JunipersCDHstory: 33 week ultrasound

Juniper's current weight measurement is 3lb 12 oz. The way they measure this is by two measurements of the head, belly, and thigh. The most important measurement is the belly. Since Juniper doesn't have her organs in her belly, this is causing that particular measurement to be really small. Her measurements now put her at the 5th percentile and she is officially considered growth restricted. That being said, JJ weighs more than they think she does because they cannot account for the organs in the chest that are supposed to be in the belly. This means she is likely over 4 lbs. If you take out the belly measurement this will actually boost her back into the 10th or 12th percentile based just on the measurements of the head and thigh bone. With all that information, although her belly is small putting her into the 5th percentile, we are still okay and on her growth curve. She is just a more complicated case due to her CDH diagnosis. Babies that are below the 10 percentile are recommended to have an umbilical doppler test where they test and listen to the heart. JJ's number was slightly elevated so when her heart contracts the heart should be stronger and push blood to the placenta, when the heart is relaxed it should still be able to push blood back into the placenta. With this measurement being a little high, this is a sign that the placenta isn't stronger than her heart but is getting closer to being stronger. With it being a little elevated she is still within the normal range. Abnormal would be when the heart is relaxed and they don't see any flow, or when the heart relaxes the blood flow goes back to the baby instead of the placenta (This is called reverse flow). JJ does not have this but is trending toward this. This means we need more tests and frequent watching so I will have two NSTs weekly and a doppler once a week until delivery. If we have the reversal on the doppler test, I will need to be admitted to the hospital and monitored daily until she would need to be delivered. Today we couldn't get an LHR (Lung-to-head ratio) because her stomach is bigger. The reason for that is when her stomach herniated into the chest, her stomach twisted so the fluid can't flow through like it normally would and this is causing more compression on the lungs so we can't see the lungs at this point. We are hoping the stomach will un-twist but it has been twisted since I had my MRI so we don't know if that will happen or not. If it does this could lessen the fluid build-up.

They have scheduled me for an induction on the 15th of March but I am trying to figure out a way we can be close to the Hospital is SLC so that I can go into labor naturally. This is just how I prefer to proceed and believe this is the best option for both JJ and myself. We have a few options for this. One option would be to stay at the Ronald McDonald house which is probably the closest to the hospital or stay in a discounted hotel nearby. The only issue with this is that I would need someone with me 24/7 to drive me to the hospital when I do go into labor and Ryan's (my husband's) work doesn't permit him to work from home. The other option is for us to stay with Ryan's sister who lives about 35 minutes away. I am not sure if the doctors would be okay with being this far from the hospital or not because of all the risks involved such as pre-term labor and placental abruption (due to the fluid being high) but I will talk with them at our next ultrasound appointment on the 6th of March. They think I will likely go into labor around 38 weeks because the fluid is high enough and will keep building and even though I will be 38 weeks my uterus will think I am 40 weeks which would cause my water to break. having this high of fluid will also cause labor to occur much quicker than a normal birth. Sometimes, we can have the opposite problem where the uterus is so big that it can't contract or function like a muscle anymore, if this happens a c-section would be necessary. When I do go into labor, Ryan will go with JJ to the NICU and once I am recovered I will be able to follow behind. If I do get an epidural, they will wheel me in a wheelchair, if I end up needing a c-section they will bring me to the NICU in a bed. I am going to try to go without an epidural so that I am able to recover and walk as quickly as possible. Anything that happens at this point would be explained to us then since we will know a lot more about how JJ is doing, what her actual severity is, and how she is responding and stabilizing.