32 Week Appointment and Growth Scan

I didn’t write a second trimester update, as I actually felt fantastic. My energy took a while to come back after the first trimester, and it never hit “pre pregnancy baseline,” but all the other symptoms of the first trimester faded away. I got to experience life as a “normal” person, with a normal body, having a normal pregnancy. Honestly, I haven’t felt that healthy in years!

At 23 weeks, we got to have our anatomy scan, which is an hour long ultrasound where they check out every part of baby to make sure everything is growing and forming as it should. Bee is totally perfect! During the anatomy scan, we noticed the umbilical cord was inserting in the side of the placenta instead of in the middle, so I was scheduled to come back at 32 weeks for a growth scan. Sometimes, when the cord inserts in the side, it can get kinked or compressed and inhibit baby’s growth, so we wanted to make sure Bee stayed on track.

Profile picture from the anatomy scan!

I felt amazing up until about 31 1/2 weeks. Suddenly, I felt awful. I felt like I’d been hit by a truck, I was exhausted all the time, and I felt extremely puffy. It really felt like someone had hooked a bike pump up to my uterus and was inflating it. The skin on my stomach went from white to blotchy-purple, and my stomach wouldn’t stop tingling and itching, no matter how much lotion I applied. I told Dan that it felt like pregnancy had decided to take me to “hard mode” overnight. My stomach still won’t stop tingling or itching, despite thick lotion two to three times per day.

Bee was still moving fine, and since I knew it would be just a couple days before I saw the OB, I didn’t call. I still wasn’t feeling great when we got to the ultrasound. I had a lot of pulling/tearing feelings in my abdomen, and what felt similar to intestinal cramps. The exhaustion was extreme, and moving was uncomfortable, and every single part of my body felt like it was puffy. I also really couldn’t breathe, and was borderline panting after minimal exertion.

Profile picture from the 32 week growth scan!

I got up on the table, thankfully Dan was there, and immediately Bee showed us their heart again. It’s so reassuring that that keeps being one of the first things we see every ultrasound! “Look Mom, Dad, my heart is still good and strong!” The sonographer measured all the things, including the fluid volume. Bee is looking great, but was suddenly in the 96th percentile?! They went from measuring “right on track” to measuring two weeks ahead, and my amniotic fluid level was excessive! At 32 weeks, the ultrasound was estimating that Bee already weighs 5 pounds (ultrasound weight estimates are notoriously wrong though, so it’s unlikely). Why is 5 pounds a big deal at 32 weeks? Because from 32-38 weeks, Bee is supposed to gain a 1/2 pound to a full pound per week. If they put on a half pound every week, then they’ll be 8 pounds, which is fine. But if they gain a full pound, then they’ll be 11 pounds, which is huge!

32 week footprint!

When we saw the doctor, we talked all about the ultrasound results. Most cases of excessive amniotic fluid have completely unknown causes, and don’t cause too many problems. There are some complications that can result, including breech presentation (baby is butt down instead of head down at birth), premature rupture of membranes (water breaks early), or preterm labor (due to the extra pressure). They will keep an eye on it. Mostly, the extra fluid makes me uncomfortable. Fundal height is measured from your pubic bone to the top of your uterus in centimeters. The measurement should be the same as the weeks pregnant you are. At 30 weeks, my fundal height was 30cm, exactly where it should be. At 32 weeks? My fundal height was suddenly 35cm. That means that instead of just growing a centimeter per week, it grew 5cm in just two weeks! No wonder my abdomen hurt so much.

Expected baby size at birth can be estimated by the parents’ sizes at birth. I was born just a bit past my due date (40+5), and weighed about 7 1/2 pounds. Dan was born a little early, and weighed somewhere between 7 and 8 pounds. That means that our baby should be somewhere between 7 and 8 pounds at birth. Having them suddenly measuring so huge is definitely a concern. Obviously, the baby doesn’t mind, they’re just growing away happily in there until it’s time to come out. There’s no complications to the baby; the concern is “why are they so big?” Sometimes, it just happens. Dan’s family has “larger than average” head sizes, so Bee’s head measuring in the 99th percentile will likely make a vaginal delivery uncomfortable but isn’t totally unexpected. Their head being so big can also skew their overall size estimate, so that could throw it off.

Thirty Weeks Pregnant
Thirty One Weeks Pregnant
Thirty Two Weeks Pregnant

You can really see how fast my belly grew in my weekly photos. (Above)

However, if you pair the two things (excess fluid and huge baby) together, you can reasonably assume gestational diabetes. My family also has a history of both type two diabetes and gestational diabetes, so with that in mind, the doctor said “it appears you have gestational diabetes.” There’s really not much else that can cause both things to happen at the same time.

The weirdest part, is that my 1 hour screening test several weeks ago came back perfectly. An hour after drinking the sugar drink (called Glucola), your blood glucose should be below 140, and mine was in the 120s. That was the only part that made the doctor scratch his head a little bit. Since I already own a blood sugar monitor to catch hypoglycemia episodes that I’ve had since I was a teenager, the doctor and I agreed that I would do finger pokes four times per day (fasting, then one hour after each meal) until my three hour glucose test on Wednesday the second.

The three hour glucose test is a more extensive test, that catches more cases of gestational diabetes than the one hour test. It’s a time suck, and makes people feel awful (even when not diabetic), so they only perform it if there are symptoms or the one hour test was positive or inconclusive. I show up at my doctor’s office early in the morning, fasting, and get my blood drawn for a fasting sugar level. They then have me drink two of the Glucola drinks (the one hour test is a single drink), and I wait around in the office. They draw my blood at one hour, two hours, and three hours after the drinks have been finished. This test will tell them what my blood sugar levels are doing, and they can compare them to what is “expected.”

Image from Pixabay

Because I’ve been doing finger sticks for a week though, I already suspect that the diagnosis of gestational diabetes will stick around. The finger sticks are also giving me hope, however, as they show that it will likely be easy to manage with diet. I always wake up borderline hypoglycemic (low blood sugar), spike to hyperglycemic (high blood sugar) after breakfast, my standard lunch seems to balance my sugars really well, and then most of my dinners balance my sugars well too. Some dinners that we don’t attempt to balance well result in hyperglycemia, but the ones that are balanced result in normal readings. Thankfully, with it being summer, it’s produce season, which makes eating balanced meals much easier! I’m also glad that this seems to have happened relatively quickly near the end of pregnancy, so it should only be about 8 weeks of management before it goes away.

What’s the difference between gestational diabetes and type two? There really isn’t one, they are functionally the exact same thing. Gestational diabetes is called that because it is first detected during pregnancy, and tends to go away very shortly after birth as hormones level out. If the GD didn’t go away after birth, then the diagnosis would get switched to type two diabetes. That means that currently, my body cannot properly metabolize and use glucose (sugar). Insulin is the hormone secreted by the pancreas that tells your cells to suck the glucose out of your blood and use it for energy, and in gestational diabetes, the insulin isn’t working properly. Because the insulin isn’t working properly, your cells aren’t getting quite enough glucose for energy, and there is too much glucose just floating around in your blood. There’s a lot more detail to the process, but that’s the general summary. Hyperglycemia means your body isn’t using glucose properly, and hypoglycemia means your body is using more glucose than you’re consuming.

Hopefully, the test tomorrow will show the gestational diabetes, and I can really focus on getting it controlled ASAP. Thankfully, after all of the injectable drugs for infertility treatment, if I do require insulin shots, they really won’t be a big deal.

Overall, Bee is great and happily growing away! I am feeling a little physically worn down, but still doing well mentally. Most importantly, I know we’ll both be okay!

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