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Author Topic: New here: Placenta previa w/ multiple early bleeds + history of PPOM  (Read 6439 times)

EnglishRose23

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Hi everyone,

I came across this site a while ago but have never got around to posting before. Now I'm stuck on hospital bed rest I figure I have the time to say hi and share my story.

I am currently 24 weeks and 2 days into my fourth pregnancy. Like many on here I have a messy OB history. Baby #1 and #3 were early miscarriages.

My daughter Sophie was baby #2, with her I had HEAVY bleeding for over a month late in my first trimester so we were constantly expecting to miscarry. Miraculously when we had our mid-pregnancy scan at 18 weeks she was perfect and healthy head to toe. Our relief was short lived though, because at 21 weeks and 6 days my waters broke out of the blue. Neither myself or DH actually believed I could have broken my waters...we thought it HAD to be an embarrassing leak of urine or something, but we went to get it checked out at the hospital just in case.

Once at the hospital they hooked me up to all the monitors and swabbed me to test for amniotic fluid. When the test came back positive we asked the doctor what that meant for our baby girl. He told us it was too early for them to do anything. I would deliver within the next 24 hours and she would not survive. As we broke down over the news, the doctor gave us the option of waiting 24 hours for nature to take it's course or to get it over with now by induction. I refused induction and argued with the doctor, insisting there had to be more options since I was not having any labor contractions and was not dilated. I remembered stories of 23 weekers surviving and I did not want to give up on my daughter. The hospital near my house is a good enough facility but they did not have any high risk maternal fetal medicine specialists, or a NICU that could deal with micro-preemies. Despite the doctors repeated warnings that there was no hope he finally listened to my demands and called the hospital across the lake which did have those facilities. They agreed to take me in for evaluation.

After being loaded up with antibiotics, and waiting what seemed like forever for my ambulance ride I finally transferred (don't even get me started on the ride over...backwards in an ambulance on a rocky ferry at 2am). Once at my destination they once again checked me for dilation (none), amniotic fluid (tested positive) ,put me on continuous monitoring for contractions and signs of stress in baby (none) and did an ultrasound to assess my fluid levels (none left).

Several doctors came in to consult with me and my husband, explaining the bleak odds, the dangers of infection, and they all agreed that induction was the recommended course of action. What was different is that they did give us the OPTION, to wait it out and see how things progressed after explaining how statistically unlikely it would be for me to go more than 72 hours. My husband and I agreed that despite the outlook that we wanted to do whatever it took to give our daughter a chance so we decided to wait it out. I was checked in as an inpatient, and after a few nights of showing no signs of going into labor they moved me from the L&D ward to the maternity ward to camp out.

Lots of monitoring for infection revealed an ever so slightly elevated white blood cell count, but no other signs of infection so they started me on some really intensive antibiotics to try to prevent infection setting in. I don't recall the name, just that it felt like ice cold poison being pumped through my veins. I was on very strict bedrest to try to let gravity hold new fluid in for baby, but it just kept leaking out anyway. After I amazed all the doctors by making it past the 72 hour window they began to talk about steroids if I made it to 24 weeks, and had neonatal and ethics consultants come to talk to us about survival and disability at 23 weeks. The recommendation for a 23 week delivery was "comfort care" only, but they would attempt resuscitation at the parents wishes. We asked for every measure to be taken if I reached the magic 23 week mark. We celebrated 23 weeks. More consultations followed, and one of my high-risk doctors was willing to push the envelope and start steroids before 24 weeks so I got those fun shots.

Yet another week in hospital and I had officially amazed all the doctors by not going into labor, not even hinting at going into labor. Things were starting to look more hopeful. Then at 24 weeks and 1 day the contractions started. I had a vaginal birth 9 hours later which I can remember in vivid detail to this day. The magnesium they gave me for babies brain gave me a unpleasant flu like feeling, but I otherwise delivered smoothly without medication. My girl was whisked away to be tubed, but we heard the tiniest and most reassuring little cry from her first. After what seemed like an eternity they had her tubed and breathing, and rolled her over to say hi to me and hubby before getting sent down to the NICU. She was so tiny at 1 lb, 10.5 oz, but not how I had expected a preemie to look, she was so well filled out with muscular arms and legs, her skin was a beautiful delicate pink, her little face like a dolls with whispers of fine blond hair on her head. As they wheeled her out of the room I turned to the doctor and asked if I was supposed to be bleeding this heavily. All eyes had been fixed on my daughter for the past ten minutes, so no one had noticed the increasing pool of blood between my legs. The placenta was not coming out on it's own, and without being able to wait for pain meds the doctor had to reach in and rip it out, something incredible painful given how sore I was from the birth, and that by the time I delivered the placenta and uterus were both brewing nasty infections.

The fun of the birth was not yet over, because they immediately hooked up more antibiotics to my IV. Unfortunately the nurse forget that there was still a bag of magnesium hanging on my IV and accidentally turned that on at the same time. I had been starved for the past 9 hours, so sent my husband for toast and apple juice. By the time he came back I was flat on the delivery table with doctors yelling at me to stay with them. A massive overdose of magnesium had progressed me quickly from being feverish and throwing up to fading away on the table with all my muscles shutting down. I could hear everyone yelling, but couldn't move my mouth to respond. I remember seeing them hit my knee to test my reflexes and my leg just hanging there limp. I remember how hard I had to concentrate not to fall asleep, and to remember to keep breathing in and out. Someone finally realized what had happened and pulled the magnesium, switching it out for calcium which acts as an antidote. I slowly came back to the land of the living.

My daughter was born at 9:36 pm. We didn't hear any news until almost 3am, when they finally let me go from labor and delivery, and the NICU sent up word she was stabilized and we could visit her. It was different seeing her there, all hooked up with tubes and the ventilator pumping fast unnatural breathes into her tiny lungs. The doctor told us she was critically ill, but holding her own so far. We sat there with her for a few hours, dazed and in love, but completely overwhelmed and frightened. At last I dragged myself away back to my room, I wanted her to have breast milk, and my time window to get things going was running out. So at 4 in the morning the lactation nurse came in and showed me how to use the electronic breast pump. The tiny vials I expressed were sent up to the NICU for my daughter. Exhausted I managed about 2 hours sleep.

Showered and ready to go, we spent most of the next day at my daughter's side. I had to keep leaving to pump, and we took a lunch break to keep up our strength, but otherwise we stayed there, gently holding her hand or stroking her feet. Reading her stories softly that we had read to her when she was in my belly. All the nurses said how good she looked, more like a 25 or a 26 weeker with her build. Her weeks without fluids though had taken a toll on her lungs, and things got progressively worse during the day. The doctors used many big medical terms, but basically even on maximum settings the ventilator wasn't getting her enough oxygen, and her other vital organs were beginning to shut down. She was on her way out and there was nothing else they could do. They suggested taking her off ventilation so she could die more comfortably in our arms. After getting a second opinion we finally understood there was really no hope left. They took detached her from all the tubes and wires, and late that evening she died our arms.

Roll on forward through all the anguish and grief of losing a child, past the tiny coffin, past the return to work and college, to the part where we try again, after many failed attempts by me to try to convince my husband that adoption was a better option.

The doctors were able to tell us from examining the placenta that it was not an infection that caused my membranes to rupture although it was infection that caused the labor over two weeks later. They're best explanation was my abnormal uterus. It was discovered early in my second pregnancy, they thought it was bicornuate at the time, but evaluations afterwards determined it was in fact a large septum. It was heavy with a wide base, dividing my uterus almost completely in two. The sheer weight of it gave the exterior of the uterus a bicornuate shape. I had surgery to remove the septum, which was hailed as a complete success by my overconfident surgeon who was convinced he got the whole thing.

We started trying again 6 months after the surgery, almost a year after my daughter's birth. We had no idea how long it would take for us to get pregnant again as I have a whole host of fertility issues, including PCOS and endometriosis. Amazingly we got pregnant quickly, only to miscarry again. Months later of tracking ovulation cycles and peeing on sticks obsessively we got another positive.

Heavy bleeding and cramping at 6 weeks got us into the doctors quickly, but they decided I wasn't miscarrying yet but guess what showed up on the scan...my septum, turns out they only managed to remove 7mm of it. This time round we went to the hospital across the lake for all our appointments, as a high risk patient of the maternal-fetal-medicine team. Plan of action was cervical length scans every two weeks from 16 weeks and weekly progesterone shots starting at 16 weeks. I had many trips in for ultrasounds in my first trimester, as the bleeding and cramping kept returning sporadically. They found my placenta was completely covering my cervix at 12 weeks, but I was reassured that it was almost certain to move as the pregnancy progressed.

The second trimester started out well. I was on pelvic rest and taking it easy around the house and we went weeks without problems. At 18 weeks 3 days I sat in the breakroom at work with a glass of water, a co-worker saw I was distracted and asked what was wrong, my answer: "I'm timing my contractions, I think I may need to call my doctor". They were about 5 mins apart, over a minute long, painful, and coming from my back round to my front. Off to labor and delivery for evaluation, but my cervix looked great so they sent me home. They contractions continued for 4 solid days and nights, and then seemed to ease up after my weekly progesterone shot on Sunday night. After a few days of no contractions, there was suddenly blood in the toilet, and 30 mins later the contractions were back with vengeance. Into labor and delivery again. Cervix looked good, the active bleed stopped and they sent me home on bedrest. I went two weeks before my second bleed; the story was the same, contractions and bleeding but no dilation. They sent me home again, as it was still too early for them to help my baby boy if things took a turn for the worse.

Another five days and I was on the phone to the hospital again, after seeing what I was sure was my mucus plug in the toilet. Sent home again since cervix looked good. 3 more days brought me to this past Sunday, my official 24 week mark of viability. Saturday night the cramping had started up again, and I was so relieved to see no blood in my first morning urine on Sunday, but bam, an hour later I sprung a fresh bleed. Off to the hospital. I had one bleed too many for the doctors comfort, and now I was at viability they decided to keep me in. The bleed was not too big, and stopped not long after I got the the hospital. They put me and high risk for early delivery given my history, and the intense contractions the bleeds have been triggering, in addition my white blood cell count is coming back high and they think I could be brewing an infection at the site of the repeated bleed. And then there's my septum of course, who knows what trouble that is planning on causing.

Despite the reassurances at 12 weeks, the placenta previa is still complete. All my cervical length scans came back great, so no cervical incompetence at least. They've given me steroids for my little boys lungs, and I'm still getting my weekly progesterone shots. I''m on hospitalized bedrest for a week minimum to see if I bleed or go into labor. So far things have went smoothly and uneventfully during my hospital stay, so I am hoping I will get discharged at the end of the week, it is very strange being back here, where I have so many memories. At this point all I can do is watch and wait and drink lots of water.

 My hearts go out to the rest of you in these scary impossible situations. Wishing you all the best outcomes. Sorry for the super long post, which I was too lazy to check for spelling and grammar.


 

Hopeful

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Re: New here: Placenta previa w/ multiple early bleeds + history of PPOM
« Reply #1 on: March 02, 2014 at 12:51 AM »
EnglishRose23,

I'm so so sorry to hear about your losses. I too list my baby girl at 27 weeks and had a miscarriage at 8 weeks. I know exactly how you feel and what you must be going through. Please stay strong my dear. You are not alone. Most of us on this forum have experienced terrible losses, and yet we muster up the courage to try again.

Your post is dated February 18, please do let us know how you are doing. Sending you hugs, best wishes and prayers...

H

EnglishRose23

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Re: New here: Placenta previa w/ multiple early bleeds + history of PPOM
« Reply #2 on: March 13, 2014 at 04:48 PM »
Update on how things have progressed since my last post:

I was admitted at 24 weeks with bleeding due to complete placenta previa. Fortunately the bleed stopped, and they only needed to keep me on hospital bedrest for 5 days before sending me home on modified bedrest. They doctors were not real optimistic when they discharged me...basically a see you in a few days kind of goodbye!

I surprised them by making it to my 26 week checkup without incident. They did another scan of the placenta and announced that it had moved and was now a low-lying placenta, so my risk of further bleeding was significantly decreased. Made another appointment for 28 weeks to check for growth and further movement of the placenta...if I made it to this appointment without incident there was even talk of lifting the bedrest  :)

Fast forward to 27 weeks and 2 days. Over three weeks since the last bleed and the contractions had really settled down. Mucous looked a little pinkish in the morning which put me on guard, and then a small bleed started around 4 pm with some cramping. Back to labor and delivery for evaluation, by the time I got there things had already settled, and blood was looking old. They decided to keep me overnight for evaluation, and after some time with no activity they moved me down to the maternity ward. I had barely got checked in when a bigger redder bleed started around 9pm, so whisked back up to L&D. Bled moderately for a few hours, then it seemed to slow down again overnight. 4 am rolled around and I sprung an even bigger bleed: not a life threatening faucet-left-on kind of bleed, but one the doctors weren't real happy about.

They started me on a new round of steroids for lungs and magnesium for baby's brain. Anesthesia and pediatrics came to talk to me; everyone thought delivery was imminent. The bleed kept on strong red and angry for close to 24 hours, but baby looked great on the monitor and my blood count was dropping but not critical. Then finally this morning it surprised us all by stopping suddenly!

According to my latest scan the placenta has moved enough to be in a normal position, so they are calling the bleed a placental abruption (seriously what else can possibly go wrong!). Plan is to move me back down to maternity if things stay stable for the rest of the day. I will be waiting around on hospital bedrest for a while. They said three weeks without a bleed before they would even consider sending me home, but no one here thinks I'll go another three weeks without a bleed...

Good news is I am much further along than at my last post! 27 weeks going on 28 weeks feels like a huge victory. Baby boy has done great on the NST and his scan put him right around the 50th percentile for growth at an estimated 2 lbs 9 oz.  We are hoping to drag this out one day at a time. I also won back food and shower privileges this morning, so in a much better mood :)

Hopeful

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Re: New here: Placenta previa w/ multiple early bleeds + history of PPOM
« Reply #3 on: March 18, 2014 at 10:03 AM »
Wonderful to hear this! I'm so glad you've made it to almost 28 weeks. Can't tell you how happy happy happy I am for you. Here's wishing you all the very best for the next few weeks. Will keep you in my thoughts and prayers.

EnglishRose23

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Re: New here: Placenta previa w/ multiple early bleeds + history of PPOM
« Reply #4 on: April 12, 2014 at 10:17 PM »
So time I wrapped up my story...big bleed started on Friday, March 21st, causing strong regular contractions. Doctor's give me another round of magnesium which slowed down the contractions a little and I was only 1 cm dilated so we were still hopeful this was another false alarm. After over 12 hours of intense bleeding and contractions my waters broke and the contractions and bleeding got even stronger and faster...doctor checked me for dilation again and after what seemed like forever I asked her how bad it was, she looked at me and my nurse and said "there's a foot, we need to move to c-section NOW". They quickly moved me to the operating room, I was awake for all the prep, the catheter, the cutting off of my clothes, the cold of the metal scalpel ready to go on my belly, and then I was under a general anesthetic and my son was born. 28 weeks and 6 days gestation, 3 lbs 3 oz.

My son is now 3 weeks old and making good progress in the NICU. He has been putting on weight and gradually needing less respiratory support. I wish I could have kept him cooking longer, but at the same time I feel lucky to have made it as far as I did, and so grateful that my little boy is on his way to healthy.

Best of luck to everyone still cooking!

Zoe

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Re: New here: Placenta previa w/ multiple early bleeds + history of PPOM
« Reply #5 on: April 14, 2014 at 02:50 PM »
Hi EnglishRose23,
I have just read your last entry - Congratulations on the birth of your Son.
I wish you and your family alot of love and best wishes.
Zoe
x

andi-pants

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Re: New here: Placenta previa w/ multiple early bleeds + history of PPOM
« Reply #6 on: April 14, 2014 at 04:47 PM »
Congratulations! I wish your son a full and speedy recovery, and as boring of a NICU stay as is possible :)