What to Expect at Your First Maternal Fetal Medicine Appointment

I saw my primary care, Dr. L, after seeing those two pink lines show up. She brought up that we should go see Maternal Fetal Medicine, just to keep a better eye on Little Turtle’s growth.  Now, if you do some googling on why you should need to see this specialist, I recommend that you don’t, you come on the other side more afraid than relived.

When I first got the phone call about setting up my appointment with Maternal Fetal Medicine, you expect to be setting up one appointment. However, it’s almost a whole day affair, or it at least feels like it.

We started with seeing the nurse, who took my vitals and asked if we had any questions about what was going to happen during the appointments or about the pregnancy. She explained about the three appointments what we had scheduled, genetic counselors, ultrasound and then meeting with the doctor.

The genetic counselors were very genuine and explained our testing options. We decided to go with the least invasive of the options because neither side of our families have any chromosomal disorders. This option is a blood test for me and during the ultrasound the tech measures the fluid in the spinal cord right behind the brain. Luckily, for us, everything came back with crazy low odds of Little Turtle having any chromosomal defects, not that it really mattered for us either way.

Then we had our ultrasound, Little Turtle just wanted to sleep though the whole thing. However, after some cold water and a little break, Little Turtle gave us some nice hand waves and profile photo.

Finally, we met with the nurse practitioner who works with Dr. VanEerden. We ended up changing my due date, pushing it back a week to 12/17 form 12/12. During this time I was able to bring up my concerns with going into labor naturally. I worry about this because we live an hours drive away from the hospital in Fargo I would like to deliver at. This is also concerning because of my Spinal Cord Stimulator, the doctor that puts in the epidural has to be even more careful with placement.

Having Complex Regional Pain Syndrome in my left hip brings up a whole host of other issues. The nurse practitioner, said she will bring those concerns up to Dr. VanEerden, that way he can talk with his colleagues around the country, to develop the best plan for how to move forward. I am hopeful we will have a pretty solid plan in place after I see them again in August.

 

 

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What does having a high risk pregnancy mean?

Well, everyone’s pregnancy is different, however mine just happens to be high risk. Everyone talks about it but what does it actually mean?  A lot of it has to deal with the mother’s medical history. Lucky, our first semester genetic screening came back with a 1/220,000 chance of a chromosomal disorder.

My medical history is complicated. As a teenager, I was diagnosed with Bipolar disorder, which means a life time of medications. Some of these can cause birth defects. Having bipolar disorder during pregnancy can add to the hormonal changes that happen which can increase the symptoms. Oliver and I had started trying to get pregnant in January and prior to that with the help of my doctors, we made some medication changes that are “safer.”

I also have a rare nerve condition called Complex Regional Pain Syndrome (CRPS). This condition is basically an overreaction of the nerves following an injury. I fell and broke my right hand in December of 2015, the fractures healed but the pain never went away. In August of 2016, I had a Spinal Cord Stimulator (SCS) placed in order to help distract the pain signals that run from my right arm to the brain. However, in April of 2017, Oliver and I where in a car accident, which caused some damage in my left hip. In late November of 2017, a second SCS was placed to help with those pain signals. I have gotten great pain relief from my SCSs. I stopped using my SCS when I found out I was pregnant in April.

However, my pain has since returned in the last couple of weeks and I have made the decision to turn it back on. The decision was not made lightly and was made with the input of my primary care, pain management specialist and the maternal fetal medicine doctors. We decided that the stress of the pain on my body could cause more harm then the electricity that powers the SCS for Little Turtle.

These are the reasons why my pregnancy is labeled high risk. What changes does this make to my prenatal care? Honestly, this doesn’t change a lot right now. During my first trimester I had the typical 2 ultrasounds. My next scan is the anatomy scan at 20 weeks, which we are doing this one at 22 weeks, so my mom can make it. However that is when my prenatal care changes. I go in for a 4th scan at 27 weeks to check Little Turtle’s heart for defects due to my medications. We will also most likely be induced early. I won’t know more about that till the week 27 scan and appointments.