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Two Vessel Cord or Single Umbilical Artery (SUA). What it means. How it's affected the process.
Going through IVF you learn to expect the unexpected but prior to pregnancy the stress of any mishaps falls on you and your body. Once we learned we were pregnant I felt a huge shift in my anxiety, now I had this little person I had to take care of and keep alive. For the first 12 weeks we went in every Monday to monitor him and make sure he was hitting each milestone. The two days leading up to those ultrasounds were always filled with doubt and worry, trying desperately to reassure myself that he is ok. After we graduated to our OBGYN the ultrasounds became much less frequent and that safety net of weekly check ups was suddenly gone. I had to learn to trust the process, trust my body and really give up trying to control every aspect because this baby's destiny was not up to me. Weeks dragged on and finally we made it to 20 weeks, a huge milestone because that is when you go in for a big ultrasound known as the Anatomy Scan. We were so excited, but also super nervous because this is the appointment where not only do they confirm the gender but they can see if the baby is developing the way it needs to and if there are any abnormalities.
Our appointment was the last one of the day and the ultrasound tech was awesome, she spent over an hour with us going over every little detail and showing us as much as she could. It was the first time we saw his little face, first time we saw him move his mouth, it was incredible. I fell in love at that appointment, I know I am biased but I couldn't get over how cute we was! The techs can't officially say if things look good or not but I think she could tell we were nervous and was pretty reassuring throughout the whole process which was so appreciated. So we left that appointment feeling so relieved, we finally felt like we have a healthy baby!
Flash forward three weeks, we were scheduled to go in for a fetal echocardiogram. IVF babies have a slightly higher propensity for heart defects so our OBGYN wanted to make sure a specialist checked him out and that his heart was good. I remember being so nervous for this appointment, my family has a history of heart issues and the thought of our little baby being anything but perfect scared the crap out of me. Plus, to add to things the ultrasound office was in the same building as our RE. It was so hard to not feel a wave of anxiety just pulling back into that parking lot after months of finally breaking free of that place. I am sure not everyone who does IVF feels this way and I know ultimately that is the place where our baby was made but it still just holds a lot of negative emotions for me. So there we were back at the place where it all started almost a year before. We went into the ultrasound room and the tech started to make all kinds of measurements, with each one she would say something simple like "here's the forearm, looks great..." and then move onto the next. She finally got to the heart, I held my breathe waiting for that moment of worry but she moved right on and said "there are all four chambers, looks great." I couldn't believe it, I had mentally prepared myself for something being wrong, old habits die hard I am telling you! Then she kind of got quiet and said "let me go grab the doctor and we'll be right back." To be honest, I didn't really think much of it, we were there to look at his heart and that looked great so I felt so relieved.
When the cardiologist came back in he went over every measurement with us, spending extra time discussing his heart and kidneys, two markers for other issues. Then he tells us our baby has SUA, also knowns as Two Vessel Cord or Single Umbilical artery. He said about 1% of all pregnancies have it, it's not genetic and they have no real understanding of why it happens. There is was again, my heart sank. That curveball, that 1% category medical mystery that we always seem to find ourselves in. He went on to say that SUA usually develops around 7 weeks and it should have been caught on the anatomy scan. Worry immediately hit me and I began to think the worst. Well, this is it, our happy ending is over. Dramatic, I know. But the thing with going through infertility is you don't trust the happy, you learn expect the road blocks or the heartache, it's a gnarly mindfuck. The doctor goes onto to say that since our baby doesn't have any of the other markers he doesn't see any cause for concern. I guess usually SUA babies tend to have developmental issues in their heart and kidneys but our baby showed no signs of that which was good. So we say our goodbyes, he said this means we have to come in every four weeks now to keep a close eye on the baby and make sure he is thriving and growing on track.
What is SUA?
Of course the second I got home I started to google everything I could find about babies born with a two vessle cord. Let me just say that was a horrible idea. The research that has been done isn't very extensive and it really is a case by case with some outcomes being absolutely terrifying. I spent most of that day crying, feeling like my baby is going to have a life full of struggle and there was nothing I could do to control it. After some doctor friends and clients of mine reached out I started to feel better. They all said the same thing "usually isn't a big deal." Not exactly the reassurance I wanted but it was the best I was going to get and I had to be ok with that.
For those of you who have no idea what a Two Vessel Cord diagnosis means let me break it down for you. When babies are developing they have an umbilical cord, it's their source of blood flow and nutrient from the mother. Normal babies have a cord with one vein and two arteries. The vein carries oxygenated blood from the placenta to the baby and the arteries carry deoxygenated blood from the baby to the placenta. Babies with SUA only have one artery instead of two, this can increase the risks of cardiac, skeletal, intestinal or renal problems. It can also increase the risk for lower birth weight or grown restrictions, thus the reason for growth scans and extra monitoring. About 75% of babies are born perfectly healthy, having adapted to their SUA while about 25% are born with other abnormalities. The cause of SUA is unknown. There is nothing mom can do that can really affect babies growth (trust me, I have asked a million times), you just have to trust that their genetics are strong. All our embryos had PGS which is genetic screen prior to transfer so we had that going for us as well since we knew genetically they were strong. Plus, having SUA in one pregnancy does not mean future babies will have it as well. IVF babies are more prone to SUA, something we learned much later on, because their implantation isn't natural and therefore that initially attachment and umbilical cord development can be a little wonky.
What it means for the rest of your pregnancy...
After that 23 week echocardiogram appointment we were back to our normal OBGYN schedule except for now we were considered "high risk." Not exactly a category you want to be apart of, especially after the battle it took us to get here. Our OBGYN didn't seem concerned and neither did our Cardiologist so we put our trust in them and took things day by day. I have to say, at this point the day to day worry was a struggle. All I kept thinking was "please let this baby grow big and strong." I tried to eat lots of protein and rest as much as I could, praying that at the next growth scan his weight would increase and he would be ok.
When you have a baby with SUA you go in every four weeks to a high risk ultrasound office for growth scans. They measure each part of the baby, check their heart, kidneys, bladder, stomach, brain, and weight to make sure they aren't loosing nutrients and everything is developing. These appointments were nerve wracking, it's like waiting to see if you passed a test or not. Each time our baby passed with flying colors and measured ahead on his weight, those were truly proud mama moments for me. I remember asking out doctor "is there anything else I can be doing to encourage weight gain and growth?" he looked at me and laughed and said "geez how big do you want this baby to be?" Big, strong, and healthy is all I've wanted from day one and I would do anything to make that happen.
In addition to the four week growth scans you also have to start Fetal Diagnostic monitoring around 34 weeks. Something I just started last week. Basically they hook you up to the monitors to make sure baby is progressing, heart is strong, fluid is good, and you aren't having any preterm labor symptoms. With SUA, once it is determined that the baby is growing just fine the worst thing that can happen is if their growth slows they induce early because they can get more nutrients on the outside then on the inside at that point. Thus, the reason for all the monitoring. Even though you never want a preemie or for your baby to spend time in the NICU, knowing this was my worst case was a big relief for me. I remember my OBGYN saying that 34 weeks was going to be a huge milestone for me, so hitting that was beyond emotional.
So here I am 35 weeks tomorrow and this morning we had our last growth scan. Baby looked great, coming in at a whopping 6.4lbs already. Our doctor wants us in one more time to make sure he doesn't get too big and if he does we can at least be prepared. Oh the irony, this whole pregnancy all I have been stressing about is him gaining weight and not coming early. Watch him be a 10 pounder who is three days late. As long as he is healthy, nothing else matters!
Right after we found out we had SUA we went away to Big Bear for the weekend, I was so scared to go out of town. I was scared of anything upsetting me or spiking my anxiety because I didn't want it to affect the baby. I just wanted to feel calm and safe at home in my bed but we packed our bags and hit the road. So glad we did, it was an awesome trip, reminded me how important it was to do things that make us happy and of course we made it a point to stop for some photos. Photos are my love language and they help remind me of the happy. It was important to keep celebrating, to keep moving things in a positive direction. I am a strong believer in energy and staying in a calm headspace can only help baby so that's what I have tried to do ever since our SUA diagnosis. Must have helped since baby is doing great!
Going through IVF and having a high risk pregnancy has tested every ounce of my soul but my best advice for parents who find out they have SUA is to just breathe and take it day by day. Easier said than done, trust me I know, but just know there is nothing you can do. You are already so much stronger that you realize that you, better than anyone, can handle anything that comes your way. Infertility has taught you so much and made you a badass warrior, don't forget that.
xoxo, Chelsea
PS Here are some photos from our little tripod impromptu shoot in Big Bear, we were celebrating 27 weeks. Always makes me laugh looking back because I thought my bump was so huge then!
