Ok ladies, this is going to be mega long so you might want to grab a drink and something to munch on. I'll try to break it up so that you can follow it. I really need your input.
Ok... I will say that my family history has signifcant evidences of cardiac issues. No clots that I am aware of, but lots of heart attacks, and my uncle had a stroke in his 40s. Other than my mom losing a baby to an incompetant cervix I don't have a family history of pregnancy loss or pregnancy complications (although there is some possibility that my aunt had IUGR, but my Grandmother was such a bold faced liar it's hard to believe anything that came out of her mouth).
In 1996 I had a very early miscarriage
August 1998 I was induced at 35 weeks for IUGR complicated by oligohydramnios* - my induction took 3 days and in that time I developed PIH
March 2000 I delivered at 41 weeks - developed PIH at 35 weeks but was not induced, baby had signs of possible late onset IUGR and was STARVING - he did nothing but cry and nurse until my milk came in and then he was like a different child
March 2003 after almost 3 years of TTC I miscarry twins at 9 and 10 weeks. Termed blighted but a later pregnancy makes me doubt that was what really happened. My prenatal care with this pregnancy was terrible.
June 2003 I had another very early miscarriage.
June 2005 I had yet another very early miscarriage.
March 2006 I was initially diagnosed with a blighted ovum but things weren't adding up so we canceled the d&c and followed the pregnancy by ultrasound. Slowly but surely in the next 5 weeks a yolk sac and fetal pole appeared in the sac before I finally miscarried 12 weeks into the pregnancy.
After this miscarriage I finally got someone to pay attention. My thrombo panel and karyotype came back perfect. I started taking extra folic acid and baby apsirin with my prenatal vitamin.
January 2008 I was induced at 38 weeks for PIH. Delivery and baby were perfect.
I got lax and stopped taking the extra folic acid and baby aspirin because I didn't think I would conceive on my own (last baby was a clomid baby). And then I got pregnant. But I still didn't take the baby aspirin and folic acid regularly because I was so nauseated and since I had been told my thrombo panel came back negative so I was just being treated on a whim.
January 2010 I went in for my regular OB appointment at 17 weeks 3 days and they couldn't find a heartbeat. When he was born it seemed very evident that it was a cord accident, but my OB was not convinced. She wouldn't even consider it even though she hadn't been at the delivery and hadn't seen any reports or spoken to the delivering doctor. She refused to redo the thrombo panel or run any more tests.
Finally I got fed up and went to see my PCP yesterday. I truly believe he died of a cord accident, but we still need to see what the path report says and with my history it is definately possible I threw a clot into the placenta. My OB has been talking about possibly doing lovenox with my next pregnancy but was going to consult with a perinatologist first. I need to call and set up a telephone appointment to discuss the results of the tests from the hospital and hear the perinatologist's recommendation.
ANYWAY... my PCP ordered a TON of tests - 20 vials of blood for 24 tests! AND!!! She referred me for genetic testing.
One of the tests she ordered is for my homocystiene levels. We have Kaiser and my lab work is available for me to view online. I went back and looked at what was in my thrombo panel and that wasn't in there!!! There's nothing in there related to MTHFR either (I don't think? Unless that is found in the karyotype?).
I am so angry!!! If that placental report is bad and I have MTHFR I am going to be SO BEYOND PISSED!!! If that happens, as far as I am concerned she killed my son!
So, I have 2 questions for right now:
1) I am taking 1600 mcg of folic acid. Will this intefere with the results of the homocysteine test?
2) Is MTHFR found in/on the karyotype or is that a seperate blood test?
My pregnancy related autoimmune tests all came back fine. What are the chances of having all thrombo tests come back negative, but actually have something? This is what my OB has been assuming - that I have a thrombo not detectable on the lab work. But then, she never freaking tested me for MTHFR!!!
*Now, about ultrasound screening for IUGR at the end of pregnancy. I want to make sure you all understand why this is so important. IUGR does more than just make the baby small.
When a baby is not receiving sufficient nutrition from the placenta, it automatically shunts the nutrients to the essential parts of the body first, and as there is more to spread around it goes to the other parts of the body. The first thing to be sacrificed is physical growth, and this lets the doctors know there is a problem. These babies actually tend to mature a little faster than their peers because they are under stress.
Eventually as the baby becomes more compromised the kidneys will shut down. This is when the baby is in trouble. If baby is not peeing, baby is not making amniotic fluid. If baby does not have enough amniotic fluid, baby can't float. If baby can't float baby will likely roll over onto it's cord and suffocate itself.
Those frequent sonograms are not just to monitor the baby's size, but also (and more importantly) to measure the pockets of amniotic fluid to make sure baby is in a safe environment. If the levels drop they can do things to try to bring it up - IV fluids, hospital bed rest, and hydrotherapy will usually bring it up at least for a time. If the levels wont stay stable the baby needs to be born to prevent a cord accident.
Please please don't refuse or avoid sonograms for IUGR because you think they are unnecesary. If my daughter hadn't been monitored by sonogram she would not be here today.