24 Weeks

We are now 24 weeks pregnant. This means we have done a couple things:
1. We have reached what doctors refer to as viability of this pregnancy. If the little one is born from this point on they will do the best they can to sustain his or her life. Lungs will begin forming and our new little one will begin to practice breathing this month.
2. We have passed the gestational time when my water broke, or pProm'd, with our Mighty Max.

Unfortunately, we visited Labor and Delivery again this past Saturday. I woke up to blood in the toliet. It was red, which is a bad sign. So once Grammy and Grandpa Stevenson were here to care for Nate we were off to U.H. My urine was accumulating very quickly and was very pale - essentially translucent. When I was getting my sample ready at L&D I sniffed it because it was so pale and couldn't smell amonia or that, "yup this is urine" scent. This scared me quite a bit - when I pProm'd with Max fluid did not gush from me, I lost the amniotic fluid somewhat gradually. I would go to the bathroom over and over, but I could hold the amniotic fluid in like urine, so it just kept reaccumulating to be released. I was pretty scared that my water had broken again, along with the bleeding.

Fortunately, all checked out with the speculum exam: cervix is closed, the stitch (or cerclage) is as it should be, and there were no real signs of blood except after Dr. E did the thin prep for cultures. They did not find pooling (this is when amniotic fluid accumulates near the cervix), the nitrazine test was negative (a pH kind of test to see if the fluid near the cervix is basic or acidic or alkaline; vaginal secretions and urine are acidic while amniotic fluid is alkaline.)Finally, the ferning test was negative as well. Ferning is where a bit of fluid taken and spread on microscope slides. If it dries with a fern like pattern to it, it is a positive test for amniotic fluid. However, even with all the negative tests, I asked for an utltrasound at the end to see the fluid around the baby. The staff was happy to do this. I also really wanted them to make sure the bleeding did not come from inside the uterus, even though they felt confident it did not. The baby was happily spinning around in fluid, very active and the placenta was adhered to the uterine wall with no clotting behind or around it.
On Monday, I got a call from Dr. E saying my urine had tested positive for bacteria, so I am back on Macrobid. (Our first trip to L&D was two weeks ago for all day cramping that wouldn't go away and that also resulted in my urine culturing bacteria.) However, the normal dipstick test showed my urine to be "clean" both times. So apparently this is not an effective way to keep track on my urinary tract ect and we are going to send cultures every two weeks instead.
The bleeding still makes me uneasy, but it seems the answer to that is the urinary tract infection that was brewing. A urinary tract infection can send the body into preterm labor - contractions begin but they are a usually painfree tightening of the uterus as opposed to the contractions of full term labor. However, they are contractions nonetheless and are serious. For me, the contractions had started on and off fortunately not occurring four per hour. In addition I had menstrual cramping that would wake me around 3-4 in the morning. Both are signs of preterm labor. I am so glad we went to L&D - they caught the infection and we are now treating it, so things should calm down.
On Thursday we have a 24 week ultrasound. Dr. L will look at the baby's heart, again, a transvaginal ultrasound will meaure how long my cervix is and give a good look at the cerclage itself to see if there are any issues there. Hopefully we will see the baby happily swimming around, oblivious to all the craziness going on around him/her. I am going to have my urine cultured again on Thursday and then again next week to be sure the Macrobid has taken care of the infection.
So all in all, this past month has been a little more crazy than we had hoped for.