Anatomy Scan - little concerns

The anatomy scan is typically scheduled between 18-21 weeks and this is usually a very exciting ultrasound for parents because

But the anatomy scan isn't done just so Mom and Dad can find out if their baby is a boy or a girl, there is a lot of big things that the doctors want to see have developed properly and at this age

My ultrasound was split into two, the first was over an hour where a not-so-great technician pushed too hard and made me immensely worried for (realistically) nothing and because our beautiful baby girl is as stubborn as her Momma we were scheduled to come back in hopes our little one would cooperate and let the technician get a couple other pictures/measurements. Our second ultrasound was much better, in part because by then we had already spoken with our obstetrician and were feeling a bit more relaxed, our technician was wonderful and although our sweet little girl was still being stubborn they managed to get all the photos/measurements they needed and it was a much better experience to finish the anatomy scan.

During the anatomy scan they found a few things;

First that I have a low lying placenta, this is a pretty common finding at this stage of pregnancy. The concern is with a placenta that is low lying or full placental previa (where the placenta covers the cervix) if I were to go into labor naturally or try to labor naturally the placenta will detach trying to be delivered first (since it is too close or covering the cervix) if the placenta is to detach if has the same results as a placental abruption (which was what caused our stillbirth, although our placental abruption was without reason or cause and just happened). Due to the risk this poses to mother and baby a c-section is typically performed to ensure a safe delivery (I have read of some women who have delivered naturally despite a slightly low lying placenta, however that isn't usually the case) . With orders for pelvic rest and some restrictions depending on the obstetrician, this isn't usually a problem and will typically move away from the cervix before delivery.
UPDATE: after an ultrasound at 23 weeks our placenta has officially moved away from the cervix

The other finding was that our baby girl has a two vessel cord or single artery umbilical cord (I typically refer to it as the single artery), normally the umbilical cord consists of three vessels but sometimes the third one will not develop/will disappear. This can be a soft marker for problems with the heart or kidneys as these organs develop around the same time as the umbilical cord - usually an echo ultrasound is done in the following weeks to rule out any problems with the heart. The other concern with SAU is growth restrictions for baby, doctors usually suggest additional ultrasounds to monitor growth and will deliver baby if growth slows as it is easier to help baby's gain weight outside of the womb than inside. However, in most cases a two vessel cord/single artery umbilical cord has no affect on the baby and is considered a "variant of normal".
UPDATE: as of our echo at 22 weeks, baby girl's heart is perfectly developed and although follow up ultrasounds will be done to monitor her growth as of that ultrasound she is growing right on track and weighing 1 lb 4 ounces at 22 weeks.
At 32wks4days our baby girl is growing well and weighs an estimated 4lbs4oz.

At 23 weeks we were sent to Maternal Fetal Medicine to have another ultrasound and be seen by a perinatologist regarding echogenic bowels (or bright bowels, as the fluid she is swallowing is taking longer to pass through). They did see echogenic bowels at this ultrasound (this was also seen at our anatomy scan and although during our echo ultrasound the week before our very skilled technician looked for this and in her opinion this was ruled out) this is a very common occurence with echogenic bowels because each technician/ultrasound machine sees things differently and often this is a false positive. However most doctors will err on the safe side and if seen will assume it is there.

The perinatologist at the Maternal Fetal Medicine clinic told us that although it is strange to see two things that are different and he stressed that "different doesn't mean abnormal" the single artery umbilical cord and echogenic bowels were not connected and more than likely would just be a variant of normal. He did go over what the echogenic bowels could indicate; cystic fibrosis or down syndrome, a rare infection that could have  passed through me to the baby (all of which typically have other markers, which our beautiful baby girl doesn't have), there is also lesser concerns like a possible blockage that they'd fix after birth or that she may have swallowed a bit of blood which would work through eventually and not be a problem. According to the perinatalogist there is a huge likelihood that it will either disappear before she is born and/or cause no problems. He didn't suggest further testing (which includes blood work to check if we are CF carriers, we would both need to be carriers to give her a 1 in 4 chance of having it. Blood work to check if I've been exposed to any of the infections, but the test isn't good enough to tell when I was expose if I have been at all - which the only time that matters is during my pregnancy and the amnio to test our baby for these things which have no treatment until delivery anyway and increases the risk of loss to 1 in 200 a risk we are not willing to take since it wouldn't change anything). We have an ultrasound scheduled in a month, at the beginning of the third trimester to see how she is doing and hopefully that the echogenic bowels have either gone away or at least gotten better, as well as rule out any possible markers that are assosiated with CF or downs. Although we pray and hope that she will be healthy and that she will not have to experience the difficulty that growing up with cystic fibrosis or down syndrome, I am grateful that (for the most part) these are not "incompatible with life".
UPDATE: As of 30weeks our ultrasound with MFM no longer showed echogenic bowels and although they will continue to watch her it is believed to have cleared up on it's own.

While I wish that we didn't have to worry about added concerns for our pregnancy (as I am already considered very high risk) I am grateful that in both findings there is a great likelihood that aside from extra ultrasounds/monitoring, our baby girl will be just fine.

I will continue to update this throughout our pregnancy as there will be many future ultrasounds and follow up.

xo, Anne.