The Expectant Father. Armin A. Brott

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СКАЧАТЬ the fact that you won’t be having biologically related children, I urge you to talk to some other people about what you’re feeling. Your partner certainly has a right to know—and she might be feeling a lot of similar things. In addition, the adoption agency you’re working with will probably have a list of support resources for adoptive fathers. Give them a try.

      If you’re planning to go to your partner’s checkups, you’d better get your calendar out. Here’s what a typical schedule looks like:

      

MONTH	IF YOU’RE EXPECTING ONE BABY	IF YOU’RE EXPECTING MULTIPLES
1–5	Monthly	Monthly
6	Monthly	Every other week
7	Every other week	Every other week
8	Every other week	Weekly
9	Weekly	Weekly

      Of course, taking time off from work for all these appointments may not be realistic. But before you write the whole thing off, check with the doctor—many offer early-morning or evening appointments.

      Screening and Testing

      Besides being a time of great emotional closeness between you and your partner, pregnancy is also a time for your partner to be poked and prodded. Most of the tests she’ll have to take, such as the monthly urine tests for blood sugar and the quarterly blood tests for other problems, are purely routine. Others, though, are less routine and sometimes can be scary.

      The scariest of all are the ones to detect birth defects, most commonly Down syndrome and other chromosomal abnormalities. One of the things you can expect your partner’s doctor to do is take a detailed medical history—from both of you. These medical histories will help the practitioner assess your risk of having a child with severe—or not so severe—problems (see pages 59–60 for more on this). If you’re in one of the high-risk categories, your doctor may suggest some additional prenatal screening.

      The words screening and testing are often used interchangeably, but there’s actually a big difference between them. Noninvasive procedures such as ultrasounds and blood tests are used to assess potential risks. If the risk is high enough, the doctor may order a test to confirm a diagnosis. Those tests are usually invasive (to your partner and your baby) and involve some risk. The OB will be able to help you decide whether the benefits of taking the test (knowing whether your baby is healthy) outweigh the potential risks (causing a miscarriage).

      If you did ART and PGD (preimplantation genetic diagnosis; see pages 298–299), you and your partner may not have to be tested at all—the lab was able to test the embryo itself for more than a hundred diseases and abnormalities. If any were found, that particular embryo wouldn’t have been implanted. However, because there is a small risk of getting a false negative on the PGD, many fertility doctors will recommend additional testing once the pregnancy is underway.

      NONINVASIVE PROCEDURES

      ULTRASOUND (SONOGRAM)

      This noninvasive test is painless to the mother, safe for the baby, and can be performed any time after the fifth week of pregnancy. By bouncing sound waves around the uterus and off the fetus, ultrasounds produce a picture of the baby and the placenta. To the untrained eye, standard, 2-D images look remarkably like Mr. Potato Head, without the glasses and mustache. 3-D ultrasounds generate a more complete image of the fetus. And 4-D ultrasounds (sometimes called dynamic 3-D) actually let you see your future baby in action, sucking his thumb, napping, swimming, and doing whatever else fetuses do to pass the time.

      In the first trimester, your doctor will probably recommend an ultrasound only if there’s something going on that’s a little out of the ordinary. The most common reason is that the size of the uterus doesn’t correspond to the age of the fetus when measured from your partner’s last period. The doc may also order an ultrasound if your partner has experienced any bleeding, if there’s any doubt as to the number of fetuses, or if he or she suspects an ectopic pregnancy (a pregnancy that takes place outside the uterus). At this stage, the ultrasound can confirm that there’s a heartbeat and can measure the baby (starting with the charmingly named Crown-Rump Length, which will give you a better due date estimate).

      Depending on your partner’s risk, her doctor may offer or recommend a nuchal translucency ultrasound (NT scan), a special type of ultrasound that measures fluid in the nuchal fold, a spot at the base of your baby’s head. Excess fluid in that area is often associated with chromosomal abnormalities and some heart conditions. The test needs to be done between 11 and 14 weeks and is usually part of what’s called the combined first trimester screening, which includes a blood test measuring your partner’s levels of pregnancy associated plasma protein A (PAPP-A) and a hormone called hCG. The combined test is about 85 percent accurate and has a false-positive rate of 5 percent.

      There’s also an integrated screening, which uses the results of the combined screening and adds in the Quad test I describe below, which is done between 15 and 20 weeks. Taken together, this increases the detection rate and reduces the false-positive rate to about 1 percent.

Second-trimester ultrasounds are usually the ones that low-risk couples see first. They’re used to determine the sex of the baby (this one is optional), to get a more accurate estimate of the due date, or just because you’re curious about what the baby looks like. If this is the first ultrasound, your practitioner will want to confirm the number of residents in the uterus, see how well they’re moving around, and make sure all the body parts and organs are the right size and in the right place. The test may also be used to firm up the due date and to confirm anything that may have come up in other prenatal testing, including the Triple or Quad Screen, amniocentesis, and CVS (see pages 61–62).

      During the last part of the pregnancy—and especially if the baby is overdue—your partner’s doctor may order additional ultrasounds to determine the baby’s position, to make sure the placenta is still functioning, or to confirm that there’s still enough amniotic fluid left to support the baby.

      TRIPLE OR QUADRUPLE SCREENS

      The Triple Screen measures three chemicals that may show up in your partner’s blood: AFP (Alpha-Fetoprotein), hCG (human chorionic gonadotropin), and estriol. The Quad adds one more substance, Inhibin A, to the screen, and there’s actually a Penta, which includes yet another substance, ITA (Invasive Trophoblast Antigen). Together they’re used to flag potential abdominal wall abnormalities and a variety of neural-tube defects (defects relating to the brain or spinal column), the most common of which are spina bifida and anencephaly (a completely or partially missing brain). Whether you have the Triple, the Quad, or the Penta (is this is sounding like Olympic gymnastics judging, or is it just me?) will depend on what your doctor orders. Theoretically, the more things you test for, the lower the false-positive rate.

      These simple blood tests are conducted when your partner is 15–20 weeks pregnant, and the results are usually available within a week, sometimes even the next СКАЧАТЬ