Jan 10, 2013

Cholestasis and the High Risk BabyDoc

Today Casey and I met with a new MFM, Dr. E-B, to check in on the babies and learn more about cholestasis and what this means for the babies and I.

Dr. E-B was very thorough and did a complete anatomy scan of both boys. In summary:
  • Pip and Pop look healthy and all of their parts are where they need to be and doing what they need to do.
  • My cervix is no longer closed (I guessed that from the whole mucus plug experience - which I will never blog about or share because eeeew!) and is fairly short, but it's okay because I'm 33w0d with twins. She didn't tell me how open my cervix is (she had the nurse write down 15,12 but I don't know what that means).
  • Pip is sitting VERY low down in my pubic bone area and putting constant pressure on my cervix. He does not have much growth space or amniotic fluid, which that needs monitored. He is also measuring a lot smaller than Pop (and much smaller than the ultrasound tech predicted on Monday).
  • Pop has plenty of growth space and amniotic fluid and is measuring slightly big. He is spooning with his brother with his head down and taking up all the room. His gestational sac is bigger than his brothers, so he can spread out more.


(Baby A)


(Baby B)

PositionHead DownHead Down
LocationMy left,
VERY low
My right,
up high,
making an L
Size Percentile24%64%
Size Discordance-16% (or +19%)

To watch out for:
  • Pip's amount of amniotic fluid
  • Discordant fetal growth (the differential between the babies is now at -16% (Pip is 16% smaller than Pop), which is barely above the cutoff for concern and so it just needs watched. Because math is fun, the size differential the other directions says Pop is 19% bigger than Pip, which is closer to the 25% discordance problem zone.)
  • My cervical length
  • Dr. E-B believes that 37w is the latest possible delivery date for twins and as soon as a complication develops, they need to be delivered earlier. In her opinion, the boys should come out between 35 and 36 weeks at the latest. However, she also said that with cholestasis the likelihood of preterm labor increases dramatically and I probably won't make it 35 weeks. In her opinion, I could deliver at any time and the boys will be healthy and 33w0d is a great place to be with twins.
  • This fits with my gut feeling that they are coming sometime in the next week or two.
  • We need to get busy this weekend! Lots of preparation. If you are bored this weekend, drop by and we can put you to work!

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