Back for round 3

[EnglishRose23]

Here I am again!

This is pregnancy #5 for me.

#1 early miscarriage
#2 Heavy first trimester bleeding, PPROM at 21 weeks 6 days, vaginal birth at 24 weeks 1 day. Daughter Sophie lived almost 24 hours.
#3 early miscarriage
#4 First trimester bleeding, placenta previa from 12 weeks, cervical length scans (normal) and progesterone shots from 16 weeks, first round of preterm labor at 18 weeks 3 days, multiple rounds of heavy bleeding and preterm labor to follow, steroids at 24 weeks when they thought I'd deliver, ended up making it to 28 weeks 6 days and had an emergency c-section due to a placental abruption. Son Vincent initially spent 11 weeks in the NICU, he's had many trips back to the hospital since, but overall he is a happy thriving 3.5yr old.

#5 Crazily enough this is a planned pregnancy, I'm 6 weeks along now but it's not been going smoothly. Bad cramping from before I even had my first pregnancy test, gets much worse with even light activity. Sunday night I had my first bleed and it was a massive one, I was up all night changing pads and passing golf ball sized clots of blood in the toilet. It stopped as suddenly as it started, had an ultrasound today to confirm the miscarriage and baby was still in there, healthy and normal with a heartbeat. It was right at the 6 week mark I bled heavily with my other children, so apparently this is something I do. So now I'm on bedrest for the week, I'm sure there will be more to follow. I've lost track of how many weeks of bedrest and hospital bedrest I clocked up between Vincent and Sophie but it was A LOT. I have a uterine septum that I've had surgery to remove but some still remains, I'm being considered "high-risk" again and being seen by MFM once I've made it past my first trimester.

It's going to be a bumpy ride! I'm already finding bedrest so much harder than I did before, I stay home to care for my son so it's not something I can take a break from really. He's trying his best to help mom out so far though <3

[Angela]

English Rose! I can't believe you're back! How exciting! I'm sorry though that you're certainly off to a rough start. Must have been a happy surprise to know your little one is safe. I will certainly be thinking of you and praying for an easier road ahead for you. Keep me posted, okay? 

[EnglishRose23]

Thanks Angela

[EnglishRose23]

so some good news and some bad news:

Good news: Baby was doing well on my 7 weeks scan, good heartbeat and growth, and no new bleeds so I'm back to light activity, just need to rest when the cramping gets really bad, next scan at 9 weeks.

Bad news: There will be blood. Dr said the lining on the uterus right of my septum is already building up again for another "cycle" and isn't onboard with the pregnancy yet (baby is on the left). So there will definitely be more bleeding before the end of my first trimester, just have to hope it doesn't harm the pregnancy when the contractions to get rid of that blood start up again. I'm also super worried that I'm pregnant on my left, since I carried both my children on my right side before which means I've just lost any hope from my uterus having been stretched out all the way to 28 weeks that it can get that far again (my non-pregnant half of the uterus doesn't really expand with pregnancy, just gets pushed off to one side). Who knows though, maybe left is my good side!!

[Jadeandrainbowbub]

How are you going? Hope things are going ok

[EnglishRose23]

Another update:  had my first MFM appointment, as predicted the plan is cervical length checks every 2 weeks from and weekly makena shots starting at 16 weeks, although the dr wasn't optimistic either will do much for me.  They'll also be doing ultrasounds to monitor growth every month. Good news is they'll let me attempt a VBAC even if baby is premature, and this hospital will attempt to resuscitate a baby born at 22 weeks if we insisted on it (odds are terrible, but not hopeless). I'm 11 weeks 4 days today, baby was bouncing all over the place for my scan, and had normal growth and heartrate. Everything was looking good until I'd been home a couple of hours and another big bleed started. They had me turn around and come back in. Cervix closed and normal, baby still looking good, but my non-pregnant uterine horn was bloated and swollen with blood. I'm back on bedrest and it's going to be a rough weekend to pass all that without losing the baby. Back for another scan on monday. They think it's my body attempting another period despite all wisdom to the contrary 

[Jadeandrainbowbub]

Oh no. How frustrating for you that you are back on bed rest! It will be worth it for your beautiful bub tho. That's good that your baby has a good heart rate and growth is good too. And cervix closed. That's good news, despite the bleeding. I hope the bleeding stops soon though. That would be very stressful for you.

I am so glad your hospital does try and save bub at 22 weeks if you insist! Ours won't budge from less than 24 weeks. That is great news that they will give your baby a chance if it arrives that early. Hopefully it doesn't tho!

I hope your scan on Monday goes well and bub is hanging on in there

[EnglishRose23]

Scan went OK today, baby still looks great and doesn't seem bothered by the bleeding and constant cramping. Bleed has slowed down and is more clots and old brown blood at this point, but my dr still thinks they can see an active bleed on the scan with more blood pooled to come out. They seem to think light activity is ok for me as long as I'm not have any gushes of red blood, so I'm doing my best to find the right balance between resting and getting on with my life!
 
How are you doing? Still stuck in bed? We've made it through our first trimester now 

p.s. I would call around any other hospitals within a 5 hour drive of you and talk to them about their policies, it is hard to find places that will attempt 22 weeks, but 23 weeks is becoming standard care especially if baby is a girl the odds are beginning to improve at that point.

[EnglishRose23]

Bah, it got worse with a large gush of red blood wednesday evening that went right through my pad and jeans. They had me come back in for ANOTHER scan, the active bleed has expanded inside the uterus, there's some behind the placenta now too and it's getting large enough to threaten the pregnancy. My cervix is still closed and baby still had a good heartbeat but my dr seems to think late miscarriage is my most likely outcome. She said if I was further along they'd call it an abruption and stick me on hospital bedrest, but with it being so early there is nothing they can do for baby so I just need to wait and see at home and go to the hospital if the bleeding increases to the point where it would be a threat to my health. She said it's basically up to me if I want to come in for a scan after each big bleed, since they know it's there and they aren't expecting it to let up anytime soon but if I need the reassurance of seeing a heartbeat they'll always fit me in on the schedule. IF I make it to viability, hospital bedrest is very likely, as they seem to think this bleed will come and go till whenever I deliver. I've been pretty much in constant pain with the cramping too, I really suck at pregnancy!!!!

[OBmom]

Hey English Rose.

Just wandering if there are any updates?
The " I suck at pregnancy" thing really stuck with me, I've had that feeling too. Please don't beat yourself up, this is NOT your fault or anything you could change. Nobody wants this baby to be okay and have a chance more than you. Therefore, you're this baby's best shot.

Bed rest sucks, and it's even more frustrating if we're not that sure it is even helping. But we keep on doing whatever we can right? Just hang in there, and keep hoping for the best!

[EnglishRose23]

Hi OBmom,

Thanks for asking, after waking in pain several times last night I've been bleeding heavily and passing large clots since this afternoon. I suspect this is the end of the road for this baby. I'd had a bad feeling about it all day yesterday and now the pain and bleeding seems to be confirming what my intuition was already telling me. Waiting till I see for sure on the scan tomorrow before I give up all hope though.

[EnglishRose23]

Wow, false alarm. after being in pain all night, bleeding through a ridiculous amount of pads, and catching and inspecting every large clot I passed in case it was the baby...suddenly around 4am the bleed stopped. Had my scan at lunchtime and baby was wiggling and kicking like nothing had happened, even better the multiple large SCHs that had been visible on my last scan were gone...they were the clots I was passing. Despite contractions with the bleed, and that "full" need-to-bear-down kind of feeling I had with it, my cervix was closed when they checked!! I should be elated, mostly I'm just emotionally exhausted from almost losing this baby over and over again. Hoping and hoping and hoping things get smoother from here on out.

Edited to add, one thing she did mention after the exam was that my cervix was "soft" even though it felt long enough and closed. Not sure how concerned I should be about this, wondering if I should push for getting my first cervical length check before 16 weeks...thoughts?

[OBmom]

Hooray for false alarms! 

I can't imagine how exhausted you must be. Just the stress of dealing with the bleeding and the possible outcomes day in and day out is enough to send anyone off their rockers.

Great news about all those clots passing, eh? More room for your little one inside!
Speaking of room, make sure your bowel is working properly (i.e. daily) and without needing too much effort. Try a mild laxative if it helps to get along. No need for the extra pelvic pressure.

Even through the Ultrasound probe we can get a feel for the cervix - "soft" in your case probably feels like "mushy". It's just a warning sign but pretty much what you'd expect in your case. You can check for cervical length before 16 weeks but the predictive value isn't great. Also, the more we probe around in there, the more we stimulate ctxs.

Have you started progesterone yet?
I would definitely discuss placing a pessary. Cerclage not so much, not with previous history of PPROM and uterine structure anomaly. Also, a little bit of cervical opening is good for draining. We don't want those clots staying inside and causing inflammation..

Anything to look forward to this week? Sending lots of patience and good vibes your way!

[EnglishRose23]

Thank you so much for your detailed response. I will definitely bring up the pessary with my dr although honestly the size of the clots I passed the other day I doubt they'd have made it through the tiny hole left by the pessary (biggest one I was able to save was 5"x 3"). I would worry about the clots and blood not being able to get out and making my angry uterus even more irritated. My MFM had discussed cerclage but not pessary as an option if my cervical length scans were concerning, I'm wondering if it is a less common option here in the USA.

They checked my cervix via a speculum exam and then manually feeling it, which is when she commented on it being soft...sounded like a good thing at the time (i.e. it's only soft, you aren't dilated at all!), the ultrasound tech didn't do a cervical length measurement on my scan that time. With my last pregnancy my cervical lengths were all good so it's still uncertain if cervical incompetence is on my list of problems, although they never felt the cervix last time because of my previa, so maybe it was softening then too and we just didn't know.

I'm relieved to have stayed regular so far and not needed to strain, I have a fairly high fiber vegetarian diet to begin with, but always found I needed the stool softeners for strict hospital bedrest!

This week my hubby has a 4 day weekend, so I'll get to rest a little more and give that bleed time to settle down. Blood was dark purple this morning which was a new one for me! My current medical team aren't big believers in bedrest, but right now I'm self-imposing staying off my feet completely on my husbands days off and doing only the bare minimum of moving around during the week since just about any activity sets off the cramping.

I'll be starting my progesterone shots right at 16 weeks along with a good dose of the migraines that accompany them! I wish there were more dosing options for the shots, last time I would find they helped settle my uterus for the first 4 days, and then it would be irritated/contracting on the 3 days before my next shot was due.

[Jadeandrainbowbub]

Oh no! Sorry to hear that you have been having more complications again. Hopefully your bleeding settles down soon. The progesterone shots sound like they could be helpful. Can u get them more frequently than once a week? How is bub doing? Hopefully all is well with bub and he or she is growing well. I am glad you can rest on the days that your hubby is home. I think it could make a big difference.