For the last two months, I've had the 30-Day House Cleaning Challenge picture up, but no actual posts.

I tried to do the challenge, but my pregnant self was always a day or more behind.  I had just caught up with the old chores and was about to clean the bedrooms when the contractions started in force.  And four hours later...

Meet "Rose."

And that's my excuse for not cleaning and blogging.

It's been a while since my last post.  The reason, more or less, is that life happened.  In more than one way:

The resolution to the scariness described in my last post took about a week to happen.  I had to go back in to my OB's office for a repeat hCG level, and while I was there I demanded to have a face-to-face with a nurse to explain exactly what was going on.  A large part of the scare was caused by the first nurse (who called) refusing to stray from what the radiologist's report said on the sonogram, which was "cannot rule out the possibility of a psuedogestational sac / ectopic pregnancy."  Which is a far cry from "probably has an ectopic pregnancy."  The second nurse (who I like very much as a competent and caring healthcare provider), said an ectopic pregnancy was very remotely possible, but so unlikely that I shouldn't waste energy worrying about it.

However, her news still wasn't good, and seemed to be confirmed when we got my next hCG back.  Likely, she said, I was looking at a blighted ovum - an egg that develops some embryonic tissues (which produce the hCG), but not the rest of the embryo.

I did get one more sonogram scheduled, since my hCG was rising (though not even close to the "doubling every other day" rule of thumb for healthy early embryonic growth).  And everything was there.  A perfect little gestational sac with a perfect little curl of an embryo inside.  Including a perfect little heartbeat.  It even measured to be spot-on with my calculated date of ovulation.

I don't know why things happened the way they did.  The second ultrasonographer said that it's not unusual to see nothing at six weeks' gestation.  But that never felt like a very satisfactory answer - it's really hard for me to see how something with so many published statistics on size, even at five and four weeks, could have been missed with such a thorough transvaginal (in other words, more accurate and higher-resolution than transabdominal) sonogram on such a good ultrasound machine.  Whatever the reason, this was truly an answer to prayer.

I am now thirty-four weeks along.

It's going to be another little girl.

I'd been looking forward to announcing the impending arrival of our third child on this blog. I thought I might even have some early sonogram pictures to share. Although I don't normally get such early sonos, I was having vague symptoms and my doctor decided to run some tests to make sure everything was normal. Unfortunately, it's not.

Yesterday I had a sonogram, and I started getting the impression from the ultrasonographer that she wasn't seeing what she expected. She was scanning the fluid sac in my uterus several times without taking measurements (more than what seemed to be the usual amount of redundancy in a scan) and she kept shifting her position as if trying to see something hidden by viewing it from a different angle. It reminded me of the way I tend to try and look around corners in a first-person computer game by peering into the edge of the monitor without actually advancing my character. It was a strong enough feeling that I felt compelled to ask straight out if everything was normal. She was professional enough to dodge the question without letting her concerns leak into her voice, but I still wondered whether she dodged all questions as a habit, or just the ones with bad answers.

Three incredibly long hours later, my OB's office called. The nurse confirmed the bad feeling I'd gotten from viewing the sono: they weren't able to find any obvious embryonic structures in the fluid sac in my uterus. It's possible that I'm just not quite as far along as I thought. But with the normal hCG levels they tested on Wednesday, they are also concerned that I may have an ectopic pregnancy. Two different abstracts on PubMed estimate (from an admittedly small sample size) that 3% to 9% of ectopic pregnancies have "pseudogestational sacs" - a simple fluid build-up within the uterus.

I've done a fair amount of Googling to try and figure out what I get to look forward to, as the nurse who called only said I'd have to repeat my hCG today and, when pressed, agreed that probably there would be a repeat sonogram. "Dr. Google" talks about scary-sounding things like diagnostic uterine curettage if ultrasound remains inconclusive. Assuming, of course, that I don't end up in the ER before that time with severe cramping.

That's the really scary part. Not knowing whether I am carrying life or death for my child (or even for me, though the risk is low) is keeping me awake at night. The worst part is knowing that if my pregnancy is confirmed ectopic (currently I think I fall into the technical definition of a PUL: pregnancy of unknown location), I will probably have to choose an abortion. I have always been pro-life, and I am finding that it's much easier to say in theory that this is one of those no-question exceptions than to be staring at the prospect of making the real choice for oneself.

All I can do now is wait and pray.