First official OB appointment

Up to now, I've only had "GYNO" appointments. Today was my first official "OB" appointment. Alan joined me this time. We both got to hear the heartbeat! A whopping 170 bpm - how amazing!!!

Doc told us several things. Let's see if I can remember all of the information!

• Pap smear was normal. This means that the cervical wart might not be a cervical wart afterall. She'll wait until I'm into my 2nd trimester to look at it under a microscope. I'll see her again in 4 weeks for this.
  
• Blood work came back normal. So no anemia. No hepatitis.
  
• Cystic fibrosis screening also came back negative.
• I am indeed 9 weeks, 6 days along. My due date is July 29, 2010.
  
• The mild food poisoning I got a few weeks ago did not affect the baby. It would have if I had a persistent and high fever and became dehydrated. But, I had no fever and made sure to keep drinking water.
• No studies have shown the effectiveness of taking special prenatal vitamins. As long as I am getting the right amount of iron, calcium, and folic acid, I don't need to buy relatively expensive prenatal vitamins. Yay!

Doc presented us with two options for genetic diagnostics and two options for genetic screening. The diagnostics include amniocentesis, or amnio for short, and chorionic villus sampling, or CVS for short.

Some information about amniocentesis and CVS:

• Amnio performed between 14 and 20 weeks; CVS between 10 and 13 weeks.
  
• Amnio performed by sticking what I can only imagine is a HUGE needle into my uterus to extract amniotic fluid. CVS sticks that needle into the placenta instead. CVS collects larger samples and provides faster results than amnio.
  
• Amnio tests for chromosome abnormalities, neural tube defects, and genetic disorders. Down syndrome, or Trisomy 21, is the most common chromosome abnormality. Genetic disorders include disorders like cystic fibrosis. The most common neural tube defect is spina bifida. CVS tests for these except neural tube defects.
  
• Both tests are highly accurate.
  
• There is a risk of miscarriage though. For amnio, anywhere between 1 in 400 to 1 in 200. And for CVS, 1 in 100. Those are some scary high risks, I think. Doc doesn't recommend these tests since I am not over the age of 35. She says that my risk of complications from the procedure is actually greater than my chances of having a chromosome abnormality. What do you think?
  

For genetic screening, there is the 1st trimester and 2nd trimester screening. These procedures are non-invasive, so pose no risk to the pregnancy.

• First trimester screening: 
• Combines blood work with an ultrasound for evaluation of the fetus to identify risk for specific chromosomal abnormalities, including Down’s Syndrome Trisomy-21 and Trisomy-18. It does not detect neural tube defects. 
• The New England Journal of Medicine reported that the 1st trimester test is the most accurate, non-invasive screening method. 
• Accuracy is compromised, compared with that of amnio and CVS. Both false positives (5%) and false negatives are possible.
• Second trimester screening:
• There is the quad screen or triple screen. 
• Both are blood work only, with no ultrasound.

I think I'm most comfortable with getting the first trimester screening. Then, if any red flags go up, then continue with the invasive amnio and CVS testing. What do you think?