Friday, August 27, 2010

No news is good news.

I meant to update after my appointment with the neonatal ultrasound specialist last week, but it ended up being so uneventful that I forgot all about it.

At the appointment, I had to provide a urine sample and then had an ultrasound. First the tech looked everything over, then the doctor himself re-examined baby. Luckily I remembered to remind both not to use any pronouns when referring to the Deuce!

The sort-of-bad news is that the ICEF (intracardiac echogenic foci) is still there. Basically, what we're talking about is a tiny bright spot on baby's heart. The heart is completely normal structurally and is functioning perfectly- the ICEF has no impact in that respect. However, ICEF CAN be a soft marker for some genetic issues- specifically trisomies like Downs.

The good news is that baby is completely normal otherwise and growing right on schedule. There are no other markers that would indicate a genetic issue.

The doctor asked me if I was interested in an amnio, but I told him I was not comfortable with the procedure at this point. To me, the risk of miscarriage (no matter how small) is not worth knowing with certainty whether baby is genetically normal or not. Because of my age (not being at advanced maternal age) and lack of family history of genetic issues, I am otherwise considered very low-risk, and the doctor completely supported my decision to not undergo amnio. I also spoke with a geneticist, who backed my decision as well. In fact, I have been referred back to my midwife, and don't have any additional visits with the specialist scheduled.

I am comfortable with the idea that the ICEF is likely an anomaly- it is estimated that up to 10% of babies exhibit an ICEF at some point, and nearly all are benign, not indicators of chromosomal issues. In fact, many ob-gyns and midwifes hate to even identify such markers to their patients, because they are so very rarely associated with birth defects and often cause unnecessary worry. Conversely, some trisomy babies are born with absolutely no markers at all.

If I felt as though I would worry about the baby's genetic health excessively, and thereby make my pregnancy increasingly stressful, then I might consider amnio. However, I am comfortable with my decision at this point, and most days don't even think about it. I know that the baby's health is in God's hands, and no amount of worrying on my part will change the outcome.


Jo said...

is there a point where the ICEF goes away? Hugs for you momma. And I agree with you on the amnio.

Emily said...

In some babies, ICEF does go away. One theory out there is that ICEF is "normal" for some people-sort of like freckles or curly hair. It wasn't ever noticed until ultrasounds got really good. That's why some doctors are arguing that identifying ICEF (in the absence of other markers) really just causes unnecessary worry.

That's why my follow-up ultrasound was scheduled for a few weeks after my first- the thought was that it might go away on its own, because many do.

And thanks for the support on the amnio. Because there are no serious birth defects evident, I don't really see a benefit to finding out pre-delivery. I couldn't deal with it if I chose to have an amnio and miscarried.