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Follow-up Appointments at Johns Hopkins Hospital

6/16/2014

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Our follow-up appointments today at 23 weeks/4 days consisted of a fetal echocardiogram, ultrasound and meeting with the perinatologist.  I was lucky enough to have my sister, Melinda, accompany me to the these appointments. She has been one of my rocks since we learned of Caleb's diagnosis and she was beyond excited to finally see her nephew on the ultrasounds.

The fetal echocardiogram was performed to evaluate Caleb's heart and assess it's structures and function.  His heart appears to be developed with all four chambers, however, the pediatric cardiologist is slightly concerned with something called an aortic coarctation.  CDH can be associated with other anomalies, therefore, the doctor wants to schedule another fetal echocardiogram at 32 weeks.  Despite the appearance of the aortic coarctation, this is difficult to determine in Caleb due to his CDH and diagnosis of this accompanying cardiac malformation may not be made until after his birth.  Aortic coarctation associated with CDH may occur as an isolated, surgically correctable malformation, but this is usually more complicated with CDH patients.  So, once again, we must wait and hope for the best...

The ultrasound went as well as could be expected.  Caleb is measuring the correct size for his gestational age and there is still no excess of amniotic fluid, both of which is good news.  As of now, I have a complete placenta previa, meaning that the placenta is lying unusually low in my uterus, next to or covering my cervix.  If the placenta covers the cervix completely, it's called a complete or total previa.  If it's right on the border of the cervix, it's called a marginal previa.  This can change over time and can cause bleeding and a few other complications so they will continue to closely monitor this during the pregnancy.  I will need to have a cesarean section if I still have the placenta previa when it's time to deliver Caleb.  Since I was in labor for 3 hours and 45 minutes with Brody, I can't say I would be too disappointed if I needed a c-section...haha!

Finally, we discussed the previous two appointments with my perinatologist and he addressed some questions and additional concerns we had regarding the pregnancy.  I am scheduled to have a follow-up appointment and ultrasound on July 14th and they will also perform my routine one hour glucose screening test to check for gestational diabetes.
  
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One of our favorite ultrasound pictures...
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Caleb's CDH Story
Tim & Candice Salkeld
calebscdhstory@yahoo.com


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