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October 2011 Due Date Club | My visit to the ER at 6 weeks and follow-up

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POSTED BY: September on 03/26/2011 09:45:53

This is very long....

Something had felt not right down there for a few days. I didn't know if it was yeast or UTI. On the 5th the discomfort peaked and I decided it was time to get checked out.

They took blood and sent me for an ultrasound. I didn't get results as they came in so I got the information like this: 
-Blood work showed a progesterone level of 13.5 which the RPA said is a little low. I think she said normal was 15 or 18.
-On the u/s they saw a subchorinic bleed, 2 cm
-The fetal heart rate was 104 which she said is a little low, normal is 110

She said the low progesterone and bleed increase my risk of miscarriage. She was surprised no one ever mentioned low progesterone to me before. No one has so I have no idea if it's been "normal" for me in previous pregnancies or new to this one. I wished I could get an answer to that right then but it doesn't work like that. She asked me if I had bleeding, I hadn't. I asked about quant and measurements and she said those were OK but didn't tell me exactly what they were.

She also diagnosed me with yeast infection and told me to use Monistat 3 day for that. In addition to that she gave me a prescription for Prometrium (200mg twice a day for 14 days vaginally. She gave me one for that night and I got the prescription filled the following day. She said no intercourse and no lifting. She said to call the OB and tell them I was in the ER, it should get the receptionist's attention. She said I should be seen again no later than Wednesday...my original first prenatal with this office was March 18th. She said she would send all the docs over to the office.

I called my OB's office and they wouldn't set me up with an earlier appointment until they had my records from the ER. On the 8th we went to the hospital and signed a release in person which allowed the hospital I was seen out to immediately send the records over to my OB. I also got a copy for my own personal records. The ultrasound report stated simply:

Single living intrauterine pregnancy of 6 weeks 0 days. The crown to rump length is 4mm. The fetal heart rate is 104 beats per minute. There is a subchorionic hemorrhage seen noted measuring 20 x 7 x 17mm.
My hcg was 15571 and progesterone, as you already know, was 13.5. According to the ranges listed on the documents I am within normal range for 6 weeks but listening to the RPA...gah!

According to LMP going by first day of spotting (01/20) the u/s measurements were two days off, going by first day of red flow (01/21) it was one day off. It seems to me that things were lining up OK.... but I needed to hear something from my OB before I started to relax and stop stressing. 

I called the OB's office that Tuesday, because Monday we got a lot of snow and it basically locked everyone down, they weren't in the office. Of course the doctor's office didn't call me back until we had left the house so I missed the call but will called them back the following day. 

The OB wanted to see me that week (duh) so I went in on Thursday afternoon. this appointment was just follow up for the ER. Apparently there was a misunderstanding and the doctor thought I had bleeding. When I told him I didn't he didn't understand what the ER had made a big deal everything. I gave him the rundown-they diagnosed my with yeast but during the process found SCH, low[er] progesterone, and FHR was 104. 

He told me he wanted me to stop the Progesterone immediately, he said that they do not like to put women with history of clotting on hormones like that. Other than that he wasn't concerned. 

He did a quick ultrasound and said the most important thing right now was the heartbeat and he found that. He said he eyed it and it looked fine, didn't measure it. He tried to get a CRL had an issue getting a good one because I was still so "very, very early". All I saw was a big blob so I don't blame him, lol. Because of that I asked him about fetal demise and he said because we saw the HB we have a 97% chance everything will be fine.

He saw what the ER called a SCH. He showed it to me on the screen and said "See this fluid here? It shouldn't be here and so the ER assumed it was a hematoma." He said chances are it will be re-absorbed. He took me off light duty but still on pelvic rest, he cleared me to go back to the biz....I'd not went in since the ER, Daddy and two of our employees were covering. 

He wrote me a prescription for my blood thinner and more prenatals. He's also referred me to a perinatalogist due to my history of developing blood clots during pregnancy.

If it wasn't for his inability to get a CRL I would have felt a lot better but I worried until our first "real" prenatal on the 18th.

Jamie, kinda crunchy, computer geeky, very blessed, attached mama to four Crunchy Cupcakes & another on the way!