One thing I didn't mention on the blog about the 20-week ultrasound was that the radiology report came back with one minor area of concern highlighted: slight kidney dilation. Nobody said anything about it during the scan, and the research I did after reading the report made me convinced that it was not a big deal, but the radiologist did recommend a follow-up scan, which we did yesterday.
I actually wasn't concerned at all; at 20 weeks, one kidney was measuring 3mm and the other 4mm, and the upper threshold at 20 weeks is 4mm, so they were still within the normal range. Dilated kidneys can mean there's some sort of kidney blockage that would need to be addressed after birth, and in combination with certain other issues they can be considered a soft marker for Down Syndrome, but both of those are normally in more severe cases of dilation: 8-10mm or sometimes more. So even though the ultrasound report said that the kidneys were slightly dilated and that follow-up was recommended, I wasn't worried.
And it turned out that I was right not to be. The ultrasound yesterday was great. At 24 weeks the threshold of normal is 5mm, and both kidneys were measuring at 4mm, so not dilated at all. We met with the perinatologist afterward and she told us that not only was she not concerned, but that if she had been the one to review the 20-week ultrasound, she would not have flagged the kidneys as an issue at all, and would not have called for a follow-up ultrasound. In fact, she said there's only one radiologist on the team who would think those measurements required follow-up, and he happened to be the one who reviewed the 20-week ultrasound.
However, once you're flagged, you can't be un-flagged, so even though the kidneys were never really dilated to begin with and by now are in fact right in the middle of the normal range, since the issue has been flagged the perinatologist referred us for another follow-up ultrasound at 32 weeks, so we went ahead and scheduled that for late November as well.
No harm, though. Because these ultrasounds are medically indicated, they're covered by insurance, and it's nice to get a chance to look in on Piglet again. I actually really enjoyed yesterday's ultrasound. I hadn't been nervous about the kidneys going into it, and the tech put us even more at ease by telling us the same thing the perinatologist repeated later, which is that most people wouldn't have been concerned by the 20-week measurements, so we got to just enjoy looking in at our baby, seeing his measurements, watching him kick and squirm and wave his arms, checking his heart beating, and so on.
He was very active in there, much more active than last time, and the tech said she could actually see him kicking my cervix repeatedly, which explains why I've been feeling it so much in that area. And, at one point he had his arm up by his face and was repeatedly mashing it against his mouth like he was trying to eat it, which was, you know, adorable. He's measuring right on schedule in the 49th percentile, and everything looks good and healthy.
And, I still swear he looks just like his dad:
Also, during my regular prenatal appointment after the ultrasound, the midwife told me that because the 3-hour gestational diabetes test is diagnostic rather than just a screening test, and I had great numbers on it only a couple weeks before it normally would have been indicated, they are officially declaring me diabetes-free and I do not need to be retested. So that is another nice bonus.
When I go back it will be at 28 weeks, the start of the third trimester. Eek!
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