20 week ultrasound

We had our ultrasound this week.  Most everything looks great.  They did discover that the baby has a two vessel cord or single umbilical artery (SUA), which is seen in only about 1 in 100 babies.  Usually there are 2 arteries and a vein, making a total of three vessels.  We had never heard of this before, but after a lengthy discussion with a doctor, it is not a big deal.  There is a lot of stuff on the internet, but basically what usually goes along with SUA is cardiac problems.  The ultrasound technician did a thorough analysis of the heart, including multiple views, and everything looks great.  The baby does have an echogenic intracardiac focus, which is basically a white spot seen on the heart during an ultrasound where the valve connector connects to the tissue.  This is pretty common and becoming more common with the improvements in ultrasound technology and resolution.  Neither of these two things are medically concerning.  They do act as soft markers for certain chromosomal disorders, but I had a negative Papp-A indicating no elevation in risk and everything else was checked very carefully because of these findings (nasal bone, heart, facial structure, head shape, etc).  I essentially had a level-II ultrasound or a targeted ultrasound.  Because of the SUA, I will be delivering with a doctor and not just midwives.  There is a small possibility for a lower birth weight (like 5-6 pounds) and everything is monitored a little more closely to be sure the baby is getting everything he or she needs.  Our practice also does a routine ultrasound around 28-32 weeks that examines facial structure, so weight will be closely checked then as well.

This first scan is a little creepy, but it shows how the baby was for most of the scan, with his or her foot above his or her head. The other two are the more typical profile shots.  It is kind of hard to tell, but it appears that this baby will also have the Kelling nose :)