Monday, September 23, 2013

The utter suckiness of ultrasound days

Thank you all for chiming in. The day of the ultrasound is always incredibly stressful for me, and no matter what, I'm always shook up that day. I spent Saturday evening crying, and my father told me that I needed to not get so emotional during this process. I told him that I'm only emotional in fits and bursts, and that I would be fine on Monday. Turns out, that was true. I'm fine today, and I will continue to be so till  the next scan in 2 weeks, at which point I'll turn into a wreck again, unless things look picture perfect, and they never probably will.

There is no telling what will happen now. The lag in growth IS a bad sign. Does it mean 100%  that it will translate in miscarriage? No,  but it sure does raise the odds.

Then again, as somebody commented, miscarriages can come out of the blue. Pregnancy # 2 grew at just over 1 mm per day, and had a pretty normal seeming hearbeat (150 at 8w1d), and everything stopped 5 days later.

Btw, here is an interesting fact: while there can be a larger variability in measuring the sac, inter operator variability in measuring CRL is much lower: one interesting study noted that one person measured 6 mm, a second person would measure between 5.4 and 6.7 mm, a +/- error of less than 1 mm. So no matter who is measuring, I'm behind.  
 
Reproduced from http://onlinelibrary.wiley.com/doi/10.1002/uog.10075/full#tbl3
Right now, I'd give myself a 50-50 chance of making it. I found this very interesting study from England. They got a batch of patients who looked like they may miscarry in the early ultrasounds, and took 2
ultrasound readings in the first trimester, and looked at what cutoff of CRL growth predicted miscarriage most accurately. Note that normal growth in most viable pregnancies is about 1 mm per day.

All the pregnancies shown in blue made it, while the ones shown in red did not. Based on this, the authors concluded that if CRL increased at less than 0.2 mm  per day, you had no chance. If the increase was 0.4 mm per day, you had a pretty high frequency of loss, but some did make it. Note that the authors only observed them till 11-12 weeks; some of these may have been the viable trisomy category (which is the absolute worst case scenario). At around 0.7 mm growth per day, things seem split down the middle, and that is where I stand. My chances are definitely lowered, but things may turn out to be okay.

And very importantly, today, I am okay. And I'll be okay no matter how things pan out here.

6 comments:

  1. Just sending positive thoughts

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  2. So lucky i never knew any of this when i sent to my ultrasounds! Very interesting though. Hopefully everything will turn out just fine for you

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  3. hang on there Jay....ur in my prayers!

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  4. I'm sending good vibes, thinking lots of growth... I know how stressful these are... xo

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  5. So happy to read your story :) i wish you well!

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  6. If only you could know the outcome RIGHT NOW instead of having to wait, to agonize, to worry, to hope, to vanquish hope, to hope again, to hold your breath, etc. It's the whole roller coaster ride that is so emotionally draining.
    While your brain really wants to know the outcome, only time can reveal it to you. So, it sounds like this is an exercise in torture for you. I am sorry. I hope, hope, hope for the best outcome with this pregnancy.
    sending my warmest hugs, dear Jay.

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