Anatomy of a Cord

Yesterday was my twenty week anatomy scan, and so far everyone has asked if we stuck to our guns about not learning the sex – yep, and it was easy. As I mentioned, because Eliza’s in utero attempts to keep her face covered left her other parts rather more evident, I assumed I’d have to avert my eyes. Spatula II was more (less?) cooperative though, wiggling around and showing off everything but the goods, so the surprise remains a surprise.

In the US, it seems like the twenty week scan has become so strongly associated with finding out the sex that it’s easy to forget that isn’t really the point. The point is to check on fetal growth and development – make sure all the organs look like they are supposed to, and so forth. Well. Spatula’s organs all looked great, but there was one thing slightly amiss – the umbilical cord only has one artery, instead of the customary two (in addition to one vein, which was thankfully/obviously present) – an abnormality called Single Umbilical Artery (SUA). Because my appointment went on for THREE HOURS before I actually got to talk to the doctor, I had time to do some preliminary googling, and was pretty relaxed about what I learned. Because they hadn’t noticed any other anatomical abnormalities, it is unlikely to mean much of anything. This was reiterated by the doctor, though he is sending me to get an additional ultrasound at the perinatologist, to double check that all of Spatula’s organs are fine.

So that’s all well and good, but I’m a research scientist, and one who spends a fair amount of time focused on fetal development (though usually more in terms of what chemicals do (or don’t do) to that process). I couldn’t just leave it at the preliminary googling, or take the doctor’s “don’t worry about it” to heart. Nope, had to delve into the primary literature. And wouldn’t you know, I’ve freaked myself right out. (Though I will say, I remain less freaked out that I was – over nothing! – during my pregnancy with Eliza.)

SUA is the most common cord defect, affecting somewhere around 1% of pregnancies. Because it occurs so frequently, and is often the only thing “wrong” (called Isolated SUA), some actually refer to it as a normal variant rather than a defect. That said, there are a number of studies from the past decade or so, a few of which are larger scale epidemiology studies, that have found it to be significantly associated with a number of issues, relating both to the pregnancy itself (earlier delivery, polyhydramnios, placental issues, higher c-section rates) as well as fetal outcomes (fetal growth restriction, lower birth weight, low Apgar scores, and the scary stuff – increased rates of fetal and perinatal death).

I think I’m mostly freaked out because though the numbers for all of these issues are very low, and the odds are certainly that my pregnancy and our baby will be perfectly fine, I still read the damn numbers. And yeah, some of them are legitimately scary (3.35% rate of perinatal death! HOLY BALLS), but the thing is… the control number is scary, too (1%). Like, both of those are REAL NUMBERS. I mean, you know how a lot of doctors tell you not to take pseudoephedrine when you’re pregnant? That’s based on a (kind of shitty) study that had an adverse outcome rate of 1 in 2300, or 0.04%, for a non-life threatening, fixable defect. THAT is a small number. 3.35% is not small. 1% isn’t even small. I know 100 women with children! AIEEEEE. And then I think about it, and I know women who are part of that control group. I mean, MY MOM had a very late miscarriage, and would have counted in one of these control categories.

And that reminds me that these (and many, many other) things DO happen, we just don’t really talk or think about them much. And in the case of the less serious issues, many of them get resolved either at the end of pregnancy, or early in a child’s life, and don’t necessarily come up after that – they eventually get overshadowed by things happening now. She’s smiling! Guess what he said yesterday! Holy crap, time for college! A person ends up being way more multifaceted than some thing that happened to them when they were born. (Even if that thing maybe leaves a bit of an impression on one’s parents.)

When I was in grad school, learning about fetal and childhood development for the first time, I remember wondering how ANYONE could come out of the whole process unscathed. It is seriously amazing. Development is AMAZING and complex and so much has to go right! AND IT DOES (usually) (even if you take the good cold medicine, or have a slightly jenky umbilical cord). It is amazing.

I don’t know how I just talked myself from freaked out to amazed, but I’m going to run with it.

This entry was posted in gestating, medical anomaly, neuroses. Bookmark the permalink.

13 Responses to Anatomy of a Cord

  1. HereWeGoAJen says:

    I said the same thing, in my developmental college class. It’s really amazing, with all the things that can go wrong, that anyone gets born AT ALL.

    I hope this one gets born all nice and trouble-free.

  2. Lara says:

    As a non-scientist, never been pregnant person, I have no idea what a lot of this means, but I hear that you’re scared and I get that, and I’m sorry. Hoping everything goes well and you stay as amazed as you can and as un-scared as possible.

    ps, see you in three weeks eeeeeee.

  3. Erica says:

    I’m not sure what was janky about Anna’s umbilical cord, but it broke when she was born, which (at least in my midwife’s experience) is very rare. But nothing came of it other than a LOT OF BLOOD and a momentary freaked out look on her face.

  4. Jesabes says:

    I hope everything goes great at the perinatologist and with the rest of your pregnancy. If I ever have pregnancy complication questions I’m sending them straight to you!

  5. Erica says:

    Wow, interesting. I am hoping it’s just a blip in spatula 2’s distinguished life.

  6. Elsha says:

    I continue to be amazed that anyone gets born. I’m especially amazed by Daniel, who made it here with a whole extra chromosome and ZERO health problems. Crazy.

  7. kathleenicanrah says:

    Every, every, EVERY day my head spins with all the things that must go right for a baby to be conceived, created and born. It’s like the biggest, most intricate, to-do list ever.
    Hoping for only good news for you ahead.

  8. K says:

    I’m not sure if it’s paltry PTSD or appreciation of what *can* miraculously happen, but I find myself rather mystified and heartily exhaling when a child is born without issue, or with issues easily fixed/resolved.

    I just feel like maybe I’ve read and heard and seen too much for my own good.

  9. Michelle says:

    I love how you analyze things. How meticulous you are with your research. And how you go from freaked out to amazed. Hang in there. Hoping for good news!

  10. Nimble says:

    “some actually refer to it as a normal variant rather than a defect” is the money quote for me. There are very few perfect human bodies in the world, most of us get along with some bit or bob that isn’t ideal. All good wishes for continued amazement.

  11. LizScott says:

    Oh, I don’t know how you went from there to here and made it kind of hopeful, but well DONE SIR.

  12. Pingback: Brain Dump: Seven Not Quick Takes » snoozical

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>