Week 27- Pregnant with a baby boy, Placenta Accreta/Percreta, Placenta Previa, Thalassemia

{background info- Hello! My name is Jenifer and this is the story of my high-risk pregnancy.  I am currently pregnant with my eighth child (A BOY!!) and was diagnosed with Placenta Previa and Placenta Percreta.  I also have Beta Thalassemia which contributes to severe anemia.  While this has been a difficult pregnancy and we anticipate a difficult delivery, IT IS WORTH IT!

We NEVER regret our decision to get pregnant with this baby and are so grateful for this experience!!

 Accreta affects about 1 in 2500 pregnancies.  (It is pretty rare!)  If you have had previous uterine surgeries, your risk of Accreta increases to 1 in 500.  I have had two previous c-sections and one D&C, following a miscarriage.  Although I was at risk, prior to being diagnosed with this condition, I never knew Placenta Accreta existed.  Accreta is becoming more and more common as abortions and c-sections becoming more common.  

What is Accreta?  Accreta is where your placenta attaches to your uterine wall instead of to the lining of your uterus.  There are three different levels-- Accreta, Increta, and Percreta.  Accreta is where your placenta is attached to the first layer of uterine wall, deeper than the lining-- often Accreta's can still deliver and save the uterus.  Increta (17% of all Accreta cases) is where the placenta has grown into the muscle wall of the uterus-- this usually requires a c-section/hysterectomy.  The rarest form of Accreta is Percreta where the placenta actually grows through the wall of the uterus and attaches to other organs in the abdomen   Percreta is very dangerous and will require a c-section and repair of other internal organs that are affected.  Percreta affects only 5% of all who have Accreta.  (What is 5% of 1 in 2,500 births? Very rare.)  Most commonly, Percreta involves the bladder which is in front of the uterus (anterior placenta).  Sometimes Percreta involves the bowels with a posterior placenta.  Rarely it involves the uterus, bladder, cervix and bowels...  this is my condition.

I have been on complete pelvic rest and modified bed rest since 12 weeks of pregnancy.  My husband and other kind family members are taking care of my home and family while I spend most of my days sitting or laying.  This time of resting has been difficult, but it has also been a great gift.  I am thankful for every week that this baby is growing bigger and healthy inside of my womb.  I can't wait to meet this little guy-- our grand finale!!

This is a record of my pregnancy for my family and for those of you who may be experiencing something similar.  Yes, I share a lot, perhaps too much.  Thank you for being a part of this journey with me.  I am one who learns much from the experiences of others and I'm happy to share my experience with you, in the hopes that somehow it may help.}

Week 27--

Doctor Appointments.

Ultrasound- I wrote about my last ultrasound experience here.  It was an emotional experience for me.
my ultrasound was wonderful.  I cried a few times, which is very different for me.  I asked the sonographers to spend some time taking cute pictures and telling me how healthy my baby is.  (With a high-risk pregnancy you tend to stay in survival mode and miss out on the sweet "i'm having a baby" moments.)  I really needed some happy ultrasound experiences.

The head sonographer told me she wasn't convinced I had percreta.  She said that percreta meant my placenta had invaded my bladder.  She felt that my placenta was surrounding my bladder, but that my bladder walls were holding strong and NOT penetrated!!  She also spent some time looking at the back of my uterus where my placenta was near my colon.  It is really hard to see colon from an ultrasound, but she didn't see any conclusive evidence that my placenta was in my colon!! Such good news!

Perinatology-
My perinatologist is funny.  She does not sugar coat anything.  I completely trust her, I have heard MANY people rave about her, and I think she likes us although I'm not sure she is a fan of big families or my choice not to terminate this pregnancy.  She said, "I know that you value the life of this baby more than your own.   But we are going to keep you safe."    I replied, "Not more than my own.  I value this baby's life as much as my own."  On the way out I smiled and said, "Just you wait, Dr. W.  Next Christmas I am going to send you the most darling Christmas card with my EIGHT smiling children on it."

I had been having some sharp pain across my stomach and she was worried.  She said that my placenta is like a big ball of yarn, the yarn is all blood vessels.  Any time my uterus contracted, it would be squeezing this package of blood vessels and increasing my chance of rupture.  She is concerned that I am feeling pain, and concerned that I live so far from the hospital... and so, she wants me admitted to the hospital at 28 weeks.

They will start steriods the day I am admitted and I will hang out in the hospital until I deliver.  The plan is to schedule a surgery between 32-34 weeks.  (My vote is 34.)  She said there is a 90% chance I won't make it to my scheduled date.

I asked her what she would do if I called her on Monday, the day before I'm supposed to be admitted, and told her that I'm feeling great.  She said, "I would tell you that I'm glad you're feeling so good.  See you tomorrow."  Ha!  She's a tough one.  And so, I'm preparing myself to head to the hospital.

Hemotology--
My blood appointment was fine.  My blood levels are higher than they have been and she thinks I am over the lowest times.  She thinks I will be fine- blood wise, until I deliver.  They will probably tank me up right before surgery to try and get my pre-op blood levels up around 10.  She agrees that keeping me in the hospital until my delivery is the safest decision.

Women's Center/NICU-
While we were up at the hospital we stopped by the floor where I will be staying.  They showed me a room and told me what I could expect.  The room was much nicer than I had imagined.  They encouraged me to decorate it and make it my own.  I can wear my own clothes and have visitors.  My kids can even spend the night with me if I want them to.  This week, I'm busy getting my bags packed and deciding what to bring.  It is nice to have this time to prepare myself- physically and mentally.

We also stopped by the NICU and asked for a little tour.  We found out that siblings are aloud into the NICU (3 at a time).  Other children aren't, but siblings are allowed.  There are over 40 babies in this NICU, about 4 to a room.  Walking through I could feel a sense of peace and order, although I'm still so concerned about having a baby there that I can't stay with...  we'll see what the future brings.

Test Results.
Glucose-
1 hour- failed
3 hour fasting- passed (blah-- I didn't love this test)

CBC-
(Normal Range-- Hemoglobin 12.0-16.0, Hematocrit 36-46%)
April 15-- Hemoglobin 9, Hematocrit 29%  (Yay!  I haven't seen a 9 in a long time!!)
April 24-- Hemoglobin 8.9, Hematocrit 28%

Physically at 27 weeks.

In week 25 I had a transfusion and during the transfusion they couldn't find my baby's heartbeat for some time.  Although I knew he was okay, I felt that moment of "things might not turn out as I hope they will."  A couple days later I woke up and felt a strong, ripping feeling across the front of my belly.  I have had a lot of stomach pain throughout this pregnancy (most of it in my lower abdomen), but this was different.  My first thought was to run to the bathroom to see if I was bleeding (I was not).  My second thought was, everything could change in just a second.

For months my doctors have been giving me instructions on how to handle a hemorrhage   I live two hours from the hospital equipped to deal with my situation.  They would helicopter flight me to Portland, but I would need to get to my nearest hospital faster than an ambulance.  If I experience uterine rupture, they have only 25 minutes to get my baby out alive-- and that doesn't even address the risk of me bleeding out.  I will need a major red cross blood supply.  I have listened to their warnings and deep down I have thought I would be just fine.

Twenty minutes of no heartbeat, paired with one sharp pain, changed my perspective.  It was like a new understanding washed over me and I realized the seriousness of my condition.  Everything could change in a moment.  That sharp pain actually repeated itself three times that day and was followed by gently, but definite contractions.  My doctors were not happy that I didn't rush to the ER.  They said, "You do not have a wait and see condition."


Physically, most of the time I feel great.  I can't WAIT to be able to run and dance and jump and hold my babies again.  I want to drive and clean my house and play...  I usually wake up fine, but by the end of the day my lower abdomen is so sore I can't even stand pants.

Mentally at 27 weeks.
I am so grateful for a few days of fear that prepared me for my hospital stay.  Leaving my family for over a month is not easy-- but I feel that it is the right decision. I think I was prepared for this.  I'm glad that they told me to expect to be hospitalized at 25 weeks, so going in at 28 weeks feels like an accomplishment.

I've been compiling a list of things to bring with me and projects to do while I'm there.  I do NOT want to spend my days in the hospital just waiting to bleed.  I'm trying to set goals for the hospital like finish my photo books and complete a cross-stitch.  Even being at home on bed rest, there is a sense of accomplishment that comes from finishing something-- even if it's just a few more stitches on a current project.  I'm going to rock this hospital experience.  Even though I KNOW it won't be as lovely and relaxing as I'm hoping it will be-- I'm determined to make it a positive experience.

A merry heart is good medicine.
I can't control my placenta-- but I can guide my heart!
Life is good.  I am just loving these last days at home with my family....

ps-
the truth is-- the thought of going to the hospital makes me sick.  i LOVE being home with my family.
I'm afraid my time away is going to kill me.  But, I'm trying to find the good in this situation...
how can I leave my kids that long?  how will I sleep without my husband beside me?
dumb things haunt me... like, my toy closet is a mess and my kids really need a good clothing sort to get rid of too small winter clothes and get out summer clothes.
i know that i'm not indispensable at home and my situation is pretty dang ideal (with all the sweet helpers I have), but it is still hard.  Drowning hard if I think about it.