After a sleepless night spent scouring the Internet to learn everything I could about Christie's condition (I recommend against this, btw), we were greeted by Dr. Y and team for our 8 AM ultrasound. Once again, the babies were doing wonderfully. Unfortunately, Dr. Y confirmed what Christie's doctor had seen in her exam: Christie's cervix is dilated 2cm, she is 100% effaced, and Baby-A's membranes (the amniotic sac) are protruding about 1cm outside the womb. For those of you unfamiliar with the terminology, this basically means that while the chickens have made no attempt to escape the coop yet, someone has left the door wide open.
At this point, we had two less than ideal options. Option 1 was to use a stitch (called a "cerclage") to close things up. While this is often quite successful in singleton pregnancies, recent studies have shown that it causes preterm labor more often than it prevents it in multiples pregnancies. Dr. Y said that she would perform the procedure if we wanted it, but that she wasn't recommending it. I've read the medical studies myself, and Christie and I both agree that the risks are too high.
So, we arrive at Option 2: more waiting. Basically, the plan is to keep Christie on strict hospital bedrest and do everything possible to prevent things from progressing any further. She is on several medications designed to keep her body as relaxed as possible, and they have been closely monitoring her for labor symptoms (contractions).
When asked how long she could hold out like this, Dr. Y said "hours, days, weeks, ... maybe months". She also warned us that if the babies were born at 22 weeks, they would be too young to survive, and that they would not try to save them. Needless to say, it was a very emotional morning for us.
On Wednesday afternoon, one of the NICU (Neonatal Intensive Care Unit) doctors came down to talk to us about the birth and life of premature babies. Once again, we were thoroughly impressed, and we both felt much more optimistic after he left. He told us that "if Christie was in labor today, the outlook would be dismal. Survival rates are less than 10%, and disability rates are over 90%." However, he also emphasized the fact that this is not the situtation we're in, and that "every day, every hour, every minute" at this stage is very important. At 23 weeks, they will try to save the babies; at this age, survival rates are only ~25%, but they're increasing by 3-4% per day! At 24 weeks, survival rates are 50-60%, and at 25 weeks, 80-85%. Furthermore, disability rates decrease at roughly the same rate, so by 25 weeks, about 65% of babies grow up to be healthy and disability-free. By 27-28 weeks, premature babies are nearly as healthy as full-term babies. Based on this advice, Christie and I have decided to do everything we can to fight to save the twins.
So, we wait, we hope, we pray, and we count down the seconds until next Tuesday.
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Wednesday, May 13, 2009
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