I have never been a big fan of roller coasters, and last week featured way too many ups and downs.  Tuesday we found out we were having a pair of boys.  I foresee baseball and boy scouts in our future. The ultrasounds looked great for both boys; strong heart rates, 20 fingers and toes accounted for, no soft markers for any issues!

The following day I saw my regular OBGYN.  By her line of questions as she entered the room, I could tell something was amiss.  Turns out, her in office quick screen I tested positive for proteinuria.  Basically that means my kidneys are spilling proteins for some reason. While this is one indicator of preeclampsia, alone it would not lead to a diagnosis for preeclampsia.  She was very surprised the specialist hadn’t caught it the day before.  She decided to have me do a 24 hour screen, which is a much more accurate test to be sure there was not an anomaly.   She also decided for the time being it would be best for me to work from home.  She stopped short of putting me on bed rest and stressed I was not yet confined to the house or the bed for that matter, I just need to take it easy.

Thursday, things were looking back up again.  All of my routine blood work came back and everything looked great.  My platelet count was holding steady.  This was great news!

But then came Friday’s news!  I got a call from Dr. Reed.  When I was pregnant with Ansley, I saw him once.  I had not seen him since, but I knew when I was in the hospital he was the one requesting tests for research purposes and had been following my case.  I was yet to actually see him in this pregnancy, so you can imagine my concern as I am listening to his voicemail and he is asking me to call him.  Before I called him back, I called Chris and gave him a heads up.

Dr. Reed had been calling to discuss my sequential screen results.  The sequential screen is a test that is done in multiple parts to screen for Down Syndrome, Trisomy 18 and neural tube defects.  He started by discussing the Down syndrome results, I tested just outside the norm… again.  I tested the exact same with Ansley and it was a false positive.  He stressed they didn’t see any markers on the ultrasound, twins often throw the numbers off and as stands it was .2% chance based on my numbers.  All in all, I was not too concerned about this result, but it is something I will keep in mind.  There is another blood test I can do called MaterniT21, but it is only 95% accurate with twins.  The bigger concern for him was my high Alpha Fetoprotein levels, aka AFP levels.

Typically, high levels of AFP would be indicative of a neural tube disorder like Spina Bifida.  However, in reviewing my ultrasound he could see about 90% of what he needed to see to rule that out.  He said they will check again in my next ultrasound, but he wasn’t concerned about a neural tube disorder.  His largest concern was based on newer research that has shown a strong link between a poorly functioning/ weak placenta and high AFP levels.  A weak placenta can cause pregnancy complications like preeclampsia, small gestational age, preterm labor, early preterm labor (28 weeks or earlier) and HELLP.  Mixed with my history, the fact I am having twins, and now high AFP levels, he felt strongly that, at a minimum, I will develop preeclampsia during this pregnancy.

This was not exactly new news; my OB has done a good job of making sure we understand all that this pregnancy will likely encounter.  She told me the day we found out about the twins that this would not be a normal pregnancy.  She told me to expect bed rest, hospital bed rest, and that I would possibly deliver preterm via an emergency c-section.   I have done the best I can of preparing myself for whatever happens while trying to remain optimistic.  To me, this is just one more road bump to get past.  That being said, this road is getting awfully bumpy!