Aaron and I both were filled with nervous excitement as we walked into the Dr’s office today. It seemed like we were waiting for an eternity for our ultrasound. FINALLY we made our way into the room, and I hopped up on the table. Aaron started recording….
[vimeo http://www.vimeo.com/35547651 w=398&h=299]
We are having a baby GIRL! Yeah!!!
For those of you who don’t know, when I was a teenager, the majority of my jobs were babysitting jobs, and almost all of them were caring for little boys. Then in 2000, I became my nephew’s primary caregiver when he was born until he was 9 years old. I have had my fill of the movie Jurassic Park, and the cartoon Land Before time. I have grown tired of picking rocks out of the washing machine, stepping on plastic dinosaurs, and listening to the incessant sound of farting noises and giggles.
Ah… a baby girl :) I can’t wait to fill her room with Strawberry Shortcake stuff! I get to buy cute pink dresses, and flowery headbands, and get her ears pierced! :) I get to play in a world of baby dolls, and princesses!
However, if she decides she wants to play with dinosaurs, and bugs, I’ll be prepared! My daughter will be impressed to know that her mommy can name all of the dinosaurs, and knows all of the lines in the movies Jurassic Park, and Land Before time. I also developed a love for catching frogs, and photographing bugs! Thanks to my nephew :) And of course, she will be a huge Star Wars fan thanks to her Daddy ♥
I think I will buy these! …
Here are some new ultrasound pictures…
There is one small concern that showed up on the ultrasound. There are two cysts on her brain. It’s called “Choroid Plexus Cysts.” or “CPCs.” The ultrasound technician said it’s nothing to lose sleep over, and our Dr. also said we shouldn’t worry, but it can be linked to a chromosomal disorder in some cases.
Here is the information that our Dr. gave us …
“The secondtrimester ultrasound examination (sonogram) will sometimes identify a cyst orcysts in the choroid plexus. The choroidplexus is a tissue in the brain that produces cerebrospinal fluid. Fluid-filled cysts, called choroid plexuscysts or CPCs, are identified by ultrasound in approximately 1-3% of allpregnancies scanned between 16 and 24 weeks gestation. In the majority of cases, CPCs disappear bythe 28th week of pregnancy with no effect on the baby. However, a fetal CPC is considered a”marker”, indicating that the baby may have an increased risk for achromosome abnormality. When observed asan isolated ultrasound finding in women under 35 years of age, the risk fortrisomy 18 is increased, but remains well within the normal range. The risk ishigher for women age 35 or older. Additional abnormal ultrasound findings significantly increase the riskfor trisomy 18 . CPCs do not increasethe risk for Down syndrome in the pregnancy.
Trisomy 18 is achromosome abnormality resulting from an extra copy of chromosome #18, thusthree copies instead of two. Chromosomesare the inherited structures in the cells of the body. There should be 46 chromosomes in each cell,arranged into 23 pairs. Chromosomeabnormalities involving an entire missing or extra chromosome are not inheritedand are not caused by an exposure during pregnancy. Instead, they are caused by random mistakesin cell division at the time of conception and can occur in anyone’spregnancy. Infants with trisomy 18 havesevere mental retardation and multiple birth defects. Many pregnancies with trisomy 18 result in amiscarriage or infant death, although a small percentage can live for severalyears.
When a CPC isidentified on ultrasound, there is the option for additional testing. Detailed ultrasound, to look for both majorbirth defects and minor findings associated with trisomy 18, may berecommended, depending upon the amount of detail that was obtained duringprevious ultrasounds. Maternal serum quad screening, if not previouslyperformed, may be considered to screen the pregnancy for trisomy 18, as well asDown syndrome and open neural tube defects. Amniocentesis, to test forchromosome abnormalities in the baby, is also an option.
It is importantto remember that isolated CPCs are usually normal variants that have nonegative effect on the baby.”
Our Dr. said that if the baby does have Trisomy 18, she would have noticed other abnormalities in the ultrasound. With Trisomy 18 there would be thickening of the neck, and clenched hands for example. There are NO abnormalities. The ultrasound technician said that she is a beautiful baby girl. Weight, and length are perfect. Her body, and organs are perfect.
In this 3d picture of her, you can see her hand is open, and she is touching her cheek. No clenched hands. This is a good sign. This is a blurry picture because the ultrasound is trying to filter through the amniotic fluid so it’s impossible to get a perfectly clear picture of her face.
I also found this additional information online….
“One minuteyou’re thrilled by a glimpse of your baby during a routine ultrasound and thenext you’re told there is a problem. Here are the facts about one commonultrasound finding: choroid plexus cysts.
When Tina andJim Angelman* of Brighton, Massachusetts saw their baby on the ultrasoundscreen, it was a moment of pure joy. Exclamations of “Is it a boy or agirl?” and “Look at those tiny hands!” filled the room, untilTina noticed the technician huddling closer to his screen. When he left to getthe doctor, Tina filled with dread. The doctor’s words fell heavily. “I’msorry, but I see something that may indicate a problem. Your baby has a choroidplexus cyst.”
At that moment,Tina and Jim’s feelings about their baby and the pregnancy changed. “It’spretty hard to describe how it feels to go from cloud nine to the worst day ofyour life in the span of a two-minute conversation. I didn’t know what tothink—the radiologist didn’t really give us a clear picture of what was goingon, and it all seemed very vague,” says Jim.
A similarscenario played out for Cindy Scoville of Phelps, New York during her 18-weekultrasound. “I was so stressed, worried, sad, and anxious,” she saidafter the doctor revealed that her son had four choroid plexus cysts.
At least oneout of one hundred parents will share this frightening experience during aroutine ultrasound. What is a choroid plexus cyst? What does it mean? And whatcan parents do about it?
What is aChoroid Plexus Cyst?
The choroidplexus is an area of the brain that is not involved thinking or personality.Rather, the choroid plexus makes a fluid that protects and nourishes the brainand spinal cord. When a fluid-filled space is seen in the choroid plexus duringan ultrasound, it is called a choroid plexus cyst (CPC). “We don’t knowwhy, but between 1 and 3 percent of all fetuses will manifest a CPC at 16 to 24weeks of pregnancy,” says Dr. Roy A. Filly, a Professor of Radiology andof Obstetrics, Gynecology and Reproductive Sciences and Chief of the Section ofDiagnostic Sonography at University of California, San Francisco. CPCs can befound either on one side of the brain (unilateral) or both sides (bilateral).They can vary in size and shape, from small and round to large and irregular.Some fetuses have more than one.
Regardless oftheir number, shape or size, choroid plexus cysts are not harmful to the baby.”I am not aware of a single instance where a CPC caused damage to afetus,” says Dr. Filly.
Dr. PeterDoubilet, a Professor of Radiology at Harvard Medical School, agrees,”That’s one very important fact. CPCs are not harmful, and they nearlyalways go away by the third trimester of pregnancy.”
If CPCs are foundduring an ultrasound, the radiologist will scrutinize every organ and body partto look for other abnormalities, such as a malformed heart, head, hands orfeet, and stunted growth of the baby. When no other abnormalities are found,the diagnosis is called an “isolated CPC.”
TheSignificance of an Isolated CPC
If CPCs do notcause any damage, why does anyone worry about them? The problem is really oneof association—being at the wrong place at the wrong time. Wrong or right, CPCshave become associated with a severe genetic disease called Trisomy 18. It iswell documented that about half of babies with Trisomy 18 show a CPC onultrasound. But Dr. Bronsteen from the Division of Fetal Imaging at WilliamBeaumont Hospital in Royal Oak, Michigan points out, “Nearly all babieswith Trisomy 18 who have a CPC have other abnormalities on the ultrasound,especially in the heart, hand, and foot.” The real question arises when ababy has a CPC with nothing else wrong: the “isolated CPC.”
This is wherethe experts cannot precisely agree. “The vast majority of fetuses with[isolated] CPCs are completely normal, but when CPCs are seen, the chance ofTrisomy 18 goes up,” says Dr. Doubilet, “This risk is still verysmall: about 1 in 300.” This means that if 300 fetuses have isolated CPCs,only one of them will have Trisomy 18. “While the risk is small, it ishigher than the risk of approximately 1 in 3,000 among all pregnantwomen,” points out Dr. Doubilet. Other doctors have reservations:”The problem with this research is that it studied a high-risk populationinstead of the general population of pregnant women,” says Dr. Filly.”I have no instance in 25 years of experience of an isolated CPCindicating Trisomy 18.”
Dr. Bronsteennotes, “You need to ask if the person doing the ultrasound exam has theexpertise to look for all the abnormalities that are seen with Trisomy 18. Inthe dozen years we’ve been tracking it, we did have some babies with andiagnosis of isolated CPC turn out to have Trisomy 18, but in all those caseswe did not get a complete look at the baby.” His own research indicatesthat it is very important for the sonographer to view the baby’s hands beforeconcluding that the CPC is isolated.
This debateamong experts can leave parents bewildered. But even if an isolated CPC doesmean an increased risk, that risk is still extremely small. The take-homemessage? If a CPC is found with no other warning signs, the outcome isvirtually always positive.
When a baby isdiagnosed with a CPC, there are several things that parents can do. Afterconsultation with their doctor, they will usually undergo a Level IIultrasound. This is a detailed ultrasound exam that is targeted to look forfetal abnormalities. It’s important not to rely on the results of a scanperformed in a doctor’s office or a scan done by someone who is not a trainedexpert in detecting abnormalities by ultrasound. Only after this kind ofintense scan can the diagnosis of an isolated CPC be truly confirmed.
Once otherabnormalities besides the CPC have been ruled out, there are two things parentscan do: watch and wait, or have an amniocentesis. An amniocentesis is the onlyway to know for sure before birth that the baby does not have a geneticdisease. But even though an amnio can give a sure answer, it carries its ownrisk. About one in 250 women will miscarry her baby after an amnio, regardlessof whether the baby is healthy or not.
The otheroption is to watch and wait. Generally the doctor will track the progress ofthe fetus through several follow up ultrasound examinations. Most CPCs willresolve on their own by the sixth month of pregnancy, and a definitive exam ofthe baby’s health can be made after the birth.
While no onecan make this decision except the parents and their doctor, many expertssuggest that the risk of an amnio is not worth it when the only abnormality thebaby has is a CPC. “In our practice, we don’t like to do an amnio onsomebody whose baby has a very low risk of Trisomy 18 because you wind uplosing more normal pregnancies…than you will find Trisomy 18 babies. It doesn’tmake sense to have a miscarriage of two or three normal babies to find one withTrisomy 18,” says Dr. Bronsteen. Your doctor can tell you what his or herrecommendation is for your unique situation.
The Angelmansdiscussed the diagnosis with their doctor and opted to have a Level IIultrasound, which showed no other problems. “It was on the back of ourminds the whole pregnancy, and it made it hard not to worry. But our son wasborn healthy and happy,” say Jim and Tina.
After talkingwith her doctor, Cindy Scoville also decided to have a Level II ultrasound.”At 24 weeks no other abnormalities were found and the sonographer was ableto see everything very clearly.” says Cindy. “Our little boy isbeautiful, healthy and everything we dreamed of. Another happy ending to theworrisome beginning of dealing with a CPC diagnosis during pregnancy.”
A CPC diagnosisis scary, no doubt about it. But rest assured that the experts agree that thevast majority of these babies are perfectly healthy, and their CPC is just anormal part of growth and development.”
Our Dr. did schedule another ultrasound for us in 8 weeks. She said that these cysts normally clear up by 28 weeks. So we just have to wait 8 more weeks for another ultrasound to confirm that her cysts have disappeared, and everything is fine.
I know we shouldn’t worry. Aaron is not worried. Our Dr. doesn’t seem concerned, and neither does our ultrasound technician. I can’t help but worry a little. Please everyone who is reading this, please keep our baby girl in your prayers. Please pray that those cysts are gone soon!
No matter what happens, I’m holding onto God’s hand, always. God has blessed us with this baby girl, and I have complete faith in Him.
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