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.

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