Wednesday, July 9, 2008

Word of the day - Lew

Alrighty then kids, as the title indicates, the word of the day, well might as well make it word of the time until The Quads are born is 'Diastolic'. WTF is that, right? In a previous blog I mentioned something about normal, warning, and abnormal results from the Dopplers Tonya is getting once a week. Well, I have since went to Dr school so I can talk more sense to ya'll. I got taken to school on the association of labor and water breaking so now I am going to take you all to school.

The Dopplers are completed to monitor diastolic blood flow in the arteries of the umbilical cords of The Quads. There are 2 arteries and 1 vein in a normal umbilical cord. We are extremely fortunate to have 4 normal umbilical cords. The vein supplies the baby with oxygen rich blood from the placenta and the arteries return oxygen depleted blood (high in CO2) to the placenta. The Dopplers are monitoring the flow/pulse of oxygen depleted blood in one of the arteries. Diastolic is the relaxation of the heart, or the lowest pressure of a heart beat. Systolic is the contraction of the heart, or the highest pressure of the heart beat. For example, normal blood pressure for an adult is 120/80, or 120 over 80 - systolic pressure being 120 and diastolic being 80 - got it? We want the pulse to look like a shark fin (very doctor-like technical term) when viewed on a chart. The shark fin is kind of shaped like a 60-30-90 triangle, if you can visualize that - starting from the base, go up 60 degrees and then go down 30 degrees - make sense? We have to see this and this is essential to a growing baby. If the downside fo the triangle meets and parallels the base, we are on serious warning, referred to as restricted flow. If the downside of the triangle goes below the base, there is a problem, referred to as Reverse Diastolic Flow. That problem is not returning oxygen depleted blood that is rich in CO2 to the placenta, which WILL result in death. There are numbers associated with diastolic flow as well. The numbers are representative of the length or ratio of blood flow at peak systolic flow and lowest diastolic flow, measured in centimeters or provided as a ratio. Anyway, the problem for us is the numbers are geared for a single baby that is at least 30 weeks. So, those numbers don't really tell us a lot, but they can be used to monitor stability/instability. Increasing numbers cause for concern - which makes sense - but the main thing is good diastolic flow and not reversed diastolic flow. One variable to consider is it is a wee bit crowded in there so getting accurate Dopplers is a bit more difficult. That seems to be a general statement presented to us at each of the Dopplers we've had so far.

So, we had an appointment on Monday....and all babies are displaying good diastolic flow! Insert huge ass sigh here. Baby A, C, and D were in the 3 range. Baby B had an average in the 5 range, with one reading in the high 3s. Numbers in the 6 to 7 range are cause for concern. Yes, it was again stated that it is difficult to get representative numbers considering the crowd in there. But, Baby B also happens to be the smaller of the babies, though only by a couple few ounces (again, that crowded thing), and the diastolic numbers for Baby B went up a bit from last week.

We have not had any concerns conveyed to us with regard to Baby B.

I seem to have a growing concern for Baby B. Not that Baby B has any problems, but that Baby B might need to come out sooner than 32 weeks, which obviously means they all come out. This is only a concern of mine at this point, but I do believe Dr. J forecasted this 2 weeks ago...

Please give a shout of encouragement out for Baby B - we need those babies in there for another month.

p.s. - take the doctor talk above for what it's worth - some dude looking up words on the internet...


1 comment:

Moni Graf said...

That was a very good explanation. Of course, I was already familiar with the Doppler studies, so I had a headstart. Just remember that you shouldn't put too much stock in ONLY the doppler. Are they also doing BPP's (bio-physical profiles) on the babies? They would check both on ours and sometimes they would get great results on one but not-so-great results on the other. It really depends on if the sonographer can catch the babies at their good times. I consider myself a self-made expert on these tests, since we had them about every day for the last month of my pregnancy. If you guys need to talk to someone who's been through it or have any questions that I might be able to help you with, please don't hesistate to shoot me an email. I'd be happy to send you my phone #.

Keep up the great gestating! You've still got a few more weeks.

Love from KS,