High Wire Balancing Act or Now Comes the Hard Part

I know, I know. NOW comes the hard part? What was everything until now, a walk in the park? Let me explain.

What got the doctors worried earlier this week was confirmed today on the ultrasound. The baby is looing it’s brain sparing effect. One of the problems in the pregnancy is IUGR (Intrauterine Growth Restriction). There are two type of IUGR, symmetrical and the far less common asymmetrical, which is what I have. In asymmetrical IUGR the baby redirects blood flow to save vital organs. In a fetus the only vital organ is the brain (as opposed to a person where it is the brain, heart and lungs). Therefore the head and brain will be proportionally larger than the rest of the body; this is called the brain sparing effect. 

The fact that the baby is starting to lose this effect means that we will have to deliver soon. Now here is the catch. We, and the doctors, are faced with a difficult decision. Having the baby early in my case presents more problems than a regular premature baby. Our baby will have the problems of prematurity and the problems of IUGR. This puts the baby at a much higher risk for many different complications. If we wait two weeks, the chance of many of those complications happening drops significantly (in some cases to as low as 1-4%). However, if we wait we run the real risk of fetal demise. Additionally, the longer that I am pregnant, the high the risk of my developing preeclampsia (a condition that puts both mother and baby at risk and is occasionally fatal to the mother).

So basically, we are stuck between a rock and a hard place. Until now, I have been a curiosity, and rare patient, a hot potato, a teaching case and a “once in a career opportunity.” Now, I will be the subject of a hospital interdisciplinary board meeting. The perinatology (high risk pregnancy) department will meet with the pediatric and neonatology (premature baby) departments and try to decide which choice is the lesser of two evils, which risk has the better chance of yielding a good outcome. Neither option is good and the risks of both are very real.

I am so thankful to be in a great hospital with doctors who really care about what is best for me and for our baby. Everyone has really taken the time to make sure I understand everything that is happening and to answer all of my questions. The entire staff has gone out of their way to make sure I am not only taken care of physically, but also emotionally and spiritually. I therefore feel confident in the doctors and know that they will make the right decision. Hashem (G-d) should bless them with clarity and let them be the right shaliach (messengers) for our yeshuah (salvation).