One of the side effects of carrying a trisomy 18 baby is excessive amniotic fluid. Amniotic fluid is swallowed by the baby, and when they are having difficulties in utero, they don’t swallow as much as they should. For the past week or so, sleeping has become progressively more difficult and uncomfortable. I’ve been having shortness of breath consistently. I’ve also been getting winded periodically when walking. Today, my amniotic fluid measured at 32. Normal is generally 8-18, up to 24. I’ve gained 4 pounds in 1 week, and my abdomen is stretched tight and hard. Sleeping is miserable. Well, actually sleeping just isn’t happening. I wake up about every 1-2 hours. Add to it a nice summer cold, and I am pretty much not sleeping consistently or well.
As one might imagine, keeping an upbeat outlook is hard when one is tired. Luckily, my husband is off on Monday and Tuesday, so I’ve been able to nap during the afternoon (still fitfully). Tomorrow and Thursday however, he works all day, so I will be left to fend for my tired, stressed self.
Polyhydramnios isn’t just uncomfortable unfortunately. The increased fluid increases my risk for pre-term labor, as well as increases my risk for fun stuff like placenta abrupta – where my placenta tears off violently when my water breaks, leading to hemorrhage, and possible death for both me and our baby. A happy thought for the week.
There really isn’t any treatment for it. We just have to watch and wait. The MFM today said that she has seen levels of 50-60. I cannot imagine the discomfort if I worsen that dramatically.
After talking to the MFM today, it seems that 37 weeks may be when induction is recommended. This is going to be heavily based on my 35 week growth ultrasound next Tuesday. If he is growing and seems ok, we can wait. If he has stalled on growth however, or there are other indicators, then 37 week induction will be recommended. The good news is that he passed all of his tests today and seems to still be doing fine.
Jim and I are struggling with the decision of whether or not we would induce at that point. We have said that we are going to let James decide the course of his treatment and interventions based on his condition, his comfort level, and his overall health picture at birth. Initially, we meant after he was born. Now I wonder though if we shouldn’t let him decide from here on out – decide when he’s ready to be born even. It’s a very hard decision, because we could make the wrong one and lose our son to stillbirth. We could also choose to take him out early and lose him to complications of trisomy 18 combined with prematurity. Even though 37 weeks is technically term – he is not a healthy, normal baby, so I am not sure the 37 week rule really applies to him.
These are the first decisions that I think are looking imminent for us, and we will see how they go. I am grateful for the team of medical professionals that we have, and I have to believe that they are going to guide us to making the best decision possible.