Isolated echogenic intracardiac foci in patients with low-risk triple screen results: assessing the risk of trisomy 21.Koklanaris N, Roman AS, Perle MA, Monteagudo A.
Division of Maternal-Fetal Medicine, New York University, New York 10016, USA. koklan01@med.nyu.edu
OBJECTIVE: While an echogenic intracardiac focus (EIF) is associated with an increased risk of trisomy 21 (T21), the magnitude of that risk remains controversial, particularly in the setting of a low-risk triple screen (TS). The objective of this study is to define the risk of T21 in patients with a low-risk TS and an isolated EIF. STUDY DESIGN: A retrospective analysis was performed on patients presenting prior to 22 6/7 weeks of gestation. Patients met criteria for inclusion if an EIF was noted, a TS had been drawn, the anatomic survey was complete and was determined to be normal, and karyotyping or delivery occurred at Bellevue Hospital. A high-risk TS was defined as a risk of <1:500, assuming a 2-fold increased risk in the setting of an isolated EIF. A low-risk TS was defined as a risk of >1:500. Statistical analysis was performed using chi-square, with p values of <0.05 considered significant. RESULTS: 7,318 anatomic surveys were performed. An EIF was identified in 584 patients (7.98%), of which 391 met the criteria for inclusion. Of the 391, 51% were Asian and 38% were Hispanic; 348 had a low-risk TS and 43 had a high-risk TS. Patients with an EIF and a low-risk TS had a significantly lower risk of having a T21 pregnancy compared to those with a high-risk TS and an EIF (0 vs. 2.3%; p = 0.004). CONCLUSION: An isolated EIF with a low risk TS is not associated with an increased risk of T21.
PMID: 16318619 [PubMed - indexed for MEDLINE]
Wednesday, April 30, 2008
Reassuring Article About Echogenic Intracardiac Focus
Relationship of isolated fetal intracardiac echogenic focus to trisomy 21 at the mid-trimester sonogram in women younger than 35 years.
Anderson N, Jyoti R.
Department of Radiology, Canterbury District Health Board, Christchurch, New Zealand. Nigel.Anderson@cdhb.govt.nz
OBJECTIVE: To determine whether an isolated echogenic intracardiac focus in the fetal heart in the mid-trimester (16-24 weeks) in women aged 18-34 years of age is associated with trisomy 21. METHOD: This was a prospective population-based observational study. A search of all obstetric sonograms performed in our region from January 1997 to December 1999 was carried out. From 12,373 pregnancies we identified 267 cases of echogenic foci in the fetal heart. Trisomy 21 was detected in 38 deliveries (0.31%). An echogenic focus was seen in 193 of the 9167 women < 35 years of age who had an obstetric sonogram at 16-24 weeks' gestation, and an echogenic focus was seen in 67 of the 1968 women > 35 years. The study group comprised the 149 women aged 18-34 years who had an echogenic focus in the fetal heart as the only abnormality at an obstetric sonogram performed at 16-24 weeks' gestation. RESULTS: There were no abnormal outcomes or cases of trisomy 21 among the 149 pregnancies with an echogenic focus as an isolated finding in women aged 18-34 years (0% (95% confidence interval, 0.00-2.43)). The prevalence of isolated echogenic focus was 1.6% for women < 35 and 1.8% for women >or= 35 years old. Of the 25 fetuses with trisomy 21 undergoing an obstetric sonogram at any gestational age, five (20%) had an echogenic focus. An isolated echogenic focus was present in one fetus with trisomy 21 seen at 26 weeks' gestation in a 17-year-old mother. Echogenic foci were single and in the left ventricle in 84.7% of cases. CONCLUSION: An isolated echogenic focus in the fetal heart at mid-trimester ultrasound in women aged 18-34 years is not associated with increased risk for trisomy 21. Copyright 2003 ISUOG. Published by John Wiley & Sons, Ltd.
Anderson N, Jyoti R.
Department of Radiology, Canterbury District Health Board, Christchurch, New Zealand. Nigel.Anderson@cdhb.govt.nz
OBJECTIVE: To determine whether an isolated echogenic intracardiac focus in the fetal heart in the mid-trimester (16-24 weeks) in women aged 18-34 years of age is associated with trisomy 21. METHOD: This was a prospective population-based observational study. A search of all obstetric sonograms performed in our region from January 1997 to December 1999 was carried out. From 12,373 pregnancies we identified 267 cases of echogenic foci in the fetal heart. Trisomy 21 was detected in 38 deliveries (0.31%). An echogenic focus was seen in 193 of the 9167 women < 35 years of age who had an obstetric sonogram at 16-24 weeks' gestation, and an echogenic focus was seen in 67 of the 1968 women > 35 years. The study group comprised the 149 women aged 18-34 years who had an echogenic focus in the fetal heart as the only abnormality at an obstetric sonogram performed at 16-24 weeks' gestation. RESULTS: There were no abnormal outcomes or cases of trisomy 21 among the 149 pregnancies with an echogenic focus as an isolated finding in women aged 18-34 years (0% (95% confidence interval, 0.00-2.43)). The prevalence of isolated echogenic focus was 1.6% for women < 35 and 1.8% for women >or= 35 years old. Of the 25 fetuses with trisomy 21 undergoing an obstetric sonogram at any gestational age, five (20%) had an echogenic focus. An isolated echogenic focus was present in one fetus with trisomy 21 seen at 26 weeks' gestation in a 17-year-old mother. Echogenic foci were single and in the left ventricle in 84.7% of cases. CONCLUSION: An isolated echogenic focus in the fetal heart at mid-trimester ultrasound in women aged 18-34 years is not associated with increased risk for trisomy 21. Copyright 2003 ISUOG. Published by John Wiley & Sons, Ltd.
Even Better News!
I am officially 21 weeks today! Woohoo! I am more than halfway done with this pregnancy, no matter when I deliver.
Before I forget, I wore my first official maternity outfit to work last wednesday at 20 weeks. I got a lot of compliments on it. At home, I can still wear sweats, but I am transitioning more and more into maternity clothes.
I have more updates about our LO's condition. I finally was able to speak to my OB yesterday. The perinatologist does not believe that I have vasa previa. Instead, he thinks the veins are at the top of the placenta so that there is a buffer between the veins and the cervix. This is really, really good news.
Also, my activity level has not been changed - still just pelvic rest. No bedrest or hospital bedrest. This is huge for me!!
I will also be getting another ultrasound at 23 weeks (May 14th), so that will be cool.
Lastly, apparently, there is some shortening of our son's femur(s), but nothing that is considered abnormal. We started the referral for the amnio, but we are going to wait until I am further along - in case something happens during the amnio.
so, we are starting to get more reassuring news.
Before I forget, I wore my first official maternity outfit to work last wednesday at 20 weeks. I got a lot of compliments on it. At home, I can still wear sweats, but I am transitioning more and more into maternity clothes.
I have more updates about our LO's condition. I finally was able to speak to my OB yesterday. The perinatologist does not believe that I have vasa previa. Instead, he thinks the veins are at the top of the placenta so that there is a buffer between the veins and the cervix. This is really, really good news.
Also, my activity level has not been changed - still just pelvic rest. No bedrest or hospital bedrest. This is huge for me!!
I will also be getting another ultrasound at 23 weeks (May 14th), so that will be cool.
Lastly, apparently, there is some shortening of our son's femur(s), but nothing that is considered abnormal. We started the referral for the amnio, but we are going to wait until I am further along - in case something happens during the amnio.
so, we are starting to get more reassuring news.
A Lot Has Happened Since Our Last Update!
On Wednesday (April 23rd), I began feeling a stabbing pain "down there". I called my doctor, who asked me to come for a cervical examination immediately. I was so nervous, but everything is good. My cervix is long, closed and thick. We also got to hear the baby's heartbeat, so that was reassuring. I was also exactly 20 weeks.
On Friday (April 25th), I went for my Level 2 ultrasound. This test was supposed to reassure us about the vasa previa, but it did not do that. The perinatologist "does not think" I have vasa previa (what help is that???). He did note that the umbilical cord appears to have attached near my cervix, so that really does not reassure me. I will need more ultrasounds to monitor this (this recommendation has become a theme in my pregnancy).
The baby also has a choroid plexus cyst (CPC). Normally, these mean nothing and only 1% of pregnancies go on to have a baby born with a CPC. However, some pregnancies have an association between CPC and Down Syndrome or Trisomy 18 (fatal). The peri recommended an amnio, but i want to see what my OB says. Two weeks ago, my OB did not recommend the amnio, but things may have changed. Regardless, I need another ultrasound to monitor the progress.
With regards to the echogenic intracardic focus (another Down's marker), I will have a fetal echocardiogram on May 7th.
Then, the u/s tech and the peri seemed to think that I have more placenta previa than I did two weeks ago. Again, another u/s to monitor.
I'm still on pelvic rest, but no bedrest yet. My cervix is still nice and long, so that's reassuring. Then, I got a call later in the day that the report faxed to my OB said that I have vasa previa, so I am so confused.
On Friday and Sunday, two of Ashley's teeth broke through. On Friday, it was Ashley's top right and on Sunday, it was her top left tooth.
On Friday (April 25th), I went for my Level 2 ultrasound. This test was supposed to reassure us about the vasa previa, but it did not do that. The perinatologist "does not think" I have vasa previa (what help is that???). He did note that the umbilical cord appears to have attached near my cervix, so that really does not reassure me. I will need more ultrasounds to monitor this (this recommendation has become a theme in my pregnancy).
The baby also has a choroid plexus cyst (CPC). Normally, these mean nothing and only 1% of pregnancies go on to have a baby born with a CPC. However, some pregnancies have an association between CPC and Down Syndrome or Trisomy 18 (fatal). The peri recommended an amnio, but i want to see what my OB says. Two weeks ago, my OB did not recommend the amnio, but things may have changed. Regardless, I need another ultrasound to monitor the progress.
With regards to the echogenic intracardic focus (another Down's marker), I will have a fetal echocardiogram on May 7th.
Then, the u/s tech and the peri seemed to think that I have more placenta previa than I did two weeks ago. Again, another u/s to monitor.
I'm still on pelvic rest, but no bedrest yet. My cervix is still nice and long, so that's reassuring. Then, I got a call later in the day that the report faxed to my OB said that I have vasa previa, so I am so confused.
On Friday and Sunday, two of Ashley's teeth broke through. On Friday, it was Ashley's top right and on Sunday, it was her top left tooth.
Wednesday, April 23, 2008
I've Been Such A Slacker Lately
Too much time has passed since my last post, and too many memories have passed. The most important news we have since my last post is that I am pregnant with our first son!!! Bryan and I are beyond thrilled about this. Unfortunately, we also got some potentially devestating news too. Three conditions were identified on my ultrasound: 1) increased echogenicity on the baby's heart, which can be a marker for Down's Syndrome. My doctor is not worried about this because the rest of the Down's testing (including my bloodwork, the baby's bone length, etc.) came back negative for Down's. So, all this means is that we are going to get another ultrasound to monitor the condition.
2) I have marginal placenta previa. Placenta previa is a condition where the placenta is close to, or on, the cervix. There are three types - complete, partial or marginal. Complete placenta previa means that the baby's placenta covers the mom's entire cervix, while marginal means that the placenta is right next to the cervix. There is a possibility that the placenta will move as my uterus grows, so, again, my doctor is not too worried. Again, I will be monitored by ultrasound to determine the status of the previa.
3) The most devestating news is that I might have vasa previa. This is a condition where the fetus' blood vessels stretch across my cervix. This is a potentially fatal condition for our son, as the babies bleed out relatively quickly once the mother goes into labor. I have a Level 2 ultrasound scheduled for Friday, April 25th to determine if there are fetal blood vessels over my cervix. If so, our whole plan of action changes. In the meantime, I am on pelvic rest and I have been told to take it easy until April 25th - no strenuous lifting, exercising and trying not to pick up Ashley too much.
In other news, Ashley cut her first upper tooth today. The tooth is one of her front teeth, on the right side. Otherwise, she continues to do well. She is babbling like crazy, cruising like a madwoman and being overall cute. She is more and more interested in table food and not baby food anymore. She's been in a relatively good mood and a good sleeper through her teething. She's just the best baby anyone could possibly ask for.
2) I have marginal placenta previa. Placenta previa is a condition where the placenta is close to, or on, the cervix. There are three types - complete, partial or marginal. Complete placenta previa means that the baby's placenta covers the mom's entire cervix, while marginal means that the placenta is right next to the cervix. There is a possibility that the placenta will move as my uterus grows, so, again, my doctor is not too worried. Again, I will be monitored by ultrasound to determine the status of the previa.
3) The most devestating news is that I might have vasa previa. This is a condition where the fetus' blood vessels stretch across my cervix. This is a potentially fatal condition for our son, as the babies bleed out relatively quickly once the mother goes into labor. I have a Level 2 ultrasound scheduled for Friday, April 25th to determine if there are fetal blood vessels over my cervix. If so, our whole plan of action changes. In the meantime, I am on pelvic rest and I have been told to take it easy until April 25th - no strenuous lifting, exercising and trying not to pick up Ashley too much.
In other news, Ashley cut her first upper tooth today. The tooth is one of her front teeth, on the right side. Otherwise, she continues to do well. She is babbling like crazy, cruising like a madwoman and being overall cute. She is more and more interested in table food and not baby food anymore. She's been in a relatively good mood and a good sleeper through her teething. She's just the best baby anyone could possibly ask for.
Wednesday, April 2, 2008
Our Miracle, A Year Later...
A year ago, Bryan and I were in an unimaginable and unenviable position - we were the proud, scared, thrilled, emotional parents of a newborn baby. The only problem? Our baby was not supposed to be born in March. She was not supposed to be born in April or May either. Her EDD was June 16, 2007, which made Ashley 11w6d early.
Our ordeal began on March 19, 2007. I was 2 cm dilated and 80% effaced. By 7 am on the morning of the 20th, I was 7 cm dilated. The entire staff at St. Joseph Mercy Hospital - Pontiac thought we would have Ashley on the 20th. My attending OB that day brought in the director of the NICU to brief us. I knew most of the problems that Ashley could face (periventricular leukomalacia, intraventricular hemmorhage, retinopathy of prematurity, cerebral palsy, hydrocephalus, mental retardation, etc.) simply from my employment as a medical malpractice attorney. Bryan, luckily, or unluckily (depending upon how you look at it), did not know as much.
However, we both had the same reaction that morning, tears were streaming down our face. I remember thinking, "this is not supposed to happen to us." I had the perfect pregnancy, up until March 19th. No complications, no abnormal blood pressure, nothing. I ate perfectly, watched what I was supposed to consume, limited my caffeine intake and exercised. I was the last person in the world that I expected this to happen to. But, what could I do? Bryan and I were told to start praying that the baby was a girl, because white girls do much better than white boys in the NICU (we did not learn the sex until Ashley was born). We were also told to pray that I make it to 28 weeks, because there is an 80% survival rate at that point. We prayed like crazy!
For reasons completely unknown to me, my body cooperated until Sunday, March 25th. I was exactly 28w1d at that point. My contractions began picking up again around 5:30 p.m. or 6:00 p.m. Bryan was at home taking care of some business (he had been a dear and was staying overnight at the hospital with me). I called him back to the hospital immediately. Approximately 3 hours later, at 8:32 p.m., after 10-15 minutes of pushing, Ashley was born. She weighed 2 pounds, 8.2 oz and was 14 inches long. Much to my surprise, she cried! I think that was the best sound I could have possibly heard. The NICU staff was present during the delivery and immediately began to stabilize/assess her. I was able to hold her for a few minutes before she was whisked away to the NICU.
Those next few hours were horrible. Everyone left my room shortly after Ashley did. I showered with the assistance of a nurse, then was whisked away to my post-partum room. I got to visit Ashley, which was surreal. She was so tiny and perfect. However, she was hooked up to an IV, oxygen, etc. This is not what I pictured my post-operative experience to be. We got to visit for about a half hour, then I went back to my room. This was a very lonely experience. I decided to breastfeed, so I had a breast pump delivered to my room. I had to wake myself up every 2-3 hours around the clock to pump, but my baby was no where in sight. That was pretty depressing. I could hear babies crying in the hallway, which depressed me even more.
The worst experience of my life, to date, was when I left the hospital without my baby, I almost cried. I would never wish that upon anyone. No mother should have to leave the hospital without her baby. Ashley was relatively stable, but Bryan and I were ever cognizant of the fact that something dire could happen at a moment's notice. When I left the hospital, it was no guarantee that Ashley would make it to the next day. I really did not want to leave, but my insurance would not let me stay.
I visited Ashley twice a day until she came home - 46 days later. Bryan would see her every day as well. We got to change her diaper, take her temperature, bathe her, hold her and, eventually, feed her by bottle. We lived for these moments. We never let the staff bathe Ashley, after we got the okay to do it. These small assistances allowed us to be a part of Ashley's daily life. We got to be parents for a short amount of time. Just like my pumping at home, we were a part of her care.
Ashley came home on May 10th on oxygen and a heart monitor. This was a scary experience. The heart monitor would beep if Ashley stopped breathing or if her heart stopped beating. Quite a few times, the alarm attached to the machine went off in the middle of the night, and both Bryan and I would sit bolt right up in bed and run to her bassinet! A couple of times, Ashley did stop breathing, but she always came back (another preemie complication). We finally got rid of the oxygen on June 15th and the heart monitor in July. Thank goodness!
Luckily for us, Ashley grew really well throughout her first year. We never had a set back and all of our developmental appointments came back with flying colors. We have never needed physical therapy, occupational therapy, speech therapy, or Early On. We have also only had to experience one cold - no fevers, RSV, ear infections, breathing problems, etc. We have been very, very lucky. We realize that not all preemie parents can say this, even parents of preemies born later than Ashley. We are well aware of what could have happened, and how different our lives could be. We were prepared for multiple specialist appointments, but we never have had to do this.
All we can do is be thankful to God. We firmly believe that my grandfather and Bryan's grandmother have been watching out for Ashley. She is truly a gift from God, as is her development, her milestones, her abilities, her personality, etc. We could not have asked for a better experience, and we are ever cognizant that another pregnancy could turn out completely different than this one. The fact that Ashley is developing along the lines of a normal one year old is just amazing to us. She is so smart and engaging, something that we were prepared for might never happen. We do not know why we were blessed this way, but we continue to thank God for this blessing.
We are forever proud to be Ashley's parents. I am firmly convinced that we had Ashley as a preemie so that we would not take life for granted. Most parents take their child's development, discoveries, abilities, etc. for granted. They compete for each other for the title of first smile, first crawl, etc. When Ashley was born, nothing was guaranteed. We did not know if she would smile, if she would talk, if she would stand, crawl, etc. We did not know how her prematurity would affect her. Each thing that Ashley has done has been a miracle for us. We celebrate everything that Ashley does because there was no guarantee. Her prematurity has taught us to be grateful for everything life offers us and we would not change it for the world.
Thank you Ashley for choosing us to be your parents! We absolutely love you princess and we are soooooo immensely proud of you. You have been a blessing and everything we could possibly hope for. Happy First Birthday Sweetie! We look forward to celebrating more birthdays with you.
Our ordeal began on March 19, 2007. I was 2 cm dilated and 80% effaced. By 7 am on the morning of the 20th, I was 7 cm dilated. The entire staff at St. Joseph Mercy Hospital - Pontiac thought we would have Ashley on the 20th. My attending OB that day brought in the director of the NICU to brief us. I knew most of the problems that Ashley could face (periventricular leukomalacia, intraventricular hemmorhage, retinopathy of prematurity, cerebral palsy, hydrocephalus, mental retardation, etc.) simply from my employment as a medical malpractice attorney. Bryan, luckily, or unluckily (depending upon how you look at it), did not know as much.
However, we both had the same reaction that morning, tears were streaming down our face. I remember thinking, "this is not supposed to happen to us." I had the perfect pregnancy, up until March 19th. No complications, no abnormal blood pressure, nothing. I ate perfectly, watched what I was supposed to consume, limited my caffeine intake and exercised. I was the last person in the world that I expected this to happen to. But, what could I do? Bryan and I were told to start praying that the baby was a girl, because white girls do much better than white boys in the NICU (we did not learn the sex until Ashley was born). We were also told to pray that I make it to 28 weeks, because there is an 80% survival rate at that point. We prayed like crazy!
For reasons completely unknown to me, my body cooperated until Sunday, March 25th. I was exactly 28w1d at that point. My contractions began picking up again around 5:30 p.m. or 6:00 p.m. Bryan was at home taking care of some business (he had been a dear and was staying overnight at the hospital with me). I called him back to the hospital immediately. Approximately 3 hours later, at 8:32 p.m., after 10-15 minutes of pushing, Ashley was born. She weighed 2 pounds, 8.2 oz and was 14 inches long. Much to my surprise, she cried! I think that was the best sound I could have possibly heard. The NICU staff was present during the delivery and immediately began to stabilize/assess her. I was able to hold her for a few minutes before she was whisked away to the NICU.
Those next few hours were horrible. Everyone left my room shortly after Ashley did. I showered with the assistance of a nurse, then was whisked away to my post-partum room. I got to visit Ashley, which was surreal. She was so tiny and perfect. However, she was hooked up to an IV, oxygen, etc. This is not what I pictured my post-operative experience to be. We got to visit for about a half hour, then I went back to my room. This was a very lonely experience. I decided to breastfeed, so I had a breast pump delivered to my room. I had to wake myself up every 2-3 hours around the clock to pump, but my baby was no where in sight. That was pretty depressing. I could hear babies crying in the hallway, which depressed me even more.
The worst experience of my life, to date, was when I left the hospital without my baby, I almost cried. I would never wish that upon anyone. No mother should have to leave the hospital without her baby. Ashley was relatively stable, but Bryan and I were ever cognizant of the fact that something dire could happen at a moment's notice. When I left the hospital, it was no guarantee that Ashley would make it to the next day. I really did not want to leave, but my insurance would not let me stay.
I visited Ashley twice a day until she came home - 46 days later. Bryan would see her every day as well. We got to change her diaper, take her temperature, bathe her, hold her and, eventually, feed her by bottle. We lived for these moments. We never let the staff bathe Ashley, after we got the okay to do it. These small assistances allowed us to be a part of Ashley's daily life. We got to be parents for a short amount of time. Just like my pumping at home, we were a part of her care.
Ashley came home on May 10th on oxygen and a heart monitor. This was a scary experience. The heart monitor would beep if Ashley stopped breathing or if her heart stopped beating. Quite a few times, the alarm attached to the machine went off in the middle of the night, and both Bryan and I would sit bolt right up in bed and run to her bassinet! A couple of times, Ashley did stop breathing, but she always came back (another preemie complication). We finally got rid of the oxygen on June 15th and the heart monitor in July. Thank goodness!
Luckily for us, Ashley grew really well throughout her first year. We never had a set back and all of our developmental appointments came back with flying colors. We have never needed physical therapy, occupational therapy, speech therapy, or Early On. We have also only had to experience one cold - no fevers, RSV, ear infections, breathing problems, etc. We have been very, very lucky. We realize that not all preemie parents can say this, even parents of preemies born later than Ashley. We are well aware of what could have happened, and how different our lives could be. We were prepared for multiple specialist appointments, but we never have had to do this.
All we can do is be thankful to God. We firmly believe that my grandfather and Bryan's grandmother have been watching out for Ashley. She is truly a gift from God, as is her development, her milestones, her abilities, her personality, etc. We could not have asked for a better experience, and we are ever cognizant that another pregnancy could turn out completely different than this one. The fact that Ashley is developing along the lines of a normal one year old is just amazing to us. She is so smart and engaging, something that we were prepared for might never happen. We do not know why we were blessed this way, but we continue to thank God for this blessing.
We are forever proud to be Ashley's parents. I am firmly convinced that we had Ashley as a preemie so that we would not take life for granted. Most parents take their child's development, discoveries, abilities, etc. for granted. They compete for each other for the title of first smile, first crawl, etc. When Ashley was born, nothing was guaranteed. We did not know if she would smile, if she would talk, if she would stand, crawl, etc. We did not know how her prematurity would affect her. Each thing that Ashley has done has been a miracle for us. We celebrate everything that Ashley does because there was no guarantee. Her prematurity has taught us to be grateful for everything life offers us and we would not change it for the world.
Thank you Ashley for choosing us to be your parents! We absolutely love you princess and we are soooooo immensely proud of you. You have been a blessing and everything we could possibly hope for. Happy First Birthday Sweetie! We look forward to celebrating more birthdays with you.
Alot Has Happened Since My Last Post
If you notice, the date of my last post was Ashley's 1 year birthday. I have been hesitant to post on here because I do not know what to say, yet I have a lot to say. I'll update on the most recent events in our lives, then devote an entire post to Ashley's one year birthday.
Our first update occurred on March 28th. This was Ashley's last RSV shot and her 1 year well baby appointment. She weighed 19 pounds, 12.5 oz and was 28.25 inches long. This is the 25th percentile for both measurements, which is consistent with her growth pattern since May of 2007. We got the go ahead at this appointment to make the switch to whole milk (which was good because we had been mixing the frozen breastmilk and whole milk together). Ashley did not enjoy her last RSV shot, but, hopefully, she will never need the shots again. They did a wonderful job protecting her this past winter, so they were a necessary evil. She also began eating Velveeta shells and cheese, and she LOVES it! In fact, I cannot eat first - Ashley must receive all macaroni before mommy.
On Saturday night (March 29th), I think I felt the "new" baby moving for the first time. This is much earlier than I felt Ashley, but apparently this is common in subsequent pregnancies. I was 16w3d at this point. The baby felt like little bubbles popping in my stomach. It is so hard to describe, unless you have been pregnant, then you know exactly what I am talking about. Today, I felt the baby move a lot more after dinner - around 7 pm. The movements are not consistent yet, they come, then they go. I have not tried to get Bryan to feel them yet, because they are so fleeting. In the next few weeks, this baby will get so much more strong. I cannot wait to feel those kicks.
If you have read my previous posts, you will see that Ashley has begun pulling herself up on objects. Over the past week, she has become more agile and adept at pulling up. Well, Ashley has advanced even more in this area. On Sunday, March 30th, Ashley was standing up in her crib. This is a first for her. Bryan walked in her room and could not believe it. Today, we finally lowered the crib (especially after my mom told me that she had pulled up again). This was a milestone for me because it signals the fact that Ashley is no longer a baby. We will never go back in time with her. From this point forward, she is a big girl. I just saw her in her lowered crib and I cannot believe it - my baby is growing up.
I had my second 17P injection on Monday, the 31st. Again, reading my previous posts, you see the reason for the injection. I have to receive the injection on the same day every week. The shot goes in one of my buttocks, and we alternate each week. Surprisingly, the shot does not hurt. There are some side effects, such as fatigue, headaches and breakthrough bleeding. I think the only side effect I am experiencing is the fatigue. I feel so tired still - like I am still in my first trimester. However, I will do whatever I need to so that this pregnancy makes it to 37 weeks, at least.
Our last tidbit of news is that Ashley ate at Mongolian BBQ last night with us. This is one of our favorite restaurants. She sat in her highchair patiently and allowed us to feed her bits of chicken, potato, lamb and egg. She really seemed to enjoy herself. However, every once in a while, she experienced some of the sauce and seasonings, which she really has never had before (all her food is pretty bland). She would scrunch her face up and stick out her tongue like we were poisoning her. She's so adorable, though, and such a trooper. She really, really loves adult food.
Our first update occurred on March 28th. This was Ashley's last RSV shot and her 1 year well baby appointment. She weighed 19 pounds, 12.5 oz and was 28.25 inches long. This is the 25th percentile for both measurements, which is consistent with her growth pattern since May of 2007. We got the go ahead at this appointment to make the switch to whole milk (which was good because we had been mixing the frozen breastmilk and whole milk together). Ashley did not enjoy her last RSV shot, but, hopefully, she will never need the shots again. They did a wonderful job protecting her this past winter, so they were a necessary evil. She also began eating Velveeta shells and cheese, and she LOVES it! In fact, I cannot eat first - Ashley must receive all macaroni before mommy.
On Saturday night (March 29th), I think I felt the "new" baby moving for the first time. This is much earlier than I felt Ashley, but apparently this is common in subsequent pregnancies. I was 16w3d at this point. The baby felt like little bubbles popping in my stomach. It is so hard to describe, unless you have been pregnant, then you know exactly what I am talking about. Today, I felt the baby move a lot more after dinner - around 7 pm. The movements are not consistent yet, they come, then they go. I have not tried to get Bryan to feel them yet, because they are so fleeting. In the next few weeks, this baby will get so much more strong. I cannot wait to feel those kicks.
If you have read my previous posts, you will see that Ashley has begun pulling herself up on objects. Over the past week, she has become more agile and adept at pulling up. Well, Ashley has advanced even more in this area. On Sunday, March 30th, Ashley was standing up in her crib. This is a first for her. Bryan walked in her room and could not believe it. Today, we finally lowered the crib (especially after my mom told me that she had pulled up again). This was a milestone for me because it signals the fact that Ashley is no longer a baby. We will never go back in time with her. From this point forward, she is a big girl. I just saw her in her lowered crib and I cannot believe it - my baby is growing up.
I had my second 17P injection on Monday, the 31st. Again, reading my previous posts, you see the reason for the injection. I have to receive the injection on the same day every week. The shot goes in one of my buttocks, and we alternate each week. Surprisingly, the shot does not hurt. There are some side effects, such as fatigue, headaches and breakthrough bleeding. I think the only side effect I am experiencing is the fatigue. I feel so tired still - like I am still in my first trimester. However, I will do whatever I need to so that this pregnancy makes it to 37 weeks, at least.
Our last tidbit of news is that Ashley ate at Mongolian BBQ last night with us. This is one of our favorite restaurants. She sat in her highchair patiently and allowed us to feed her bits of chicken, potato, lamb and egg. She really seemed to enjoy herself. However, every once in a while, she experienced some of the sauce and seasonings, which she really has never had before (all her food is pretty bland). She would scrunch her face up and stick out her tongue like we were poisoning her. She's so adorable, though, and such a trooper. She really, really loves adult food.
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