing great and is quite the mover and shaker. Boy does not stop moving during ultrasounds.

Have felt him moving a little each day, and all over the place....right, left, high, low. Felt it on my hand once from the outside of belly so far....always trying to catch something from the outside, but he's unpredictable. Love those little kicks and kung fu moves.

Preston= measuring ahead & weighs 14 oz.
            = Heartbeat @ 160 bpm


4/17/14- Apt. with perinatologist (21 wks + 5 days)

Preston = Measuring 22 wks + 5 days
             = heartbeat @ 152 bpm
             = weighs about 1 lb. 3 oz

Everything looks perfect! All of Preston's organs are functioning properly, and he's now averaging a full week ahead in growth and 2 oz. + - above average. MFM says cervix is "a mile long" (really it's only 40 mm) but this is good, because there are no signs of incompetent cervix. (They want 23mm+)

Also had prenatal apt. with Preston's future pediatrician. LOVE her.


5/1/14- Apt. with OB (24 wks)

Preston = heartbeat @ 151 bpm
Mom = bump @ 26 cm, weight @ 148 lbs. (18 lbs gain so far), BP @ 110/65

No u/s at today's apt, but that's OK...Preston is wiggling away, as high as my rib cage and very low into pelvic area. Uterus is the size of a soccer ball and taking up entire abdomen at this point. Bump measured by doc for first time. Vitals looking good for mom and baby.


5/15/14- Apt. with perinatologist (25 wks + 6 days)

Preston = Measuring 26 wks + 5 days
             = heartbeat @ 145 bpm
             = weighs about 2 lbs. 4 oz.
Mom = weight @ 150 lbs. (20 lbs. gained so far)

U/s tech says "You have a fat baby." Perfect on all fronts...exactly what we like to hear. Preston's kidney size is on the higher end of range, but no red flags...just keeping watch to make sure they don't grow exponentially at any time.


5/19/14- Baaaack to the perinatologist (26 wks + 3 days)

Check-up following a fender bender the day previous (We were rear ended). Checked everything out...mom and baby are perfectly fine, placenta still in tact, fluid looks good, Preston moving tons. "Baby is happy as a clam in there," says the peri.


6/3/14- Apt. with OB & glucose test (28 wks + 4 days)

Routine OB visit + glucose 1 hour test (PASSED!). Mom and baby are healthy.

Preston = heartbeat @ 153 bpm
Mom= weight @ 150 lbs. (20 lbs. gained so far)
            bp @ 104/62



6/12/14- Apt. with perinatologist (29 wks + 6 days)

Preston = measuring 31 wks + 1 day
             = heartbeat @130 bpm
             = weighs 3 lbs. 11 oz.
Mom  = weight @ 151 lbs. (21 lbs. gained so far)
          = bp @ 96/70

Mom and baby both healthy. One of Preston's kidneys still measuring 1 mm above normal @ 8 mm (but anything under 10 is good so this is no big deal). Amniotic fluid looks great, baby is head down. If he's still head down @ 32 weeks, then there's a good chance he'll stay that way. Fingers crossed he will stay head down! Baby expected to double to 7+ lbs. by 36 weeks!

I almost threw up on the u/s table, apparently just from laying down flat with so much weight on my aorta? That was a first!

6/25/14- Apt. with OB (31 wks + 5 days)

Preston = hb @ 150 bpm
Mom = weight @ 153 (23 lbs. gained so far)
          = bp @ 110/68

OB says this is a "model pregnancy." So nice to hear! Weight, measurements, and bp look great. Instructed to continue exercising 7 days per week and to just keep doing what I'm doing. Discussed using a doula with OB and let him know we'd like to "try this thing naturally."  Our doula will come in with us to meet him at our 36/37 week apt. OB is very easy going and receptive, although I know going natural really isn't the norm at his practice. He sees many high risk patients and those delivering multiples. We shall see how this all plays out. I'm not concerned about fitting the mold of his typical patient of course.

 7/7/14- 1st Prenatal Doula Meeting (33wks + 3 days)

Our doula, Julie, came to our home and talked with us for a full 2 hours about how she will assist, discussed formulating a birth plan for NUCB (natural unmedicated childbirth), and where to go from here. She will come with us to our 36+ wk. apt. with OB to meet him in person and is available for unlimited support via phone anytime we need it from here on out.

She will be present once I begin actively laboring with consistent contractions, will meet us at our home, and travel with us to hospital, helping to guide us with optimal birthing positions and techniques that are aimed at a shorter and more effective labor, providing emotional support, giving guidance to hubby on how he can help me appropriately in whatever ways he feels comfortable, taking pics, getting us food, making sure I'm comfortable...anything and everything that is needed throughout active labor, the actual birth, through up to 2 hours post delivery (including establishing breastfeeding). She will also make a home visit post delivery whenever we want her to come. Very excited to have her as a support person, and we both feel she's a great fit for us!

7/9/14- Apt. with perinatologist (33 wks + 5 days)

Preston = measuring 35 wks + 6 days
             = weighs approx. 5 lbs 12 oz
             = hb @ 158 bpm
Mom = weight at 156 (26 lbs. gained so far)
          = bp @ 96/72

Everyone who looks at this baby (u/s techs, docs, etc) says same thing, "This is certainly not a small baby!" He's still within normal range but measures in 90th percentile on the key anatomical parts they use to assess true size (head, femur bone, abdomen). Because I passed the glucose test with flying colors though, there is no risk...he just seems to be a big baby.


7/20/14- Switched from Lovenox 60 mg to Heparin 0.7mL twice daily. (35 wks + 2 days)


7/22/14- Apt. with OB (35 wks + 4 days)

Preston = hb @ 150 bpm
Mom = weight at 159 (29 lbs. gained so far).
         *I blame the bigger increase on leftover baby shower cake all. week. long. Oops!
         = bp @ 118/72
         = retaining a little fluid in ankles

Gave our NUCB Plan to OB and it was well received! Preston is head down as usual, but head still very high up in pelvis & cervix is completely closed shut. "You are nowhere close to giving birth," says the OB. Weekly visits with OB from here on out.

Switched from Lovenox to Heparin this week, and not it's not much better. Will be so happy when I can stop injecting myself with needles. One step closer to delivery though!


7/28/14- Apt. with OB & doula (36 wks + 3 days)

Preston = hb @ 150 bpm
             = scored 8 out of 8 on biophysical profile u/s
             = head straight down and facing my back (perfect position)
Mom = weight at 157 (27 lbs. gained so far & 2 lb. loss from last week's crazy water retention)
          = bp @ 107/72
          = result of Strep B test- negative!
          = 0% effaced, 0 cm dilated (cervix still closed tightly, but normal for 36 weeks)

Beginning weekly BPP's (biophysical profile) due to APA syndrome (namely anticardiolipin antibody) that I carry...just to keep a close eye on baby in remaining weeks. BPP is an u/s test used to check amniotic fluid level, breathing, and movement/responsiveness of baby. 2 pts. assigned for each of 4 parts of test (8 pts. total). Preston got perfect marks!

Doula introduced to OB. Asked her what I can do to prepare my body for birth more effectively? She suggested drinking red raspberry leaf tea (2 cups daily) in addition to using birth ball at home (for sitting & exercises), as well as continuing walking 30 minutes daily. Sex and orgasm to help prepare body and soften cervix. Consider resuming acupuncture at 39/40 weeks for induction points (or earlier just to help relax body).

8/4/14- Apt. with OB (37 wks + 3 days)

Preston = hb @ 173 bpm (moving around A LOT!)
             = scored 8 out of 8 on biophysical profile u/s
             = head down and low on mom's bladder
             = measuring 38 wks + 4 days
             = weighs 7 lbs. 11 oz!
Mom = weight @ 158 (28 lbs. gained)
          = bp @ 118/76
          = 0% effaced, 0 cm dilated (cervix still closed tightly)

Preston blew through his BPP test with flying colors. They look for baby to practice breathing at least once during test (babies usually practice for 30 sec. at a time during this stage), and Preston just breathed steadily the whole entire test. He yawned, opened his eyes, and was very active. He has plenty of fluid to wiggle around in still. One of my favorite apts. of this whole pregnancy... could really see how much more mature he's gotten.


8/5/14- Phonecall with perinatologist

Having random delayed bleeding at injection sites since switching to heparin. Won't bleed for 12 hours post injection, and then randomly begins bleeding next day once removing bandaid, showering, after working out or being very active, etc. Instructed to reduce dose from 0.7mL twice daily to 0.5mL twice daily. See if it improves. If not, we'll run a PTT (prothrombin time) test to see if dosage needs adjusted further.


8/11/14- Apt. with OB (38 wks + 3 days)

Preston passed his BPP with flying colors. He's been extremely responsive to outside touch lately. If you touch my belly, he will kick you right back...kicked the u/s tech's wand 3 times hard enough to make her hand jump. He breathed continuously throughout the test again. Amniotic fluid looks great still. Mom & baby both doing great.

Preston = hb @ 153 bpm
             = head down, facing right, moved down slightly but hasn't "dropped"
Mom  = weight @ 158 (28 lbs. gained so far)
          = bp @ 120/78
          = 0% effaced, 0 cm dilated (cervix still closed tightly)

OB doesn't seem concerned about any "lack of progress" cervically. He just says "It will happen, I promise"....which is music to my ears. There has been no mention of the "I" word...a.k.a. induction. Glad he's on the same page as us.

Reduction in heparin dosage to 0.5mL twice daily seemed to help with random injection site bleeding as well. No bleeding incidents since tapering dose down. Yay!


Coming Soon...
8/20/14- Apt. with OB - biophysical profile, check-up
8/22/14- EDD for Preston Alexander