A New Week

It's a new week, and we are back at it. Randi went in this morning at eight for more fluids, heart rate scans, and ultrasound scans. Randi went through three liters of fluids and an hour and a half of heart rate tracings. Everything appears to be holding steady. The babies had good heart rate accelerations and no elongated decelerations during contractions.

The perinatalogist finally arrived around six in the evening for the ultrasound. Wyatt and Parks had turned 180 degrees from Saturday with Wyatt now head down and Parks head up. This is a real good sign that they are staying active and have enough energy to move this much. The doctor spent a lot of time on Wyatt's heart and wasn't saying much, which got us pretty nervous. Finally, he broke the silence and told us that Wyatt was developing slight tricuspid valve regurgitation. With so much pressure put on his heart, it is becoming hard for him to completely empty from the right ventricle. In this case it, produces a backflow into the right atrium (see picture below). At this point, the regurgitation is minimal and not clinically significant. It can potentially become threatening, although it will probably take longer to develop than the number of weeks we have left. It is just another indication of the overall stress that Wyatt is facing.

We also got a little more clarification from the doctor today about a few issues. Since it is asymmetrical growth restriction, Wyatt's head is much larger that his belly, and we have been watching these babies closely, he does not feel that there is any reason to believe that the IUGR is chromosomal in nature. We have seen no markers so far that would indicate this. His growth restriction is simply a function of trying to suck a large oxygen supply through a small straw. Also, the perinatalogist feels that we will deliver these babies at 34 weeks, at the very latest. This would be the point where both babies would have the greatest potential for survival without permanent injury. We don't know; however, that Wyatt's placenta will give us that much more time, so we are thankful for every day, but praying for at least 33 weeks.