Viablility: YES! Bedrest: NO!

So today was a day of good news/bad news. Which should I report first? Hmmm.

Good news: I have offically reached the all-important, super-vital milestone known as fetal viability. This is the gestational point in pregnancy at which doctors declare that a baby has a chance of long-term survival if born early. Most doctors will not intervene to save a baby before this point.

I am praising God for the miracle of 24 weeks! He alone has provided me with a very highly-skilled team of expert doctors, given us the right medicines, and strengthened my body for the journey.

I was thrilled to head back to see Dr. Mann today (perinatologist), for another ultrasound and our weekly pow-wow. I've been especially nervous these last few weeks, knowing that the cervix was starting to show signs of effacement (thinning) between weeks 16-18. During that time, my cervix thinned from 4.0 cm to 3.5cm, but has stayed put since then.

Which brings me to the bad news: At today's measurement, the cervix is down to 2.8 cm. And there's more: polyhydramnios. This is a fancy word meaning there's too much amniotic fluid surrounding the baby. Dr. Mann explained that this is a major problem because all that fluid causes additional pressure on the cervix, causing it to thin even more. Excess fluid alone can cause pre-term labor and delivery. Added to the fact that I already have a previous history of preterm, am continuing to have frequent contractions, and now a very thin cervix ..... it's an enormous concern to my doctors.

She explained that polyhydramnios can be caused by different things: 2/3 of the time it's "idopathic", which means no known reason. About 15% of the time it indicates gestational diabetes in the mother. In the remaining cases it can be caused by a baby with birth defects, or any of the trisomies. At this point she is feeling confident that I fall into the 2/3 category, for whom this happens "just because". I will have my diabetes screening in two days, so we should be able to rule that out soon. And they have already checked the baby's anatomy top to bottom a million times, but she spent extra time double-checking his heart again today just in case. She reports all looks fine and she sees no indication of any defects.

Dr. Mann then proceeded to tell me the word I've been dreading to hear since this all began: Bedrest. I knew I was gonna end up here at some point, so it's not like it's a surprise or anything .... I was just really hoping we'd get much further along before we had to deal with this. With Isaac and Gracie both I was on bedrest about 6weeks each time. And I nearly lost my mind being cooped up like that! If we make it to the end this time it would mean SIXTEEN weeks of bedrest. Seriously a marathon. They may have to put me in a rubber room sometime around week ten or so.

I am trying not to panic. The doctors keep telling me that as long as the cervix stays above 2.0 cm then it's not time to freak out. I would be lying if I said I wasn't full of fear ... I am. But I'm trying my best to fight it and not let it paralyze me. Of course I will do everything within my own power to keep this little guy inside and healthy for as long as the Lord allows. And my doctor's have all assured me they will do everything humanly possible on their end. I am confident in their skill and I am grateful for the excellent top-notch care they are providing me. I guess the challenge once again becomes accepting the fact that this is out of our hands for the most part: God and God alone will decide the day and time that our little boy will come into the world. I am trying to take comfort in knowing that He already knows the time, and He already has the details worked out. Being the kind of person that needs to control things, of course this is quite hard.

Dr. Mann has put me on a 72-hour course of Indocin which we are hoping will accomplish two things: (1) slow contractions and (2) reduce the amount of amniotic fluid. I was on this medication back during the chaos with Isaac, so I'm quite familiar with it and I have high hopes that it will help this time. It can only be taken for 72 consecutive hours, though, which is the main drawback of this medicine, since longer dosages can result in heart problems for the baby. I will take my first dose tonight as soon as James gets home and has a chance to run to the pharmacy for me.

Aaaaaand so ..... the rollercoaster ride picks up speed ........