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 cmathewson.hfa.aus.nz@gmail.com

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: hfa.auz.na@gmail.com  

"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