Zoey Life: April 17th Update to Family and Friends

Tuesday, May 19, 2009

April 17th Update to Family and Friends

Yep, blood pressure was up yesterday. We thought it was just because I had psyched myself out before the appointment (just expecting more bad news, you know?) but they took it three different times (the third time they had me lay down on my left side for about 15 minutes before they took it) and it was still high. The doctor told me to lie around this weekend and not do much of anything. Then I have to go back on Monday to re-check my blood pressure, the baby, etc. So it would be really great if y’all could take Sam tonight. I sent Jennifer an email but she may not have received it yet. I think she was going to pick him up from school? Anyway, I will probably stop by Payton’s party for a few minutes so I can see Sam and drop off Payton’s present and Sam’s bag. Then I’m going home and to bed for the rest of the weekend. I really need my blood pressure to stay down so that 1) the baby doesn’t come early and 2) I can work. The doctor mentioned taking me out of work if the blood pressure doesn’t go down. I really, really, reeeeeaaaaaaaaalllllllllyyyyyyy need to work.

Other than my blood pressure, the appointment went really well. Zoey did great on both the non-stress test and the bio-physical profile. This means that she’s not in any distress! I had three different people, including Dr. Howard, do an ultrasound. They were great, took their time, and answered my questions. Dr. Howard said again that he doesn’t believe she has any chromosomal disorders. He told me things they look at on ultrasound that would indicate she did (like cleft palate, club feet, hands that were balled up, etc.) and he showed me on the ultrasound that she didn’t have any of those things.

Toward the end, Zoey got tired of all the attention and shot the ultrasound tech the finger. Priceless! She’s definitely MY child.

We’ll repeat all that over again on Monday, and weekly, until D-day. Dr. Froeschke will not be seeing me anymore, only Dr. Howard. Just as well since I just might punch the ultrasound tech, that missed the omphalocele at 18 weeks, if I see her again.

Sorry for the novel. I cc’d Mark and decided to give you guys the update I planned to send out later anyway.

Love y’all,

A~

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OMPHALOCELE

What is an omphalocele?

An omphalocele is a birth defect, which is an abnormality that occurs before birth as a fetus is forming in its mother's uterus. Some of the abdominal organs protrude through an opening in the abdominal muscles in the area of the umbilical cord. A translucent membrane covers the protruding organs.
The omphalocele may be small, with only a portion of the intestine protruding outside the abdominal cavity, or large, with most of the abdominal organs (including intestine, liver, and spleen) present outside the abdominal cavity. Further, the abdominal cavity itself may be small due to underdevelopment during pregnancy.

What causes an omphalocele?

As a fetus is growing in the mother's uterus before birth, different organ systems are developing and maturing. Between the 6th and the 10th weeks of pregnancy, the intestines actually project into the umbilical cord as they are growing. By the 11th week of development, the intestines should return to the abdomen. When the fetus is growing and developing during pregnancy, there is a small opening in the abdominal muscles that the umbilical cord can pass through, connecting the mother to the fetus. As the fetus matures, the abdominal muscles should meet in the middle and grow together, closing off this opening. An omphalocele occurs when the abdominal organs do not return to the abdominal cavity as they should.

It is not known what causes omphalocele. Steps that normally happen in the development of the abdominal organs and muscles simply did not happen properly. It is not known to be caused by anything the mother did during pregnancy.

Who is at risk for developing an omphalocele?

When an omphalocele is isolated (no other birth defects are present), the risk for it to happen in a future pregnancy is one percent or one in 100. There are some families that have been reported to have an omphalocele inherited as an autosomal dominant or X-linked recessive trait. In these cases, the chance for reoccurrence would be higher.

Many babies born with an omphalocele also have other abnormalities. The chance for reoccurrence depends upon the underlying disorder:

Thirty percent have a chromosomal (genetic) abnormality, most commonly Trisomy 13, Trisomy 18, Trisomy 21, Turner syndrome, or triploidy.

Some infants with omphalocele have a syndrome known as Beckwith-Wiedemann syndrome.

More than half of babies with omphalocele have abnormalities of other organs or body parts, most commonly the spine, digestive system, heart, urinary system, and limbs.

How often does an omphalocele occur?

A "small" type omphalocele (involving protrusion of a small portion of the intestine only) occurs in one out of every 5,000 live births.

A "large" type omphalocele (involving protrusion of the intestines, liver, and other organs) occurs in one out of every 10,000 live births.

More boys than girls are affected with omphalocele.

Why is an omphalocele a concern?

Since some or all of the abdominal organs are outside the body, infection is a concern, especially if the protective membrane around the organs breaks. Also, an organ may lose its blood supply if it becomes pinched or twisted. A loss of blood flow can damage the affected organ.

How is an omphalocele diagnosed?

Omphalocele can often be detected on fetal ultrasound in the second and third trimesters of pregnancy. A fetal echocardiogram (ultrasound of the heart) may also be done to check for heart abnormalities before the baby is born.

After birth, the omphalocele can be noted by the physician during the physical examination. X-rays (diagnostic tests which use invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film) may also be done after birth to evaluate abnormalities of other organs or body parts.

Treatment for an omphalocele:

Specific treatment for an omphalocele will be determined by your baby's physician based on the following:

your baby's gestational age, overall health, and medical history
the extent of the condition

your baby's tolerance for specific medications, procedures, or therapies

expectations for the course of the condition

your opinion and preference

For a "small" omphalocele (only a portion of the intestine protruding outside the abdominal cavity), shortly after birth, an operation is done to return the organs to the abdomen and close the opening in the abdominal wall.

For a "large" omphalocele (most of the abdominal organs, including intestine, liver, and spleen are present outside the abdominal cavity), the repair is done in "stages" and may include the following:

Initially, sterile, protective sheeting is placed over the abdominal organs.

Because the abdomen may be small and underdeveloped, it may not be able to hold all of the organs at once. Therefore, the exposed organs are gradually moved back into the abdomen over several days or weeks.

The abdominal wall is closed surgically once the organs have been returned to the abdominal cavity.

Because the abdominal cavity may be small and underdeveloped, and the organs may be swollen, a baby with an omphalocele may have breathing difficulties as the organs are returned to the abdomen. Your baby may need help from a breathing machine called a mechanical ventilator while the swelling is decreasing and the size of the abdominal cavity is increasing.

What is the long-term outlook for a baby born with an omphalocele?

Problems in the future often depend on:

the size of the omphalocele.

if there was a loss of blood flow to part of the intestine or other organs.

the extent of other abnormalities.

Babies who have damage to the intestines or other abdominal organs may have long-term problems with digestion, elimination, and infection.

Tuesday, May 19, 2009

April 17th Update to Family and Friends

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