Halfway! {20 week pregnancy update}

This pregnancy has been a wild ride!  And I cannot believe we are only halfway through... it feels like much much longer!

I haven't written much about pregnancy specifically since our supposed "miscarriage" but a lot has happened.  You may have gathered from other posts that I have had a particularly difficult time with insomnia since the beginning of this pregnancy which got so bad that, even with Tylenol PM, I was still only getting an hour or two of sleep at night.  You can imagine how enjoyable that made my days chasing a toddler! I am happy to report that though I am not sleeping well by any means, I have started to get significantly more sleep at night over the past couple of weeks without medication- praise God!  Nausea and vomiting also plagued me (like many pregnant women) but I have not been fortunate enough to leave that lovely symptom behind at the end of the 1st trimester, like many women do. I fortunately am not nauseous all day anymore but do have a morning ritual of emptying my stomach into the toilet.  At least it is predictable though, so I just don't leave the house till it is over with and I am good to go for the rest of the day :-)

I continued to have bleeding on and off, sometimes heavy, through about 14 weeks which was always nerve wrecking, as you can imagine.  I have had a lot of ultrasounds as a result.  It appeared that the bleeding was coming from the placenta and around 12 weeks the blood clot showing in the placenta was gone and praise God, the bleeding didn't effect the baby's growth (which was the main concern with a blood clot in the placenta).

Around 18 weeks I had a severe pain in my lower right abdomen that felt like round ligament pain (a common pregnancy-related discomfort due to the uterus growing) but unlike round ligament pain, which should only last a couple of seconds/minutes at a time, it did not go away for hours and I ended up going into the hospital after consulting with a labor and delivery nurse over the phone.  Of course this happened on a weekend so after checking me out, the ER doctor called in my OB who ordered a urine and blood test (both came back fine) but was concerned by the unexplained nature of the pain and wanted an ultrasound of my kidneys, appendix, and gallbladder. I was due to have my genetic screening detail ultrasound (when they check for any fetal abnormalities that might require extra care at delivery) in a couple of weeks so my OB asked the hospital urologist to go ahead and do it when he checked out my kidneys.  Great news was that nothing appeared to be wrong with me internally and we found out our little one is a healthy little girl! We got to peak at her brain, her heart chambers, her kidneys, and all other internal organs and limbs.  It is truly amazing what these high-tech ultrasound machines can see!  I am happy to report that the pain also eventually went away and has not returned :-)

During the detail ultrasound, my OB also asked the urologist to take a look at my uterus because it had been speculated that I may have a bicornuate uterus. This was suspected at an early ultrasound during my pregnancy with Quinn, and again when the doctor delivered my placenta after Quinn's arrival. The high tech ultrasound confirmed that I do have a bicornuate uterus, which is a bit of a concern.

A bicornuate uterus is a uterus that is partially (or sometimes completely) divided by a septum into 2 "horns." It has a heart shape to it and there are varying degrees of severity (mine is definitely not the worst case).  Only about 0.4% of women are affected with this abnormality. Three points of concern for pregnant women with bicornuate uteruses are recurrent pregnancy loss (miscarriage rate is around 30% as opposed to the typical 18%), preterm labor (15-25% deliver preterm as opposed to 12% in the rest of the population), and breech or transverse presentation (40% of women with bicornuate uteruses require c-sections for this reason). Another suspected problem is difficulty achieving pregnancy. As far as these statistics go, we have been extremely blessed never to have had difficulty achieving or maintaining pregnancy and to have given birth vaginally to Quinn (though he was breech up until a couple weeks prior). It does shed light on as to why my water broke preterm with Quinn and that is my greatest concern with baby girl now. My OB told me that we were lucky to carry Quinn to 36 weeks.  Based on the ultrasound and the fact that currently baby girl is occupying both horns (not confined to just one side) my OB is not too concerned about extremely early preterm labor, though I will have to start being checked more regularly for signs of preterm labor (such as my cervix shortening) as well as to make sure baby girl continues to grow (sometimes the lack of space can cause babies growth to slow as they outgrow their space).

My greatest anxiety is my 18+ hour flight back to the US in 5 weeks. My OB is still supportive of me flying at that time but we will have to see what things are looking like right before time to leave. Flying itself is not dangerous during pregnancy (it will not put you into labor), but should I naturally go into labor while on an 18+ hour flight, that could be a major problem since my last labor, from water breaking to Quinn arriving, was less than 14 hours. An airplane is not where I want to be with a premie of only 25 weeks!  My OB says currently she is not worried about that so I guess I shouldn't worry about it either... 

Despite all the craziness of this pregnancy, we are so thankful that little girl and mommy are currently very healthy!  And we are just thrilled to be having a girl!  We have decided to name her Madelaine Kate and call her "Lanie." I just can't wait to meet our little Lanie Kate (though I hope I don't get to meet her for at least another 17 weeks or so)!