Monday, 9 March 2020

The 18 Week Amniocentisis

Amniocentisis at Birmingham Womens Hospital - Fetal Medicine

Monday morning finally rolled around, my sister in law, Leo and I all hopped into the car to head to Worcester (I will most likely address why Leo was there in a future post).

I knew I was heading into the eye of the storm again, that my few days of ignorance were about to be blasted out of the water, but still I had to go and hear what the consultant at Fetal Medicine thought about our little Nugget.

We arrived in Birmingham with time to spare, by now I know exactly where to park and how to get to where we need to be. We set up residence in the cafe and looked over the previous scan notes. My sister in law felt positive but I knew by the end of this appointment that feeling would have been knocked out of her the same way it had been for me over and over again.

We made our way towards Fetal Medicine and were pretty much shown right in. Instead of being taken straight to the sonography room like in the previous appointments, we were taken to one of the little sitting areas where I signed my consent for the Amniocentisis procedure that they were going to be carrying out.

They talked through what would happen, I signed the consent form and we were taken into the all too familiar room where the scan was going to take place. 

I hopped up onto the bed and the scan commenced straight away. There were 2 consultants in this appointment and they took it in turns to do a thorough scan of little nugget. 

They confirmed all the findings that had been found at the previous scan, looked at the heart in some further detail and told me that the amniotic fluid was now considered low at 1.4cm in the deepest pool.

This could be a sign that the kidney’s aren’t working as they should, which of course sent more alarm bells ringing. The second consultant Dr Kirby took over the scan and concluded with the first consultant. 

I’ve learned that these scans are usually performed in complete silence, the dr’s concentrate on what they are looking at and it doesn’t feel like the time to ask questions. I can’t help but feel though that baby measuring smaller and being in more awkward positions (combined with the low amniotic fluid) will mean that it’s harder to see exactly what is going on, and does leave room for error.

Error and hope.

With the scanning side of the appointment wrapped up, they made preparations for the Amniocentisis to take place. A midwife joined the 2 consultants and they began to prepare my tummy for the procedure. 

A very cold solution was poured all over my stomach to clean the area, paper towels were placed over my upper tummy and where my leggings finished to keep the area clean. They spoke to me as they were preparing everything so that I knew what was going on, I saw the needle come out but I couldn’t see much from behind the paper towels.

I was told that the area wouldn’t be numbed (although I can’t remember why they said this was the case), in fact it all seems a bit blurry now. I felt so calm before the procedure, but when it was actually starting I felt a bit uneasy.

The baby was still visible on screen but I couldn’t see exactly what was going on, they told me that they were ready to perform the Amniocentisis and that I needed to stay very still. 

I thought the staying still part of all this was going to be a doddle, I’ve had blood taken many times and I never flinch, but of course the Amnio is a needle going into your lower abdomen, which as it turns out is a very sensitive part of your body. The needle pierced my tummy and I automatically flinched, I couldn’t help it. They told me to stay still again like I had any control over my body at that precise moment in time, of course I didn’t want to be moving, I knew exactly what moving might mean for my baby. 

It’s like when you get stung by a bee, you automatically move away from the sting, and that’s the only thing I can compare the Amniocentisis  too. 

A bee sting.

It wasn’t painful, and when the needle was in you didn’t even notice it was there, I did feel a bit conflicted about having amniotic fluid taken out of the baby’s sack when it appeared that it was already too low. 

It was all over as quickly as it had started, the needle was taken away, the paper towels removed and my tummy dried. My tummy just felt normal, like nothing had happened but I was very aware that I needed to pee again! 

I needed to go back to the little room for the debrief, but first I needed to pee. It was only when I went to pee I realised that I had shooty pains in my lower tummy. It felt like my insides were going to fall out, and the shooty pains felt like what you might have when you have a bladder infection. 

I soon worked out that the shooty pains were worse when I was walking around, not so bad when I was sitting. I went and found a seat in the same little room we had been shown to when I had arrived, and Dr Kirby talked me through what they had seen.

His prognosis was bleak, 'if multiple anomalies confirm, the prognosis will be adverse in terms of mortality and morbidity whatever the underlying aetiology'.

To me that reads, that if all of the findings on the scans are 100% there, regardless of whatever is wrong with Nugget, there won't be a good outcome for baby.

The consultant expected the Amnio results would highlight a Chromosome Anomoly, and I could tell he was pondering Trisomy 18 - Edwards Syndrome and he mentions it more than once in the sonography report that was later handed to me.

I was basically told that the abnormalities on their own would usually be ok, but it was the combination of the abnormalities that pointed toward them being underlying issues in a bigger picture.

Ultimately this appointment solidified what I thought was about to happen. I expected the Amniocentisis to come back and confirm the diagnosis of Edwards Syndrome. My next step then would be to be booked in to have labour induced, to meet and say goodbye to my baby all at the same time.

I had accepted what I was told at my scan on Tuesday, so this time no tears fell. The consultant must have thought I had a heart of stone, this time I stayed composed and accepted everything that I had been told. 

I left the hospital knowing that I would be back on Thursday for the echo scan, but I knew that at some point on or before then... I would have the first set of results back.

I didn’t feel anxious, I didn’t feel like I was waiting for these results, because I didn’t feel that they would have good news. 

Thankfully baby came through the Amniocentisis which for me is a big milestone in itself. The shooty pains weren’t overly painful and didn’t require me to take any paracetamol for them. 

Over the next few days it was like it had never even happened. 

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