Zoey Life: April 29th Update to Family and Friends

Wednesday, May 20, 2009

April 29th Update to Family and Friends

Just a quick update…

We had another appointment w/the perinatologist yesterday. Dr. Howard wasn’t in so we saw one of his partners, Dr. Thigpen. It was nice to have a different set of eyes looking at the ultrasound and giving us another opinion.

Zoey did great on the bio-physical profile. This time she was practicing breathing (she wasn’t about to get shocked again! The girl’s a quick learner. Obviously takes after her mother. :-) She did well on the non-stress test, also. She spent a lot of it sleeping but started moving around more once I changed positions.

They did another growth check and she is growing well. Really well. Really, really, reeeally well. She’s a WHOPPER! She weighed in at 4 pounds 11 ounces!! She’s gained a pound and 3 ounces in three weeks. Her abdomen is also continuing to grow well right along with the rest of her body which is great news!

Like Dr. Howard, Dr. Thigpen estimated her omphalocele to be of “moderate” size and he also believes it mostly contains portions of the small and large intestines. He showed us on ultrasound how the veins that run through the liver are all within her abdomen so he also believes that her liver is contained within her abdomen. He said there could be a small tip of the liver that is in the omphalocele but that he believes it is mostly in the abdomen. It was nice to have a second opinion on this because the liver being in the abdomen makes for a much easier repair once she’s born.

Dr. Thigpen believes that Zoey will be able to have the omphalocele repaired with one surgery, shortly after birth. We were very excited to hear this as well! The faster she has surgery means the faster she recovers which means the faster I get to hold her. Dr. Thigpen was not as optimistic as Dr. Howard about her not having any other genetic problems. He said we don’t get “extra points” for the fact that she looks otherwise healthy (Dr. Howard seems to think otherwise). He said we just won’t know until she gets here. He did say though that the fact that she is growing so well is a good sign since, most babies with other problems are usually also growth restricted.

As far as I go, my blood pressure was good and Dr. Thigpen didn’t seem concerned about my blood sugar (which is good because I haven’t been exactly, um, diet compliant. See: Zoey’s weight gain.) and he spared me the glucose test.

After the appointment, we toured Harris’ labor and delivery and saw the neonatal intensive care unit, talked to the nurse about what to expect with the delivery and afterwards, etc. I’ll update all that on the website, though, because this email has gotten long enough already and I feel that most of it is just repeating things I’ve already said.

All in all, it was a good appointment. Nothing has changed for the better and nothing has changed for the worse. That’s the best we can hope for right now.

Love y’all,

A~

No comments:

Post a Comment

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.

Wednesday, May 20, 2009

April 29th Update to Family and Friends

No comments:

Post a Comment

About Me

OMPHALOCELE

Blog Archive