The Good News and The Bad News

We had our follow-up sonogram today, and the doctor came in joking about how many babies we were going to have. We reminded him that we were there to indeed check for multiples, and his joking tone became excited as he remembered my blood results and the report from the perinatologist the week prior.

When the sono began, the doctor had no problem spotting the beautiful baby growing in my uterus. "Just one," he said. I felt a little disappointed, having been so sure that the numbers and my symptoms could not be wrong. "Are you sure?" I asked. "The perinatologist mentioned the other thing was a little high up in the uterus." Just one, he clarified again.

We watched the heartbeat, feeling very excited. After a moment or two, he standardly scanning the rest of my pelvic region. He examined the outside of the uterus, the right ovary, then the left. When he got there, he went round and round, zooming in and out, and I could see what he saw. "There's a gestational sac here," he said, pointing out all the parts. He continued to check and measure and print and document, then agreed with himself that it was indeed a gestational sac, and I had a heterotopic pregnancy.

A heterotopic pregnancy is a pregnancy where there's both a growing intrauterine pregnancy, and a pregnancy outside of the uterus. Most commonly, the baby growing outside of the uterus grows in the fallopian tube. In very rare cases, it grows in the cervix, ovary or abdomen.

Instances of heterotopic pregnancies are on the rise with the increase of frequency of IVF, but spontaneous heterotopic pregnancies are rare. With my baby growing on my left ovary, I find myself in the rarest of rare situations.

During the sonogram, the doctor was unable to find a heartbeat in the heterotopic twin, and the "ring of fire" (bloodflow on the sonogram) was not complete, reaching only the top and bottom of the gestational sac, instead of completely circling it as it should. My doctor is hopeful that the absence of a heartbeat and the incomplete ring of fire means the baby has died, is deteriorating and will eventually be reabsorbed by my body. But, because it's still so early in this pregnancy and not totally unusual to not see a heartbeat at this stage, he's sending me to be scanned again on Wednesday. If there is growth or a heartbeat, he'll want to discuss surgery -- by Friday, if he can make me.

At this point, that's too overwhelming to consider. I've decided unless I'm in actual imminent danger -- like, hemmoraging or something -- I'm delaying surgery for at least a few more days. There are many things to consider, many pros and cons to the various approaches, lots of decisions weighing heavily on our hearts and minds. I'll lay out my thoughts in some posts over the next couple of days. Meanwhile, please keep praying for me and for my babies. (Such a bittersweet thing to say...)

The Cooperative Twin --
in the uterus where it belongs.


The Rebel Baby --
laying low in my left ovary.