Sunday, 29 June 2014

Stephanie's Story - Placenta Previa and Percreta

Baby Sienna
I fell pregnant with my second child when my son was about 7 months old, I had a c-section when he was born. The second pregnancy wasn't planned but naturally we were very happy. At 25 weeks pregnant I began bleeding I didn't really panic because I bled a little in my first pregnancy. So I rang the hospital and they told me to go in. They decided to keep me in over night because the blood was not stopping it was much like a period. I was scared but once again didn't think a lot of it and was pretty much thinking everything is going to be ok. The bleeding increased in amount over night, and the next morning my OB breaks the news to me that she was moving me to a high risk OB and will be transferred to King Edward Hospital as we may need to be prepared for our baby to come out now. I was in disbelief and I can't tell you how hard my husband and I cried. So off I went to KEMH, bleeding continued and I started passing clots of blood at the end of every bleed cycle. My new OB Craig Pennell (absolute star) broke the news to me that I would need to stay in hospital for the remainder of my pregnancy, this was a shock how could I leave my just turned one year old behind, it was by far the most painful experience of my life being away from him and my husband. Through tests it was then confirmed I had Major Placenta Previa and Placenta Percreta - the worst my OB has ever seen and he deals with this stuff all the time. Oh and I also had a blood disorder ITP my blood was not clotting properly.

Days just turned into nights, I did everything I mentally could to survive my time in hospital. I saw a psychologist, I listened to relaxation music, I journal wrote all my fears. I knew if I was going to survive this that I would come out of it without depression this was my goal! So I was 32 + 6 weeks woke up in the night to go to the toilet and a rush of blood came out, all my worst fears in that moment became a reality and I had to push that emergency button. Not having control of your own body has got to be the most scariest thing in the world I was a ticking time bomb and I just went off! The bleeding ended up stopping but they needed to deliver our girl that day. I had a double epidural in which I had to do with no support only the doctors hands to hold because of contamination reasons, my husband then came into theatre with me. It was like a movie scene doctors EVERYWHERE and machinery everywhere by that point I was screaming in my head I can't do this I don't want this make it stop! But of course it couldn't they had to deliver Sienna straight away because as soon as they cut me I lost 2 litres of blood while awake my poor husband was watching, she came out perfectly beautiful. I had no idea of anything but I started feeling very sick and I remember telling them to put me asleep. My poor husband in a distraught state was taken out with Sienna and told I wasn't going to survive he then had to tell my anxiously waiting family that their daughter/sister had a baby girl but was not going to survive... 

I was in surgery for around 4-5 hrs and lost around 7-8 litres of blood, anything that could go wrong did. They had to pump my main artery to keep the blood flowing to my brain, I had a hysterectomy which I was aware that was more then likely going to happen. My lifeless body was put into ICU and I was under close watch for the next 48 hours as I was at a high risk of having a massive bleed again. Recovery was a struggle I couldn't walk or sit up or stand because I didn't have enough oxygen in my blood so it felt like my body weighed a ton, trying to talk while standing was virtually impossible for me, I just couldn't carry myself after surgery. 

Meeting Sienna properly for the first time was a beautiful moment however I felt so very hopeless I
Our first meeting
didn't feel like a happy mum that just had a baby, I felt like I just had this major surgery but didn't have a baby. I would struggle to get down to the neonatal unit to see her, I was so exhausted I had to prepare myself each time I went down to spend time with her. I had to have a sleep, take pain killers then 30 min later I could see her. But then I couldn't stay with her for too long because I got so tired and weak very quickly. I was released from hospital after 9 days amazingly, Sienna had to stay in hospital for a further 3 weeks so she could learn to feed from a bottle. Going home was very surreal, I laid on my bed that I had missed so much but my mind couldn't work out if I was living reality or if I was really dead, it was very confusing and upsetting.

Even though this experience has been by far the worst emotional and physical pain I have ever endured, it has opened my life up to new possibilities and because of it I found myself and I continue to live a happy life because I was shown just how quickly it could of been over. I use to sit in my pain everyday of the what if's and replay everything, grief was the most important part of my process of healing. Crying like I had never cried before ,thinking about it constantly was so important as it helped me to decide when it was time for me to heal. The decision came on my daughters first birthday. I decided that I could no longer do this to myself anymore, that I wanted to be happy and free in my mind so I made a decision to stop wondering about the what if's, because it almost happened but it didn't I'am here. I have my beautiful family and I have learnt so many valuable lessons that could of taken me a life time to learn.

Saturday, 14 June 2014

Sandra's Story - Surviving undiagnosed Accreta

I had a great pregnancy. At approximately 6.30am on the 23rd of October 1992 my water was leaking it didn’t break.  I was over due on my birth they believed as the dates kept changing. We rang the hospital and they said come in as I had Step B.  I had no contractions.  They induced me at the hospital at around 7.30am the process of contractions took a while and they put a heart monitor on my baby’s head.  After a few hours they gave me pethidine as the gas made me sick.  When it came to pushing it didn’t go well the pethidine had run out and they couldn’t give me any more as it was time to push. I pushed for 2 hours and 52 minutes (I read the report) my baby was face up and not moving through the birth canal and his heart rate became a concern. The doctor said I needed forceps and they had to give me a cut to give my baby more room. They got me all ready and I remember the force was so strong when they were pulling that the bed moved away from the wall.  Out came my baby facing me he was a chubby one with heaps of hair, Beautiful.  He was just over 9 pounds and 52 cm long. He was born at 10.52pm. Then that’s when it went downhill.  I remember them pulling on the placenta when all of a sudden I had the worse pain, I remember pleading with them to stop (I didn’t know at the time but my uterus had inverted and they were pushing it back in and it kept coming out with the placenta still attached) at this stage I became very restful, no pain and at peace.  There was a lot of movement in the room and then I remember the lights on the ceiling going fast as I pasted them on the bed.  I had surgery where they said I required 6 pints of blood. They took my uterus and stabilized me. The surgery took all night and into the morning.  The hospital didn’t have an ICU unit so they set me up in a birthing room with a one on one nurse and machines and tubes everywhere.  This was all because of placenta accreta.  Which was not known until I gave birth.  My cut was from my bellybutton to my pubic bone.  My son was taken to a children’s hospital for surgery as he had a small problem too.  He was there for a couple of days. I was in hospital for 2 weeks other complications were surgical infection, Bowel and bladder in shock and not working.  They had to remove some stitches so the infection could weep and intravenous antibiotics. I was still on iron tables when I went home.
Over the next 5 years I still had some problems because of the damage to my tummy.  I had incisional hernia twice which required major repair.  So twice for periods of months I was unable to hold my boy and on the last surgery I slept in an arm chair for 7 weeks.  My son had some minor medical problems which required doctor visits and treatment.

When my son was 8 I returned to school and worked hard and found a new career in working with children with special needs.  My son and I have been through a lot.  I am so proud of the young man that he is.  I now have 3 other boys in my life who also mean the world to me as does my son. I also have a very supportive partner.

Wednesday, 4 June 2014

Overcomers of Placenta Accreta

The journey to survival is not an easy one, there are many bumps in the roads. We are overcomers! 

Tuesday, 27 May 2014

Meagan's Story - Placenta Previa and bi-lobed placenta

5 Day old embryo
My first baby boy was born in 2011 via c section and I had an ectopic pregnancy in 2012 which required a D&C and removal of my one working (or not maybe lol) tube.  IVF was to be our only option to conceive. 

I started my IVF journey in November 2012 and discovered I was pregnant in December.  I started bleeding at just 3.5 weeks and was put on modified duties. A scan at 6 weeks showed a happy baby with a strong heartbeat.  I was still spotting and my dr told me to take it easy and continue pelvic rest (which I had been on since 4 weeks).  At 9 weeks I was at work and had a significant bleed and was convinced that I had lost the baby.  An ultrasound showed a happy baby who was growing perfectly.  I did 15 weeks of bed rest and at my 12 week scan I was told I had a placenta previa that was not likely to move.  When I saw my ob he said it was not previa as it was too early to diagnose and told me to just keep taking it easy and see him every 3 weeks.  I continued to spot but continued life as normal.  My 20 week scan showed that my placenta had not moved and was bi-lobed and completely covering my cervix.  The MFM sonographer and my OB both said it was unlikely to resolve.  It also revealed that we were having a little boy. 

At 21 weeks my section was booked for a month before my due date- I would be 35&4.  Just 5 days later I had a bleed.  I will always remember the day as it was our wedding anniversary.  I rang my OB (it was 5pm and he was grocery shopping lol) and he had me go straight to the hospital.  Bub as checked and was happy and I was admitted for  monitoring and spent a week in hospital and another week at home on bed rest.

I saw my OB at 24 weeks and we discussed steroid injections and what to do if I had a massive bleed as I was an hour from hospital.  He prepped me that if I had another bleed I would not be leaving the hospital until baby was born.  I started steroid injections at 30 weeks and had one a week.  At 33 weeks I had another scan with the MFM which showed I still had CPP but no Vasa was detected (we already knew this as OB has a ultrasound machine in his office so we were seeing it every 2-3 weeks).

On 11 July 2013 I arrived at the hospital for my scheduled section, which was to take place in the main theatre.  I met my OB, a special care nurse, the pediatrician, anesthetist and the heap of others who would be there for the birth of my baby.   The anesthetist had blood on standby and discussed that they would let me be awake but would put me under if needed after baby was born.  Hubby was with me and at 9.35am our beautiful baby boy Fletcher James was born weighing 6lb12. 

Baby was taken off to be cleaned up and checked out and I laid there anxiously listening to the sounds of my OB.  After a little while (it seemed like forever) he announced that he was happy.  Placenta had come away easy and bleeding was minimal.  I was taken to recovery while baby was taken to special care for some breathing issues.  
My first feed

Fletcher was put on CPAP and I got to see him on my way back to my room.  It was a shock to see him but the nurses assured me that he was a great size and would be fine.  I was checked every 30 minutes for the first 5 hours and then hourly for the night to monitor bleeding.  I was up early the next morning, showered and off to special care to see my baby. 
Fletcher in his humidcrib

Fletcher was off CPAP within 24 hours, in an open crib day 2 and allowed into my room by day 3 during the day.  We were released together day 6.  My pregnancy was not how I would have planned it but the end result was worth it- Fletcher is perfect!  We have decided that we have two healthy amazing boys so our family is complete but I still question if maybe Fletcher's pregnancy was different we would have had another. 

Sunday, 25 May 2014

Infant and Pregnancy Loss - Babies We Honour You.

Placenta Previa and Accreta, are life threatening conditions for both Mothers and Babies. While the journey of these pregnancy conditions is stressful and can be heartbreaking, being separated from family and friend, feeling like a like a ticking time bomb,  doing what you can in the hope to give your precious baby more time to grow, get strong, and flourish. However there are situations we can't prevent. Labours that can't be stopped, and for many many reasons we can't carry our blessings to term.

These babies are just as much a part of us as all of our others, and we would do what ever we could to have them here and watch them grow. This is a page to honour those babies that didn't make it.  If you have lost a baby in the journey of placenta previa, and or placenta accreta, we want to honour that baby.  Sharing a photo, picture, name, phrase that speaks to you.

In honour of the twin we didn't get to met.  I will met you in heaven.
-  23rd of November 2012
- Christina Mathewson

- If you would like to add to this post please message me at

Saturday, 24 May 2014

Kirsten's Story of surviving Percreta

My Placenta Percreta Story

I had been blessed with three beautiful healthy children, with uneventful pregnancies. They were all born healthy, by caesarean section. I was pregnant with our fourth baby, and I was so happy. I’d always wanted four babies. 

Unfortunately, this pregnancy ended at 8 weeks, when there was no heartbeat found at my first scan. I was absolutely devastated. I had to have a d&c. 

Another confirmed pregnancy, followed by another miscarriage. Then another pregnancy, followed by yet another miscarriage, and another d&c was required. 

I felt like all hope for having another baby was fading. I decided to see a gynaecologist/obstetrician to see if there was any reason as to why this was happening. No reason could be found, so we were told to keep trying. When I confirmed that I was pregnant again, I was almost too scared to be excited.  The Doctor that I was seeing had a small ultrasound machine in his rooms, so I was having very frequent scans from as soon as I knew I was pregnant, more for my piece of mind than anything else. 

I started bleeding early in my pregnancy, and just couldn’t believe it. Surely it wasn’t happening again. This time though, every scan I had showed our beautiful, precious baby growing, and healthy. The reason behind all the bleeding was a peri-sac haematoma. The Doctor said that this would resolve on it’s own, and then the bleeding would stop. I think I bled from about 5 weeks to about 14 weeks. I changed Doctors to a local Doctor, as I had been travelling an hour to see the gynaecologist/obstetrician.  At my 19 week scan, I was told I had placenta previa, that was completely covering the os. All I was told was that if I had any more bleeding, to go straight to a hospital. 

I was going really well, and the baby was growing beautifully inside me. I didn’t start to organise much, and thought that once I reached the 30 week mark, I would start getting organised. My other three babies had all been born within about 10 days of their due dates, so I thought that this time would be the same! At about 26 ½  weeks, I had a bleed. My kids were at school, and my husband was at work. I rang my Doctor, and he told me to pack a bag and organise for someone to take me to a hospital about 35 minutes away, as the local hospital wasn’t equipped for my situation. 

I was absolutely terrified, and got a friend of mine to take me to the hospital. Once there, I was assessed and had an ultrasound and admitted for the night. The next day the Doctor told me they wanted me to get an MRI of my pelvis done, to further check the placenta, and to check for a condition called placenta accreta. I was also told that I would be in hospital for a minimum of a week. I was devastated. I was missing my babies like crazy (and my husband).  The MRI showed possible placenta accreta, so I had to be transferred to another hospital, as this hospital didn’t have the facilities to help a baby born prior to 33 weeks. I felt like I was going to the other end of the earth, and just sobbed uncontrollably until the ambulance came to transfer me and bub. I was settled into my new room. I had an echo on my heart, as I had a VSD repair when I was 16 months old, and now have a leaky pulmonary valve. Thankfully the cardiologist didn’t think this would be any cause for concern.

I remember the day my husband and babies came to visit for the first time since I had been admitted. I was like an excited kid on Christmas Day!!!! It was such an amazing day, and we had a wonderful time together. I was given my one and only day leave for the whole of my hospital stay. A couple of days later the Doctor came to see me about my MRI results and told me that they weren’t sure if it was accreta, or a big fibroid (which is some kind of benign growth). They would do another MRI in a day or so, and do it deeper so that they could hopefully get more information. She said that they wouldn’t let my pregnancy progress any further than 37 weeks if it was accreta. When I had my next MRI, the results weren’t good. The placenta had grown into my caesarean scar and through to other structures, possibly the bladder. I had placenta percreta. This meant that I would need a hysterectomy, and possibly bladder surgery. I couldn’t believe this was happening.  I

 had bleeds here and there, and was just monitored each time. As long as the baby was ok, and not distressed, they would leave me as long as the bleeding didn’t get worse. My caesarean date would now be at 34 weeks, instead of 37 weeks. At 28 ½ weeks, I had my glucose tolerance test, and it came back that I had gestational diabetes! Due to the upcoming surgery, and them wanting me to be in optimal health, they started doing finger pricks on me four times a day, and administered insulin if needed. I also started having celestone injections, which are steroids to help mature the baby’s lungs.  The bleeds continued, with no real pattern to them. Some days I would have them, some days I wouldn’t. They increased in frequency, but not in amount. Each time I was monitored, and baby was checked. They would much rather do my surgery and deliver the baby under a controlled situation, rather than an emergency situation. All of the Doctors and Nurses have been so wonderful here, they are more than happy to answer any questions I have, even when I ask them a million times!! 

I was absolutely terrified, but so glad that I have my faith, and also that the Doctors are aware of my situation, and can prepare for it as much as possible. When I was 32 weeks, the Doctors held a big meeting with everyone that would be involved with my surgery. From this meeting they discussed the pros and cons of waiting until 34 weeks to deliver the baby. They decided that my surgery would be brought forward to 32 weeks and 4 days. I signed forms to consent to surgery, and a hysterectomy if required.

The day of the surgery arrived, and I was so scared. I had lots of tears, but I was also so excited to meet this precious baby that was growing inside of me. I got up early and had a shower, and then was wheeled to the theatre waiting bay at around 7.15am. I was checked in for theatre, and then met with my Doctors who did a quick ultrasound to check the positioning of the placenta. They answered any questions I had. In theatre they would have the ultrasound machine to use. They would also be using the cell saver machine which would filter any blood I lose, and put it back into my body. At around 8.30am I was wheeled off to angiogram, where I had my groin x-rayed before being given a local anaesthetic in each side. I then had balloon catheters put into my major uterine arteries, that could be inflated if I had a lot of bleeding, to minimise blood loss. 

At around 10am I was wheeled to theatre and prepped for the surgery. The anaesthetist put in an arterial line in my left wrist to measure blood pressure. I don’t like the oxygen masks, and had previously asked if I could avoid this at all. They were very kind, and just gave me the tube to suck on, without the mask, so I still got the oxygen. I was then given the general anaesthetic, and was asleep.

Our precious baby daughter was born at 12.32pm. She had to have a breathing tube put in because of the general anaesthetic I had.

With my surgery, they put in ureter stents so that they could feel where the ureters were easily during surgery. I had a CVC line put in my neck, and also had a least one other large gelco in my arm. There was minimal blood loss to begin with, and the placenta wasn’t attached to the abdominal wall, or to the bladder thankfully. It came away easily from the right side. 

The left side was another story. The placenta had wrapped around a major blood vessel supplying the placenta, and apparently started to bleed like a tap running. I thank God for the gynae-oncology surgeon that was there, as he was able to remove the placenta, and told me he was madly stitching. I’m not sure how long that took, or how much blood I lost. I needed a blood transfusion, and had 3 units.  I also had a hysterectomy. I was closed up, and was apparently woken up in theatre before being taken to ICU, although I have no recollection of this. 

I remember waking up in ICU at around 4pm. I remember being so thankful that our baby was safe, and that I was safe and alive. At around 2am, they took out the balloons in my groin. I had a really sore lower back and had to lie still for a few hours with pressure on them so that they didn’t bleed. This scared me a lot. I was on Fentanyl (a bit like morphine) for pain relief, but this didn’t seem to help the back pain. I was sick a couple of times, which really hurt, and I remember they had to roll me to change the sheets, which hurt a lot. 

Miley Ella Grace
Our baby girl’s breathing tube was taken out around midnight, and she is doing really well.
The next day we decided on a name for our beautiful baby daughter. Her name is Miley Ella Grace. She weighed 1850g (4lb) at birth, and was 43.5cm long. I was shifted from ICU to the ward, and was wheeled in my bed to see Miley for the first time. She was in intensive care, doing really well. The following day, I got my first cuddle of our beautiful, precious baby, Miley. What a very special time that was. I could have laid there cuddling her all day!
Our First Cuddle

Three days after surgery, I was really unwell with an ileus, which is when your bowels go on strike and don’t work. It was so painful, and I couldn’t move, or get comfortable. As I was too unwell to go to neonatal, a beautiful midwife arranged for Miley to come to see me. It was just what I needed. The ileus resolved later that afternoon, and I got out of bed for the first time. The next day I was just really nauseous whenever I moved. This really hurt! I was feeling much better later that night. Six days after having the surgery, I had my CVC line taken out of my neck. The ureter stents were left in for about 6 weeks before being taken out under local anaesthetic. I was in hospital for 5 weeks before surgery, and then another 8 days after. Miley was in hospital for a total of 4 weeks before we were able to bring her home. She is a beautiful, caring, sweet girl and we are so thankful for our beautiful family. What was a very hard and difficult time, was definitely worth it all.

All Safely together.

Monday, 19 May 2014

WHO - World blood donor day.

WHO - World blood donator day, is quickly coming up.  

The theme for this year is.............

                    "Safe blood for Saving mothers" 

Many women with Accreta will need a blood transfusion to save their lives, so that they can be here on the other side.  The average transfusion for an Accreta mother is 8 units- around 4 litres of blood. Many however will need much more than that.  I myself needed 54 Units and 80 blood products from around 134 donations.  Without that gift of safe blood I would not be here today to enjoy my baby growing up.  WHO Donor day is a time to for us who have received to help give back, by saying a big 'thank you' to all those that have generously given. 

If you, like me, have a received the gift of blood donation and want to be a part of giving back to donors this World Blood Donor Day, then send an email:  

"Safe blood for saving mothers"

The focus for this year’s campaign is “Safe blood for saving mothers”. The campaign will increase awareness about why timely access to safe blood and blood products is essential for all countries as part of a comprehensive approach to prevent maternal deaths.
WHO encourages all countries and national and international partners working on blood transfusion and maternal health to develop an activity plan to highlight the need for timely access to safe blood and blood products in the prevention of maternal deaths.

WHO/O. O’Hanlon
Activities may include commemorative events, meetings, publication / dissemination of relevant stories on media outlets, scientific conferences, publication of articles on national, regional and international scientific journals, and other activities that would help in promoting the theme of this year’s World Blood Donor Day (WBDD).

Background information

Every year, on 14 June, countries around the world celebrate World Blood Donor Day. The event raises awareness of the need for safe blood and blood products and to thank voluntary unpaid blood donors for their life-saving gifts of blood.
Every day, about 800 women die from pregnancy or childbirth-related complications. Almost all of these deaths occur in developing countries. More than half of them occur in sub-Saharan Africa and almost one third in South Asia. The risk of maternal mortality is highest for adolescent girls under 15 years of age.
Severe bleeding during delivery and after childbirth is a major cause of mortality, morbidity and long-term disability. However, access to safe and sufficient blood and blood products and the rational and safe use of blood transfusion still remain major challenges in many countries around the world.

The objectives of this year’s global campaign

  • Ministries of health, particularly in countries with high rates of maternal mortality, to take concrete steps towards ensuring that health facilities in their countries improve access to safe blood and blood products from volunteer donors for women giving birth.
  • National blood services in countries with high rates of maternal mortality to focus on safe blood for mothers in their activities and products for the 2014 campaign.
  • Maternal health programmes and partnerships engage in the 2014 campaign.
  • WHO and partners throughout the world highlight ." - World Health Organisation

Don't forget if you would like to help, or be a face for the International Hope for Accreta Blood Drive in  January 2015, please let us know. We look forward to hearing from you. 

- Christina Mathewson

Monday, 12 May 2014

Jess's story with Grade 4 Placenta Previa

My fourth pregnancy (my son was born when i was 26) was smooth sailing until 20 weeks. I had no morning sickness, no bleeds nothing. After my third pregnancy i thought i had got off lightly. Then the 20 week ultrasound said i had placenta previa. By 23 weeks I had big bleeds.   
at 31 weeks I went to my check up with my ob, there i had a bleed in the waiting room and contractions. The ob and head ob (who later became my ob) decided it was safer for me to be admitted. I had steroid injections.  I remember ringing  hubby scared,  i was alone, being told all this information and everything seemed overwhelming. 

The head Ob set me the mini goal of reaching 34 weeks. I couldn't go home. I was having too many bleeds. No drs or midwives were allowed to touch my stomach for fundal height measurements, the only time my stomach got touched was by the head OB or for  the monitor straps to be put on.  I was stuck in hospital . 

Hubby had to take time off work to care for our older 3 boys. Every day that passed made me cheer. It was one day closer to my goal.  34 weeks would mean my baby wouldn't need to go to melbourne.  I was too unstable to go to the melb hospital while still pregnant.  Once I reached 34 weeks (after being in hospital for now 3 weeks) the OB hi5'ed me . 

I had monitoring after every bleed to check how my baby was going. I was told if i got a big bleed or  had any further regular contractions  i would be taken down to have an emergency csection then and there.   I spent a night in birth suite being monitored once. being wheeled in  and seeing all the IV stuff ready for me  made me burst into tears. I texted hubby who knew to be on standby for a call from the hospital just in case.  I watched tv and read a few magazines, the monitor tracking all my contractions. As the contractions stopped after being given medications I was whisked back to my ward room.  I would be back in birth suite at 35 weeks. Again, monitored and then eventually sent back to my room. 

I had an ultrasound at 36 weeks to do a final check on bub and placenta. The ultrasound showed bub would be on the small side of average, and he was breech.  The night before my csection a midwife came and chatted to me and watched tv shows with me, a lot of the ward staff had grown fond of as i never whinged.  

the day of my csection, i was so anxious. I tried putting on a brave face. I'd never had a csection before. It was all new to me. My ob had agreed to follow my birth plan that had delayed clamping in it, and what i wanted to happen if i was separated from my baby.  As soon as I was in the prep room of the theatre I burst into tears. Hubby tried to reassure me it was ok etc, but I recall telling him it wasn't ok. 

then the spinal block attempts started, first attempt failed. I cried.  then attempt 2 failed  and I started to freak out, i knew if the next one failed It was GA for me.  Attempt 3 worked. but that was with hubby holding one hand , an anesthesiologist holding the other and a midwife talking to me all trying to keep me calm.  I have a history of anxiety attacks, they wanted to avoid that happening.
Once the csection started, the anesthesiologist showed me that i couldn't feel below my breasts by holding an ice block along my body.  Lots of IV's and tubes were in my arms. One was measuring my BP and pulse.  I recall the anesthesiologist saying " can you feel anything? its started now" and I said " oh really? i thought i'd get a count down or something "   my baby was out within 15 mins of the csection. 
A healthy baby boy.  He was 48cm and 8lb 2oz, everyone said he was a good size for a 37 weeker.  Then , the Ob turned his attention to me, the midwife ushered hubby to come with her to recovery room to do measurements etc, i knew she was following my birth plan  and it meant something was going bad.  Then I blacked out.  I came too with the anesthesiologist talking to me and saying "stay with me jess"  and  i recall hearing  voices asking how much bags of blood was on stand by.

I told the anesthesiologist as he sat next to me, i felt dizzy and sleepy , he told me to stay awake and it would be ok.  after 45 min of entering the operating room, i was stitched up and in the recovery room.  I finally got to hold my baby.  All my fears and anxiety over how scary the csection would be etc vanished.  It turned out , that hubby was sent out as soon as my PPH started  and he was sent out as a precaution in case it went really bad.  Hubby wasn't even aware that I had requested he be kept with our baby at all times. 

Our son didn't require SCN or NICU.  He took to the breast within 20 mins. and He breastfed all the way back to the ward from recovery room. 

Alistair Ryan
48cm 8lb 2oz

Wednesday, 23 April 2014

Simone's story with Placenta Percreta, Complete Placenta Previa, and Bicuspid Aortic Stenosis

My  Family

At the age of fifteen, I was diagnosed with a serious congenital heart condition, Bicuspid Aortic Stenosis. At the age of eighteen, I was told I needed to have children as soon as possible, something that was far from my mind at that time.
I married my soul mate in 2011 at the age of twenty six, children were on our immediate agenda and I quickly sort the advice of a cardiac specialist to find out whether it was safe for me to get pregnant. At the appointment I was told it should be safe and a follow up echocardiogram should confirm this. We took this as a good sign and immediately started trying to conceive, positive news quickly followed. We had succeeded at our first attempt to conceive and I was pregnant. Two weeks later I attended the specialist to receive the result of my echocardiogram, the news was not positive. The specialist told us I should not get pregnant before having my aortic valve replaced as the valve area was under the safe allowance of one centimetre. At this stage we told the specialist I was already two weeks pregnant. My care was transferred to Flinders Medical Centre, which was 45 minutes from our house, on a good day. I was considered a high risk patient. I made all the doctors nervous and all medical departments involved knew who I was. The pregnancy was fairly uneventful, other than breathlessness, some slight chest pain, swelling and palpitations, that was until twenty nine weeks gestation. I walked into my obstetricians office on this one Friday, she took one look at me and rushed me to be admitted. I couldn’t say three words without taking a breath, I was clammy and my lungs had fluid on them. My heart had started to fail. I remember seeing the surgical equipment sitting outside of my room just in case. I was given steroids for the baby’s lungs and preparations were made to deliver me after the weekend. All of my medications were increased and the medical team worked hard to clear the fluid off my lungs, fortunately they succeeded and by Monday I was doing a lot better.

I continued the pregnancy without event. I met with the anaesthetist and was told I had a 1 in 100 chance of not making the surgery and a 50 percent chance of complications occurring, I cried. I found it particularly hard to bond with my first unborn child, I even remember telling my husband I wanted her to call me Simone instead of mummy. On some level I blamed our unborn daughter for my deteriorating health and possibility of not being around to meet her; I knew I needed to seek counselling so I did. The mental health nurse helped me prepare for the worst case scenario, I prepared my will and wrote letters to my husband and unborn child. I cried often at the possibilities and days before the surgery my husband and I embraced crying in each other’s arms, we were scared. At 36 weeks and 2 days gestation, on the 27th March 2012, the planned caesarean section was performed under general anaesthetic. Our daughter was born and everything went well, I spent 36 hours in the Intensive Care Unit for observation before being transferred to the normal maternity ward. I met Isabella Jade approximately five hours after the surgery, she spent three days in the NICU and was then released to room in with me. Isabella was perfect and I had no problems at all connecting with her. My health returned and my heart symptoms disappeared after the pregnancy.
Isabella and me

Approximately sixteen months later we decided we wanted to start trying for our second child. Again we discussed this with my cardiologist, Doctor Robert Minson at Flinders Cardiac Clinic, and he gave us the all clear. We had done this before, we knew I could make it through the surgery. We were quietly confident everything would be just fine, so we started trying to conceive. Soon after we received positive news, we had again succeeded at our first attempt to conceive our second child. By six weeks, my care was transferred to Flinders Medical Centre, under Doctor Jay MacGavigan and Doctor Bill Jefferies. Every two weeks I drove an hour and a half to attend appointments.

Symptoms of heart failure started presenting by eleven weeks and my doctors quickly responded by increasing my medications as necessary. I was feeling good, enjoying my second pregnancy unlike I had been able to do with my first. We had done this before, I had survived my last pregnancy and I knew I could again. We were so confident that I didn't even have any plans to prepare for my death this time. The pregnancy progressed quickly and before we knew it I was twenty weeks along. We attended the anomaly scan and it was wonderful to see our growing baby, we decided not to find out the gender of bubs. One week later I attended a routine appointment with Doctor MacGavigan. I was feeling really good. I walked into my doctor’s office and the first thing she said to me was “you don’t do things by halves do you Simone”? I was confused, I thought things were going so well, I asked the doctor what I had done, at this time she informed me that the placenta was completely covering my cervix. I asked the doctor what she meant, she told me that I had complete placenta previa which would result in a caesarean section. I am not allowed to give birth naturally or go into labour normally because of my heart condition, so I was already having a planned caesarean section anyway however as the doctor revealed the concern was that the placenta was sitting directly over my previous caesarean scar and that it could have attached. “If that is the case I will have to do a hysterectomy”….

All I heard was the word hysterectomy, we had been talking about having a third baby, I wanted a third baby. I was told that I needed to be on pelvic rest and if I had a bleed I would need to come directly to the emergency department of the nearest hospital. I left the hospital hysterical, without asking any questions. I phoned my mum and husband and broke the news but none of us truly understood what I was facing.

Pregnant with Noah at 32 Weeks

At home I spent the weekend googling “complete placenta previa”, and “placenta attached to caesarean scar”…I read the words “placenta accreta” on my screen. I wondered what this placenta accreta was, why hadn’t I ever heard of it before, how come no one I knew had ever had this before. By Monday morning I was a mess, I couldn’t eat and I cried constantly…things did not look good, how could I survive this with my heart condition. I was able to get in contact with my obstetrician that morning and ask her all the questions I had. Doctor MacGavigan reassured me “I promise you Simone, you are going to be okay”. I held onto those words the entire pregnancy. In the early hours of the next morning, I had my first bleed. At 1 am, I called Birthing and Assessment and they told me to come in. My grandmother watched my daughter, while I frantically drove myself to the hospital. When I arrived, the nurses asked if I was still bleeding, I was so scared to check just in case I was having the “big” bleed I had read all about. At the hospital I was observed. Medical staff were already talking about me and a senior anaesthetist came to visit me, he reminded me how dangerous the situation was. Optimistically I tried to convince the Registrars that the placenta could still move, they were not so hopeful. Thankfully the bleeding stopped and I was released by lunch time the next day.

At 24 weeks gestation I had a MRI scan to see if the accreta could be confirmed. I clang onto hope that this was all just a mistake and the MRI scan would say I didn’t have the accreta. The MRI scan results came back inconclusive. That same day we had a scan to see what the gender of the baby was, I needed to address my letters and gifts to my baby properly. I cried when it was revealed that we were having a boy. As the weeks went on, I learnt more and more about accreta, what is was, why it happened, the risk factors, diagnosis and treatment. I learnt that it was hard to positively diagnose as it could not be easily detected on ultrasound or MRI. Medical professionals were able to suspect accreta based on the position of the placenta and risk factors, including previous births and caesarean sections, previous dilation and curettage’s, maternal age and history of any other uterine scarring but they could not be positive. However, the condition was considered rare. At my 28 week ultrasound, I again held out hope that they would discover I did not have the accreta or the placenta had moved and again the results were inconclusive. Our baby was growing well though, this was a relief.
Smallprint pins
At approximately 30 weeks I was told I needed to stop working so I did. As the weeks went by, we came to terms with the fact it was likely I had the accreta, or possibly worse. I began preparing for the worst case scenario. I felt like a ticking time bomb as I waited for the “big bleed” as a result of the complete placenta previa. I was still on pelvic rest which meant I was unable to be intimate with my husband and was unable to perform any strenuous activity. I was also not allowed to be more than 30 minutes away from any major hospital. It was all taking a toll on my relationship with my husband, my family and my friends. I spent my time preparing special gifts for my children including a patchwork quilt for my unborn son and a patchwork cushion for my daughter. I also had silver Smallprint pins made for them with my fingerprint on them so that I could still be close on those special days, even if I was not there in person. I tried to enjoy what I believed to be my last few months of my life spending quality time with my daughter. 
Cushion I Made for my Daughter 

Just before 32 weeks I had another MRI scan, we were hopeful this scan would give us answers. I was scared to find out the results but also optimistic. At this time my care was transferred to Doctor Elinor Atkinson. Doctor Atkinson had 37 years’ experience in obstetrics as well as extensive experience with patients suffering placenta previa and accreta. At my first appointment with her I would get the results of the MRI and I had a long list of questions to ask her. The MRI scan was again inconclusive. I was devastated. Doctor Atkinson was able to answer all my questions though and before I even asked she discussed preventative and interventional measures such as iliac balloon catheters, central lines, a vertical (classical) incision and cell savers (a machine in the operating room which would clean a portion of the blood I lost and return it to me). I felt extremely confident with Elinor and I asked her straight “do you think I have the accreta”, she nodded and said she would be amazed if she got in there and it wasn’t an accreta, I was a sitting duck for it. Things were getting hard at this stage as I was getting more and more tired and was now attending up to 4 appointments a fortnight at the hospital, the driving was horrible and I was feeling miserable. During this week we got 3D ultrasound done and I had a maternity photo shoot which helped me bond with my baby and enjoy the pregnancy even for a short time. 
Noah in Utero 
A week later I met with the anaesthetists. A junior doctor discussed the procedure with me, he was very mundane in his explanation, it was clear he didn’t seem confident at all. A senior anaesthetist joined the appointment approximately one hour in. Doctor Tim Porter was humorous in his discussions, but he made it clear that they were all very nervous going into my surgery. Based on my heart condition and the suspected Placenta Accreta I was given a 1 in 20 chance of dying and a 66% chance of complications occurring which could also result in death. Suddenly it all dawned on me, I smiled and laughed at Tim’s jokes and acted like I wasn’t fazed but I was scared, so very scared. From that time onwards I became a wreck. My mind was a mess and I remember hoping I wouldn't have the "big" bleed but also wishing that I did because I had heard you don't normally bleed when you had Accreta. I thought if I could just have a bleed it would mean I didn't have Accreta. I cried almost every night in the shower while my husband slept and during the day while he worked. Night after night I watched my daughter sleep for up to an hour sometimes, taking in her smell, her little hands and feet, the feel of her soft skin, her perfection.

At 33 weeks +6 days pregnant, we met with Dr Elinor Atkinson. Elinor set the date of the Caesarean section for the 13th March 2014, I would be 35 weeks +6 days pregnant. I would be admitted 2 days prior to have steroid injections for my baby’s lungs and so all doctors involved could meet with me if they wanted to. I had complained to Elinor about reduced movements that were more painful, Elinor ordered a CTG test to check the baby’s movements. The test ran for approximately 30 minutes and during that time bubs moved plenty. Everything appeared good, we just had to wait for the day of the c section. At 34 weeks + 4 days I had another growth scan as requested by Elinor. At the scan sonographer took a very long time to do the scan, I assumed she was looking to confirm the Accreta. I asked lots of questions at the scan, including if I had placental lakes, which I did. By this stage I knew a lot about Accreta and I knew placental lakes were a sign of Accreta. After an hour of scanning, the sonographer called the doctor in, I could hear her saying “see it disappears there”, I knew she was talking about the uterine wall and I just knew I had the Accreta, but still they would not confirm it. I also heard the sonographers and the doctor talking about the amniotic fluid and at the end of the appointment I was asked to stay until they could speak with an obstetrician. The on call obstetrician came down to see me and explained that the amniotic fluid was low and that she was unable to get hold of my doctor but she would call me once she was able to. I phoned my husband and my family, I knew I was most likely going to be admitted. At 3 pm that afternoon the on call obstetrician called me and asked me to return to the hospital as Elinor wanted to admit me until the surgery.
Quilt that I Made for my Son
 I was grateful not to have been admitted till now, but I still had so much to do. I asked to be admitted the next day instead and that night I had my waxing done, finished off the gifts for my children, properly packed and finished my unborn son’s nursery. The next day I had my hair done in the morning and then my mum watched our daughter while we made the trip to the hospital for my admission. Not much happened the first day I was there but on the Thursday at 34 weeks + 6 days I was sent for another ultrasound. My fluid was still about half of what it was meant to be. Elinor spoke with me, as I had not had any problems with my amniotic fluid until now, she was concerned that my membranes had ruptured or the placenta had stopped working...both were dangerous to our baby. It was decided I would deliver the next day either in the morning or late afternoon, depending on when she could get everyone together.  I called my husband at work and he immediately went and picked up our daughter from Child Care and came to the hospital, we both knew this could be our final moments together. I also phoned the rest of my family to let them know. That day I raced around the hospital updating my will, getting it printed and signed, as well as finishing off our birth plan and getting that printed. Our birth plan included details of what I wanted to happen if I was on life support. We spent the afternoon just being together. I would be prepared for delivery at 8:30 am the next morning at exactly 35 weeks gestation. That night one of my closest friends and sisters came to visit, although unspoken we all knew they were there to say goodbye to me. I shed a tear as my sister gave me a keepsake pendant and as they all left. My husband, daughter and I spent the next hour embracing on the hospital bed, I didn’t want to let my baby girl go. I said my goodbyes. That night I stayed up till 3:00 am writing letters to my family, outlining funeral details, financial details and recording video’s for my husband and children. I cried and cried as I recorded myself singing my daughters favourite nursery rhymes. I slept for 3 hours.
My husband and mum arrived at the hospital at 7:15 am. Numerous doctors and nurses visited my room that morning. I signed numerous forms giving permission for certain things including the hysterectomy if it came to that. Doctor Steven Scroggs, the obstetrician helping Elinor Atkinson deliver our baby, visited my room. Steven told me that the doctors did not want me to ever get pregnant again if I survived the surgery and did not require a hysterectomy. Steven asked how I was going to ensure that  did not get pregnant, I said I would use contraception, but Steven was not happy with this, he suggested I have my fallopian tubes removed which was the only 100 percent effective option. I asked him to let me think about it for a short time. It was so hard to make this decision, but my mum begged me to do it “Simone next time you will die”, I heard the fear in her voice and I knew I could never do this to my family again. We called Steven back and he got me to sign the consent to remove my fallopian tubes.

At approximately 9:00 am I was wheeled around to the operating theatres, I cried as I said goodbye to my mum but quickly composed myself. In recovery the anaesthetists put in 3 large IV’s and an arterial line, I could feel him putting the line in so they began giving me something to calm my nerves. I become a comedian as I joked about drinking wine after the surgery and other things. At approximately 10:00 am I was taken to radiology where they inserted the iliac balloon catheters in my main arteries, my husband had to wait outside during this time, and the junior anaesthetist, Doctor Jackson Lee, comforted me as he stroked my face and explained everything that was happening, answering all my questions every time I felt something. The balloons were in by 11:00 am and I was wheeled to the operating theatre, saying goodbye to my husband on the way, I took everything in and was able to take notice of the many people in the theatre. I had come to terms with what was going to happen and had prepared to the best of my ability for those that I would leave behind. I had to have absolute trust in my medical team and I did. Knowing all of this I remained completely calm, the last thing I remember is being told to stop talking and having the oxygen mask put over my face. While under the general, I had a central line fitted to my neck and stints put in my urethra by urology.

It felt like only 10 minutes later that I woke in recovery, I could not believe I was alive! I chanted “I’m alive, I’m alive”? I cried and thanked the doctors before asking if I had the Accreta and if I had a hysterectomy, they confirmed both. It was almost 4:30 pm when I was taken around to the Intensive Care Unit, and after 5:00 pm when my mum and husband were able to see me. Seeing them both was amazing. I was extremely sore, drowsy and had no energy.  I knew nothing about my baby, but was informed by my husband that although intubated the baby was doing okay. Noah Justin was born at 12:15 pm, more than an hour after I had been put under the general anaesthetic, weighing 2510 grams, and 49 centimetres long.
Baby Noah
He was in level one intensive care for 48 hours and intubated for 12 hours due to being under the general anaesthetic for so long. Noah had an umbilical catheter as well as various other cords monitoring him. I was able to see photo’s on a camera and the NICU had printed photos out for me to hang in my ICU room. Steven Scroggs visited me in the ICU not long after I arrived in there, he informed me that once he opened me up they found huge blood vessels the size of his fingers and thumbs riddled through my uterus and cervix. Steven confirmed it was in fact Increta instead of the suspected Accreta.
Dad and Noah

He was forced to take the vertical incision approximately 10 centimetres above my belly button, approximately 25 centimetres in total. They slowly and carefully worked to remove the baby and then my uterus and cervix, the surgery took approximately 4 and a half hours. During surgery they did require the use of the iliac balloons and I am very thankful I had them as I lost only 1500 mls of blood, 800 of which I had cleaned and returned to me via the cell saver machine. In the evening the ICU doctor removed the catheters from the arteries in my groin, upon pulling them out several pockets of blood formed, called Haematomas, these were extremely painful.

My night in the ICU went well other than the extreme pain and low blood pressure. The morning after the surgery the nursing staff helped me to move from my bed into a cloud chair in preparation to go see my baby for the first time. It was so very painful but was so worth it to see my gorgeous boy for the first time. The nurses helped me to hold Noah but I was so tired and in pain so could only be there for a short time. I was also able to see my husband and daughter for a short time.
First time holding my son! 

That afternoon I was moved to the birthing and assessment suite, although I had already had my baby, I still required a high level of care and this could not be given on the maternity ward. I remember I kept saying I was hot in the ICU and this continued in BAS. The nurses began taking my temperature, I was running a fever and was dozing in and out of consciousness. They immediately began me on 3 courses of antibiotics and searched for where an infection might be developing. It was so scary and I had vision of having to go back to surgery. The next 24 hours was horrible as they worked to get my fever down. The doctor ordered a chest x-ray to check if there was fluid on my lungs which could result in heart failure. It was so painful to sit up and be moved around for the chest x-ray, and thankfully it came back clear. By Sunday night I was feeling much better. That night I was able to see my baby again and feed him for the first time and communicate with everyone that had been trying to get in contact with me or had visited during the last 24 hours.
By Monday morning I was finally able to have the catheter removed as my urine no longer had blood in it. I was able to get up out of bed and have a shower with the help of the nurse. In the shower I saw
Battle wounds.
my incision properly and all of the bruising all over my belly and thighs for the first time. My husband and daughter arrived just in time to see me up and about ready to move to the maternity ward, hubby was so relieved to see me up and moving. In the maternity ward I was placed with the gynaecological patients as I didn’t have my baby with me. I didn’t feel like a second time mum, particularly because I had to rely on others to take me to visit my baby. Soon the weight of the whole experience hit me and I began to grieve the loss of my uterus and cervix. I was still in a lot of pain at the incision site, and in my groin area where I had bruising and the internal large haematomas. I also was extremely worried because I no longer had the urge to go to the toilet, I just had to remind myself to go to the toilet every few hours. Over the next few days I continued to recover physically and was able to walk to the NICU myself to see Noah. Noah too was improving, feeding more every day and getting stronger. Family and friends were able to visit us both and hold Noah. The Thursday after Noah’s birth we spoke with the NICU doctors and they told us it was likely Noah would be in the NICU for another 4 weeks until term. This news was devastating, but we knew Noah had to get stronger. I was discharged the next day, and to our surprise we were allowed to room in with Noah in the NICU overnight stay. The plan was to stay for two nights, and providing Noah put weight on, we would be allowed to go home. We were over the moon! After just one night, Noah put on a huge amount of weight and the doctors discharged him. We were finally allowed to go home! At home we settled into normal life again. Physical recovery was slow but for the first time in over 20 weeks we no longer had to worry about bleeding or being too far away from a hospital.

Me and my blessings
To my surprise pathology results of my placenta and uterus indicated that I actually had placenta percreta, as the placenta had started bulging through the uterine muscle, Doctor Steven Scroggs and the doctor at my 8 week check confirmed this. I have now been given the all clear physically (although I do still have pain at the incision site), however it was evident to the doctors that I am suffering some degree of post-traumatic stress disorder. I am grateful that I had the best outcome possible and I am so thankful to all the medical staff involved in my case.

Three months on from the birth of Noah, I was still struggling to feel like his “mum”. Yes I carried him for 35 weeks but I was so disconnected from the pregnancy and the birth that I just feel like I’ve been handed a baby. Something that I really wanted to do this time around was breast feeding, however due to believing that I would end up on life support, me being in the ICU and Noah being in the NICU, I asked in my birth plan not to breast feed him. When we got home I did try to breast feed Noah, however he did not latch properly and I did not know who to ask for help. I recently decided to try to re-lactate to breast feed Noah to help me feel more like his mum, to bond with him more and to see if it will help with his colic. So far I have been able to pump colostrum and milk, Noah is also latching onto the breast and I am succeeding at re-lactating. Since Noah has been getting my milk he has been much happier, his colic has disappeared and he is sleeping through the night. I am also feeling much more like his mum.

Dad and Bell, helping with Noah's Feed

I am now using my qualification in Health Promotion to raise awareness of the condition and help other women that are diagnosed. My goal is to attend the first International Hope for Accreta Foundation Conference to be held in Tennessee later this year. Please read more about my cause by visiting the link below and donate if possible, every little bit counts. 

My Adorable little man! 
 By Simone Pavils