December 17, 2013

Not Feeling Confident About This

Ultrasound #2 wound up being this afternoon. As of now, I am still incubating, but we are not feeling great about the chances.

I wound up having a lot more bleeding last night. I knew at least some of the hematoma had evacuated, I just wasn't sure if it had taken the baby with it. Unfortunately, the RI says that I need another round of IVIG, so I wanted to make sure there was a reason to do it before we fork out another $4,000.

The heart rate had increased by 3, and there was a day's growth. So, yea for those things.

Unfortunately, not all of the clot had liquefied, and the part that is still in there is pressing on the gestational sac. From what I've read online, in general, SCH tends to increase risk of miscarriage to about 10 percent. But the peri gave us only 50/50 odds since the clot is taking up more than half of the uterine cavity. She thinks if this does not go our way, it will probably end within the next week.

The bleeding stopped by this afternoon, and I was hoping that would be the end of it, but bright red has shown up again, and I'm starting to feel pain again.

I know there is a chance this could still work out, and we're not discounting that. But on the other hand, because it is a large clot, that makes me a bit nervous about what our increased risks would be if this pregnancy does continue. Large SCHs tend to be associated with higher risk of placental abruption, PPROM, and pre-term labor.

The peri wanted us to still keep our Friday morning ultrasound appointment, although she said if something else significant happens between now and then, they will bring me in sooner. Without me even saying anything about it, she also said she wants to monitor me 2 or 3 times a week until this resolves, instead of the planned weekly appointment. I appreciate her concern, but honestly, at this point I know there's not really much that can be done other than wait and see. So unless I wind up in a situation again like last night, where I'm not sure I'm still pregnant, I may try to stick with weekly appointments.

R and I also decided to hold off on the IVIG for now. If this pregnancy ends, I don't think it will be because of lack of a second round of IVIG - it will be because of the hematoma. The RI's nurse said they believe IVIG can help heal SCH. I did some searching online, and the doctor's (Beer) thought was that elevated NK cells can contribute to hematomas. But the thing is, my NK levels and my T-reg levels were fine as of the most recent testing last week. The only thing that was elevated (34.7, when they want it to be below 30) was cytokines. And, I did a round of IVIG right before the transfer, and yet the SCH still developed, so I don't think IVIG is necessarily the solution to this particular hematoma.


Libby said...

Oh Rebecca, I am so sorry you are having to deal with all of this :( I'll be praying the hematoma resolves without harming the baby.

Amanda said...

Sending positive thoughts your way.

TurtleMama said...

I had a very stubborn SCH with my current pregnancy and it is so nervewracking to have to deal with the uncertainty and the bleeding. Mine finally resolved around 17 weeks - there is not much you can do except wait it out and I was on modified bedrest which seemed to help . I pray yours resolves quickly.

SciChick said...

It is so awful not knowing what to do. If it is immune in origin, the only thing you could do is fix your vitamin d levels if you are currently deficient, because that calms down/ regulates your immune system in multiple ways.
- it supresses nk cell activation and is generally anti-inflammatory, while increasing the levels of anti-microbial peptides.

Otherwise, all you can do is pray. Doing that for your little one.

Emily Erin said...

Praying for good news that the SCH resolves and your baby thrives. Sending hugs.