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Antenatal tests

Feeling Low-Missed Miscarriage at 20 weeks, Now TFMR at 21 weeks. Plus CVS issue

10 replies

ChickArito · 20/10/2011 16:33

I've not posted before, but have looked in before earlier this year when I needed to find support. My apologies for the length of this post as there's quite a lot of things happened.

Back in March this year, our world fell apart. I was pregnant with our first. We'd worried a little about the combined test result that came back (I think it was 1 in 36), but didn't feel that we wanted to risk testing further. When we'd discussed this with the ante-natal screening midwife she'd suggested that if we didn't want to risk invasive testing the 20 week scan could be scheduled with the consultant, who had more experience and might pick up more from the scan. So that's what we went with, and when we went for the scan we were a little concerned but very aware that it wasn't statistically that high a risk. What we weren't prepared for when we went in was that the consultant would have to tell us that unfortunately our baby had died, and that it had apparently happened a week or two previously.

This was devastating. We'd had no inkling. Everybody was very kind and supportive, and eventually the days got a little less painful. There had been a problem with the placenta and the cord, which hadn't been able to support our little boy. The consultant told us there was no reason it should happen to us again.

We'd decided to try again pretty much as my cycle returned. I didn't really want to wait and in particular was anxious about the length of time it had taken to get pregnant first time round (I'd had a laparoscopy and we'd been having tests when I'd got the positive result) and my age (37). As things turned out I got pregnant again quickly. Things were very anxious and we kept the news largely to ourselves. After our loss the consultant had said that for any subsequent pregnancy, after the 12 week scan he would begin regular scans at 16 weeks to monitor and reassure us. He also wanted me to take low dose aspirin through a subsequent pregnancy as a precaution.

After we came out of the 12 week scan, my husband already looked worried. He'd seen them take the nuchal fold measurement and, although not really high it had been a little higher than average and higher than on the previous pregnancy. Given that in the earlier pregnancy the principal factor to push up the risk had been the results of my blood test, he felt it was inevitable that the risk factor was going to come back higher than the previous time. We then waited to hear, but I wasn't surprised to get a phone call about it. We'd been unsure at what risk factor we'd decide to have a CVS or amnio, but as it turned out the risk came back as 1 in 2 which took our breath away. With no greater risk available, we felt we had to have a test and know more.

Unfortunately, it was the peak of summer and the consultant we had been dealing with was not available around the time to have a CVS. The lack of availability meant we needed to go to another local hospital. This was set up for the following week. When we got there they looked on the ultrasound and told us there was a problem with the position of the placenta to do the test - as things stood they would not be able to access it either trans-abdominally or trans-cervically. They got me to go away and walk around for 20 mins or so in the hope that there might be enough of a shift with an empty bladder. It didn't work so they asked whether I wanted to try again in about a week when there might have been sufficient movement, or wait slightly longer and have an amnio.

We decided to try again, as we really wanted to know the result as soon as possible. When we returned the following week, the trans-abdominal route was still not possible, but the trans-cervical one was, so I elected for the test to be done that way. They took two samples and although they weren't huge samples, both obstaetrician and midwife were happy they should be sufficient.

We got the quick result back a few days later - that the result was clear. I don't think I have been more relieved in my life. I asked the gender and they told us over the phone we were having a little girl. For the first time in weeks/months we felt we could actually relax a little. The full result came back the following week and confirmed the quick result.

Our couple of weeks of relative comfort didn't last. When we went for the scan with the consultant he expressed real concerns with the levels of growth, and he told us that he feared that if it continued the baby may not survive to deliver. He wanted to repeat the scan in a further two weeks to see the progress. (This then took us to just below the 20 weeks point.)

At the next scan he again expressed concern about the growth rate (in particular for the limbs), but he told us that there had been better growth since the last scan than he had expected, which gave a better chance that things would be okay. During the scan he expressed concern about not being able to see all 4 chambers of the heart, but indicated that if there was a problem it was likely fixable, and there wasn't necessarily an issue as the size of the baby may have limited what could be seen on the scan at that stage. At this point there were concerns but things felt reasonably positive, certainly more positive than two weeks earlier.

As he proceeded further with the detailed scanning, he asked about the CVS and whether we knew the baby's gender as a consequence, so I said that we knew it was a baby girl. A few minutes the consultant expressed extreme confusion - as he showed us, the baby was clearly male. Given that as the case, it gave him concerns about the CVS result itself, so we agreed that to make sure of the result, I would have an amniocentisis so that happened after the scan.

You can probably guess what happened next. The CVS result was wrong, and the baby was positive for T21. [The consultant is really angry about the error over the result and is pursuing what happened.] So, then we faced the decision that we'd feared 5 or so weeks earlier. We considered it independently of each other and then discussed it - we'd both reached the same conclusion independently that we couldn't continue with the pregnancy and I went through another induced labour. Physically it was even tougher than before - I was sick repeatedly during the process and it was all prolonged by issues with the placenta not separating. They thought they might have to resort to surgery so I wasn't allowed to eat or drink for the four hours I was hooked up to a hormone drip until they were sure.

That was three and a half weeks ago. My husband has been a rock and we've been well supported but things just seem so bleak. I arranged a phased return to work and went back for a few days last week, but during this week it has just been too much for me. I was already finding it so tiring, but it's not been helped by having a recurring headache over three days with visual aura - at least it seems it has gone now today. I hadn't had one so bad for the best part of 20 years. It's felt like putting the physical effort in going back to work has meant just stockpiling emotion to overwhelm me outside work. I'm going to try going back to work again next week. We have the cremation on Tuesday and I hope that may help a little. I know we found it more helpful than we'd expected for our first loss.

Anyway, apologies for having written alot but so much has happened, and it all plays its part. Hopefully some of you out there can provide some of the solidarity that unfortunately comes with going through something like this.

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cupofteaplease · 20/10/2011 16:44

I'm so sorry for all the upset you have suffered. It sounds like you have gone back to work very soon though, would it help to take some time out?

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jasminerice · 20/10/2011 16:46

I am so so sorry for what you have been through. I don't have any experience of these things myself but I didn't want to leave your post unanswered.

My instinct tells me you need some proper time off work to grieve and rebuild your strength, emotionally and physically. I hope that is an option available to you.

Take care of yourself, jr, x

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ChickArito · 20/10/2011 17:09

Thanks ladies. I do think that being back at work even for a little time does help a little though, to give me something to focus on.

Work have actually been very good about me taking the time I need. Having said that, I knew better this time to go through HR and not through my manager. It wasn't that he caused me difficulties the first time, it's just that he says very little and my colleagues were told very little. HR have been a lot more supportive.

I'm seeing my bereavement midwife tomorrow so I'll talk to her about it. When I spoke on Tuesday to the midwife who've I've been in contact throughout she also suggested that I think about lengthening the phasing of my return.

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Cherrybug · 20/10/2011 17:35

Goodness Chick, what you have been through, I'm so very sorry to read your story. I hope the bereavement midwife can help you identify what is best for you in terms of work. The last thing you need is any additional stress and you must feel like work is so insignificant in light of what has been going on. I understand it may be good for you to keep busy but just make sure the balance is right for you.

I sadly ended a pregnancy almost a year ago. We had clear fast results from amnio (which we'd had due to high risk of T21) so thought we could relax only to get the full results over a week later where something very rare with a very poor prognosis was found. So, not the same as your situation but I can completely empathise with the horrible rollercoaster and the devastation that comes with this situation. Will you be getting any genetic testing done in light of this happening?

I'm glad your DH has been a rock and hope you get lots of support. I also hope the cremation brings you some closure in some ways though of course it takes a long time to process what has happened and start to come to terms with losing a much wanted baby.

There's a support thread here that you may find useful.
Thinking of you.

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purcellfan · 21/10/2011 10:16

Hi ChickArito, so sorry to read this, you've been through a terrible time. I know what you mean about work - I went back a few days after my TFMR just over a week ago and it really helped to be busy, although not too stressfully. I'm not working for the next few days (half term) and am finding that much more difficult. I did have one of those headaches like you after a more stressful day though, I think you might be right that we block emotions to seem normal at work. I went to acupuncture, which helped a lot with letting emotions out again (not for everyone I know!).

We also had a clear cvs result (even the full kariotype), despite 1 in 18/1in20 for the 3 common chromosome disorders but it turned out at 20 weeks that there were other problems which probably mean the baby wouldn't make it and also some of the brain missing so it was a kind of false hope. They still don't know what our son had. Everyone was so positive after the clear cvs that it came as quite a shock at 20 weeks when major problems were diagnosed.

I hope the cremation will be helpful and bring some peace. Also waiting for ours whenever the pm results come back.

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ChickArito · 22/10/2011 19:29

Thanks ladies for your messages.

I found it really helpful talking through things with the bereavement midwife yesterday. She's been helping us since the miscarriage in March so it feels really comfortable talking to her. She has said that she thinks I'm not ready for the level of return to work I tried even on a phased return, and she has suggested that instead I do half days only and no more than three of them for at least a couple of weeks, then slowly build up the half days and then reintroduce the odd full day - so not looking to be up to full time again until well into December. The timescale for being back up to five full days echoes what the ante-natal midwife suggested when I had a chat with her on Tuesday.

It all seems logical - that in boxing up the emotion at work I don't have sufficient time to deal with it on the day, as well as the physical effort it's just coming back at me, and that if I reduce the physical and mental strain both in terms of length of time and amount, I will be better able to cope.

We also discussed counselling and are going to look to try it after we've had the follow-up with the consultant. I don't know whether it will help but I think we need to try.

Cherrybug, genetic testing is something we'll need to talk through with the consultant but the previous conversations we've had with him suggested that there are no underlying reasons for what has happened (either time). Thanks for highlighting the support thread, I'll definitely be coming over - probably after the cremation.

Purcellfan, did you structure your return to work at all or take comfort in the half term break? You do need to take care of yourself. Do you know how long you'll have to wait for the pm results to come back?

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pinkytheshrunkenhead · 22/10/2011 19:48

I am so sorry for you and your DH, I don't have anything constructive to add but wanted to send kind thoughts to you both x

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purcellfan · 24/10/2011 08:20

Glad to hear you're working it out Chick, the bereavement mws do a great job I think. I'm self employed so phased return wasn't possible but I have a core of two days pw with freelance stuff on top of that so not full time every week. One of the hardest things atm is taking my older child to toddler classes etc where it feels like nearly everyone is expecting their second child or has a baby in tow!

Pm results will be long and genetic ones maybe longer, I think December possibly. We need to know what was wrong though.

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ghansell · 24/10/2011 15:06

What an awful thing to go through. You must take it easy on yourself and like the others have said go back when you are ready although it takes your mind of things while busy it will take it's toll on you in the long run.
I have to ask though is there going to be an official complaint that the cvs was wrong?

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ChickArito · 27/10/2011 16:27

Well, I've got through three half days of working this week and it has felt far less of a strain. Restricting it to a half day gives me the physical and emotional space to cope. It wasn't easy working on Wednesday as we'd had the cremation service on Tuesday, but I met a friend for lunch after working on the Wednesday which helped. The service was fine, just emotionally exhausting.

At work today, I worked with others at their request on some non-standard work that they needed help with and it felt good to be really thinking through something else and making a contribution. Apart from not wanting to be by myself for long stretches regularly, that feeling of usefulness and doing what I'm capable of was why I wanted to try to be at work.

ghansell - we'll see what has emerged when we have the follow-up appointment with our consultant in about 3 weeks. He was going to get it looked into both from the point of view of the tests performed in the lab and the taking of the samples at the hospital. He said that in 16 years of experience this had never happened to him before. He was extremely disturbed by it obviously due to the consequence on his patient, but also because it had affected his ability to do his job - in interpreting scans he was discounting evidence that would have raised the question of DS earlier because of the CVS test result presented to him.

I wouldn't want anybody else to go through that. It's not an easy decision to have the CVS due to the risk of an invasive procedure, and then effectively not to get certainty for taking that risk, well...

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