12 Weeks, but No Safe Zone

Just because the crossed legs are cute lol

I’ve reached 12 weeks. The time when most pregnant women start telling people they are expecting a baby. Why? Because we are told that the chances of miscarriage are greatly reduced after the first 12 weeks. I think the statistic from here is about 1 in 200 would end in loss after this point (in a non-recurrent loss, normal pregnancy situation).

0.5% chance doesn’t seem like much. I thought I had been safe at this point last time. I remember feeling a sense of relief, after going through an early miscarriage before that, this time I made it past 12 weeks, so I was set. We shared our news with the world and were so happy.

Then, I became the 1 in 200.

I was completely healthy prior to pregnancy and during.

There were no outright clues that something like this would happen to me.

It still did.

This time around, I’m wiser. I know there is no such thing as a safe zone in pregnancy, especially for me. I’ve had several people ask if there is a time when we can relax a little and feel safer like most feel after 12 weeks. The answer is no. Not during pregnancy for me. We can relax and breath easier when we have a wriggling baby in our arms. Not a moment sooner.

So, while I celebrate making it to 12 weeks, I also know we still have a long way to go. We are hopefully half way to viability, and 22 weeks away from our goal of making it to 34 weeks.

I celebrate making it to 12 weeks because baby is measuring right on track. I celebrate because it is one more week down. It’s progress.

Week in Review

This week started out a bit of a mess. I had difficulties refilling my prescription for tacrolimus, arguably the most important medication I’m on since it is the immunosuppresant that is hopefully keeping my body from attacking the placenta. I’ll write more on this in a different post – because WOW the American healthcare system is JACKED. Luckily, I was able to secure a refill before I ran out!

Tuesday, we went in for a scan and the tech said that everything looked great to her. Later in the day, the MFM called and said he just wanted to personally call and reassure me. He said he wanted to let me know he reviewed the scans, and he was very pleased. Then, he let it slip that the scan looked “much better than last week.” I had to hold back an “I KNEW IT!” I hate when doctors try to sugarcoat things, and I felt like that was what was happening the last week. I had asked questions about the gestational sac measuring more than a week behind and was reassured that it would be fine. This week the sac was still smaller, but the interval growth was good, and there was plenty of fluid. I think things are getting back on track. From here though, they don’t really measure the sac because it can vary so much – the focus is on baby and the fluid.

Wednesday, I had a repeat lab to check my progesterone and DHEA levels. That consultant called my Friday and let me know that my progesterone had increased nicely to 27. I was at 16 at 9 weeks and 14 at 10w+5d. So, to be back up at 27 at 11w+5d was definitely encouraging. I’m back within what the consultant considers a more normal range. Phew! As for DHEA, the consultant likes it to be above 100, and I’m at 143 after starting off at 55 at 9 weeks. I also came across this interesting article that seems to suggest that DHEA can suppress the maternal immune response, which would make it incredibly important in my case to have good levels of DHEA.

Thursday, I followed up on my labs for my tacrolimus level to see if we needed to up my dose. The nurse said they had been having difficulty being able to get the lab to the consultant in London, so I got a copy of the labwork and emailed the consultant myself. With the time difference, I didn’t expect a response until the next day. He emailed back almost immediately and said that based on the trough level, I should up my dose from 3mg twice a day to 4 mg twice a day. I then asked if he had any thoughts on my C-reactive protein number as it was 27, when the normal range is less than 10. He suggested a repeat lab and to increase my prednisolone to 15mg (from 10mg) daily if it was still high. Of course, he advised to only change one thing at a time, so start by upping the tacrolimus. A little background: CRP indicates inflammation, so the idea is that upping the prednisolone for the anti-inflammatory properties could be helpful. We watch for inflammation with CHI because inflammation in the placenta is one of the hallmarks of the condition – the “itis” in “Intervillositis.” I’m hoping that the inflammation has more to do with the fact we moved the week before (stress, moving a bunch of stuff, being tired), or possibly with the intramuscular progesterone shots, than it being a sign of placental issues. I’ll be asking that we follow the London consultant’s advice, so we’ll see! I’ve already upped my dose of tacrolimus, though, so that’s a start!

I haven’t had morning sickness in a while, save for a random bout of nausea yesterday afternoon. No side effects of the many medications I’m on, which is reassuring. No rashes or persistent itching, which I will take as a good sign so far because with Ava, my foot started itching at about 11 weeks. I can’t remember when the patchy rash started, but it was fairly soon after the foot itch if I remember correctly.

Next Up!

Next up is just taking it week by week, scan by scan for the next several weeks. My next MFM consult is at 14 weeks, so I’ll get a higher level scan with a little more information.

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