Tuesday, October 20, 2015

Healthy Passenger, Engine Light On.

Ok, great news first. I have one, perfectly healthy baby girl cooking. She is definitely a girl with real lady bits and nothing dangling below. More importantly, she has a four-chamber heart beating away, two beautiful kidneys, one little bladder, a spectacular brain, ten fingers and ten toes. She is measuring exactly on schedule. This is the most important thing. I am baking a healthy little warrior.

Here's what's not so great. Probably ok, but not ideal and possibly kind of terrifying. I have complete placenta previa. This means that my placenta is growing directly over my cervix. 95% of cases of placenta previa at this stage move on their own (due to uterine expansion) and the issue resolves. This is not the terrifying part. It's not the best news but it's manageable news. In the event that my placenta stays put, I will have a scheduled baby extraction via c-section at 37 weeks.

This is the only condition that I for sure have right now. However, I am at risk for some related complications. There is some evidence of placenta accreta - not all the evidence they would need for a diagnosis - and so I am being carefully watched for this condition. Placenta accreta is where the placenta actually grows into the wall of the uterus and cannot detach following delivery. The "treatment" is c-section followed by immediate hysterectomy. Oh, and massive blood loss and transfusions.  Right now, my OB thinks I do not have this condition as A) it is excessively rare and B) I have only one of several indications needed for diagnosis. The Maternal Fetal Medicine specialist was concerned. She was kind of a freakshow and I would rather never see her again which, fortunately, I don't have to. So, placenta accreta. Let's just not. I am being carefully watched for this.

Finally, and fucking terrifyingly (not that placenta accreta isn't a total Halloween special), the location of the umbilical cord insertion puts me and baby girl at risk of vasa previa, a condition where the umbilical cord is draped over the opening of the cervix. In order for this to develop, my placenta would have to move the opposite direction of the cord insertion point which, for this pregnancy, is near the edge of the placenta instead of in the middle. If labor started spontaneously and my water broke, the cord would have no support and the baby would die a matter of 2-3 minutes. Hence, to avoid any risk of labor, standard practice for this is c-section at 34 weeks followed by what I assume to be gobs of NICU time.

To put it all in perspective, we live in a miraculous modern age where babies can be made in petri dishes. We can monitor the hell out of scary situations and intervene before there's any real danger. What's more, aside from the placenta previa, neither of these conditions may develop. Statistically, they probably won't. But the possibility is there, a little dark cloud hanging back in the recesses of my head. For now I need to learn to live with my cloud and not let it shadow the fact that this little girl is kickboxing me all the time, moving my stomach from the outside and generally letting me know that she's a little hell raiser. I can't wait for her to arrive, safe and sound, preferably with a minimum of drama.

4 comments:

  1. Jane at Mine to Command had this worry with her pregnancy and everything turned out okay. Here is her first entry on the topic: http://minetocommand.blogspot.com/2015/04/a-new-perspective.html.

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    1. Thank you for that link! It is really helpful and reassuring to read about stories where these scary possibilities have very happy endings.

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  2. Whoa. First of all, congrats on your healthy and thriving little girl (see, I told you she would stay a she).

    That's a lot of scary what-ifs and I don't envy you those at all. But I also think that as infertiles - in the dreaded minority, where it seems like everything bad that can happen does happen - we are prone to expect the worst and hope for the best. So I'd be the same as you...mentally preparing for all the bad things... but rare means rare and I'm really hoping you get lucky and all these hypotheticals never happen. Obviously.

    As my mother-in-law kept repeating, as my sister-in-law was sent over and over for repeat, in-depth ultrasounds at the fancy specialist because the dark shadow in the baby's brain was "quite possibly a giant tumor they'd need to operate on immediately post-birth" (spoiler alert - there was no tumor) - "In my day, we didn't even have ultrasounds!" And that's the truth. In general, birth is dangerous/scary for mother's and babies, but sometimes I think we've reached the point where we know too much and we panic ourselves unnecessarily.

    That said... I'm happy you and baby warrior girl will be closely monitored from here on out, because early delivery + NICU time + even a hysterectomy beats fetal demise any day of the week. So what I'm confusingly trying to say is, don't worry, I'm sure none of these rare complications will transpire, but even if they do thank goodness we have the technology to figure them out ahead of time and save lives, amirite?

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    1. You are right on all points. Even if they seemingly contradict at times as most complex arguments do. I am so grateful for technology right now while simultaneously pissed that it's making my pregnancy a little less joyous. Almost entirely grateful. Because massive hemorrhage is the potential alternative among others.
      As a wise woman once said, "I don't need no stinkin' uterus, just a healthy baby."

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