Good News! Placenta on the move...

Okay so it's been awhile since I posted an update. Aside from having a really bad cold right now, things are doing alright. I've had zero spotting.

The good news is, I went to my ultrasound and the next day the nurse called me to say that my placenta is moving. However, they didn't take measurements or anything. It was really hard to get a good look because the baby's head is in the way.

On that note, she was already in birthing position as of 27 weeks. That's quite early to be in that position. Her head was so low into my pelvis that they had to push her up in order to do a trans-vaginal scan. But everything else seemed okay.

I've gained a couple more pounds and am at my pre-pregnancy weight officially. Some of it is water weight and it comes and goes, but I'm gaining at a healthy ratio now. Over the next few weeks I should gain quite a bit of weight. I may not. But at least being at this mark, I will most certainly gain at least the minimum 8 pounds required for a women who started off over 20lbs overweight.

So the movement of the placenta means they're ruling out the more dangerous of complications, accreta. At 29 1/2 weeks, if I were to go into premature labor, there would likely be few complications to the baby. Me on the other hand, until total resolution, bleeding may still be a risk. Still, I'm relieved that the baby's chances have improved and that accreta is ruled out.

If the placenta moves enough out of the way in the next 10 weeks, then I won't need to have a C-Section. I'm rooting for a natural birth so go team peanut.

Otherwise, I'm still taking it easy. I missed my last OB appointment because I was sick. And so I spoke to a covering doctor just to get some lab results but I still have to wait until my next appointment to really get the scoop.

My next appointment is February 7th. So I'll keep you all posted :)

Update: 26 Weeks

Aloha!

• This is the last week of the second trimester. Next week marks the beginning of the third and final trimester. 13 weeks to go from here.
• Baby measures around 14 inches, weighs between 1.75 and 2 pounds and is about the size of a small pinapple. (So that's why my back hurts.)
• Her spine is becoming stronger, allowing her to extend her body and push against my internal organs, resulting in all kinds of fun pains in my kidneys, bladder and occasionally making me almost pee myself. #TMI
• Her feet are formed, around 2 inches long and have toe prints. 
• The eyes are developed now and can partially open and perceive light more clearly than before with eyes closed. Shining a flashlight on my belly may make her move around. This may also make my foot move around to your behind. :)
• Brain wave patterns resemble those of a full term baby at birth. That means she is already determining if you're a douchebag and/or moron.
• The fetus makes breathing movements, but there is no air in the lungs yet - duh. But it's cute none the less.
• The fetal brain scan will show response to touch. Touching and playing with the baby is possible now, as they may respond to your touch through your belly wall. First person to tickle me loses a finger.

What 26 weeks pregnant looks like inside. It's cool. I don't need my internal organs that much anyway ;)

Preemie born around 26 weeks! Awez

Update: 25 Weeks

Only 14 more weeks to go (hopefully all 14 of them).

• Baby is 13.5 inches long and weighs about 1.5 lbs.
• She can make a fist intentionally now, and grasping reflexes are improving. This is to kick major butt if anyone messes with her.
• Blood vessels in the lungs develop which bring oxygen to the lungs. This will be helpful for, um... well, breathing air.
• Structures of the spine begin forming: rings, joints and ligaments.
• Her brain is growing rapidly in layers so she'll be smarter than everyone else, except me. ;)
• She should start flipping over into birthing position soon.
• You can hear her heartbeat by placing your head on my belly, no stethoscope needed. That's not an invitation to do it.
• Chances of survival if born now are upward of 50% with only a 25% or less chance of disability.

 

Preemie Born at 25 weeks

Next Ultrasound Scheduled For 1/12/2012

I haven't been blogging much due to the Thanksgiving -> Christmas holiday cramming. Despite my condition, I've realized that taking it easy this time of year is nearly impossible. The upside is, I've felt great and since my doctor said I don't have to be on strict bed rest, I did manage to get a lot done anyway.

So I had an appointment this past Wednesday. Everything was routine and quick. I did gain another .5 lb and the other 2 I previously gained haven't budged. This was great news to me although now I'm thinking that since I'm gaining, I should probably watch it. My glucose screening will be next week. I tend to tango dangerously close to diabetes. So I'm going to try to go easy on the cookies -- starting after Christmas ;)

All the baby's vitals appear to be fine. My next ultrasound is scheduled for 1/12/2012 where they'll check on the previa and baby's growth. I'm hoping for some progress.

This week marks a very important one in women with previa. At 24 weeks the baby/fetus is considered viable. So that means if she was born now, she has a really good chance of survival with intensive care. The longer she bakes the better still, it's assuring to know that the risk of loss is dropping.

 :)

Update: 24 Weeks - Viability Milestone!!!

• Baby weighs about 1.3 lbs, is a foot long and is gaining around 30 ounces per week. This week though, she'll gain 6 ounces of muscle, tissue and bone mass.
• She would be considered viable at this stage and has around a 36% chance of survival if born preterm.
• Her ears and taste buds work better and may be able to make pissed off faces if she hears or tastes something she doesn't like.
• Waking and sleeping schedule will become more regular although it may be too early to start counting kicks.
• Creases have appeared on her hands and her fingerprints are formed. She didn't do it, I swear.
• Eyelids are fully defined and her eyelashes are visible on a 3d ultrasound. She won't be able to wear mascara though for quite awhile.
• She can now get the hiccups and stick out her tongue on purpose. :p

Preemie Born 24 weeks

Preemie Born 24 weeks

Update: 23 Weeks

Peanut is still roasting <3

• Baby is almost a foot long and weighs a little over 1 pound.
• Her weight over the next four weeks will double. Eek.
• Next week marks a critical milestone in women with previa. A major growth spurt lasting several weeks usually starts to turn things toward the better. But in persistent cases, fetal weight gain can start to take a toll on the supporting womb and placenta, increasing the risk of maternal bleeding and premature delivery.
• However, after 23 weeks of pregnancy, if born now, she has a 15% chance of survival. Her odds are going up with each passing day.
• She has begun producing insulin, important for the metabolism of things like cookies and cupcakes.
• Her skin is starting to develop color as blood vessels and capillaries grow under her skin.
• Her lungs are preparing to breathe. She's starting to produce a substance which allows the air sacs in the lungs to inflate and keeps them from sticking together or collapsing.
• Her nostrils will open this week and and the enamel that will cover baby’s teeth is forming.
• All the nerve cells are all in place now and will begin to join together to fully form a nervous system.
• Thanks to a fully developed inner ear, which controls balance, she may soon have a sense of whether she is upside-down or right side up. This is also important because this may entice her to change positions.

Preemie born at 23 weeks

Update: 22 Weeks (entering month 6!) ~ Good News! I gained almost 2 lbs!

 ~~***~ ENTERING MONTH SIX ~***~~

• Baby is about 11 inches long (head to heel) and weighs about 1 pound.
• Her eyes are fully formed but they don't have any color yet. I'm hoping they turn gray like Joseph's :) Her hair is growing in but also lacks pigment. Right now it is white.
• Her kicks, punches and movement is strong enough for other people to feel when touching the belly. That's not an invitation to touch my belly. Lmao.
• Her eyebrows are visible on a 3d ultrasound.
• She has a developed brain that will start to begin to develop folds (brain wrinkles) as she collects information through her senses.
• Her sense of touch is progressing so rapidly right now that her reflexes, including grasp and sucking are becoming more instinctual.
• She knows the difference between light and dark and shining a flashlight on my belly may make her move. That's not an invitation to shine a flashlight on my belly.

Preemie born around 22 weeks.

In MOMMY news, I have gained almost 2 pounds!!! That is great news because baby growing can really help my condition. Prior to this week, I've been struggling against weight loss. I'm presently just under my pre-pregnancy weight. Let's hope it's not just water retention. *crossing fingers*

Update: 21 Weeks

21 Weeks is here. Woot woot.

• Baby is around 10 1/2 inches long (head to foot) and weighs about a quarter of a pound.
• The flavor of whatever I eat influences the flavor of the amniotic fluid, which baby is swallowing. However, now she can actually taste and is using her new tastebuds. This will influence flavor preferences later on and why my kids all like the taste of uber-loaded nachos supreme, vegi pizza and anything with curry on it.
• The tounge is formed and she might practice giving a rasberry or sticking out her tounge as to say, "Na na na na na..."
• Her skin is changing from translucent to opaque. She no longer looks like a zombie. The skin is now reddish like a pale tomato and will develop its color over the coming weeks.
• Anyone can now hear her heartbeat with a regular stethascope. However, that is not an invitation to do so. Lol.
• She's developing a sleep and waking pattern, taking regular naps and is designing her internal clock. Eating, sleeping, light and noise outside the womb serve as signals. She's definately dreaming now (REM) and might smile or scowl while asleep.
• She can now kick and punch with more coordination and with intention. She can now kick back if poked or totally push away from light or noise.

A preemie born around 21 weeks.

Update: 20 Weeks: Half Baked! Happy Thanksgiving

  20 WEEKS ~ HALF WAY POINT 

• Baby is around 10 inches long (head to foot) and weighs about 10 1/2 ounces.
• She can hear sound now and will become startled and cover ears with hands if a loud or abrupt sound is made. She can dislike whack Hip Hop.
• She should already know familiar voices and sounds and will start to memorize and become familiar other sounds like music. Now when people talk to the belly, she can actually hear the conversation. People who talk to the belly are no longer crazy at this point.
• She's starting to remember things and understand herself and surroundings, like her own hands and feet and may have a special place and position to sleep or play, suck her thumb on purpose or pick her nose.
• Her hands and toes are growing nails and her hair is growing rapidly. Mini eyelashes are done forming. Knowing my genetics, vanity is starting to form.
• At this point the baby is in accurate proporation and by the end of the week will look like a real minature infant.

Preemie born around 20 weeks.

Today is Thanksgiving and I just wanted to give a warm hug and show love to those who have been following my progress, have offerred support and made time for me. I'd also like to thank those of you who visit this blog, leave comments and have contacted me. It's all so meaningful to me, right now especially. I'm deeply thankful for the people who care, my children included and this opportunity and journey.

Happy Thanksgiving

140 days to go!

November 22, 2012 Appointment Recap, Some Questions Answered

It was nice to see a familiar face at my appointment yesterday. This whole ordeal has been very confusing and I admit I found some refuge in speaking with someone who knows my personality style and medical history.



My Personality and Medical History



The exam went well. The baby is doing fine it seems. Heart rate normal. Uterine growth on target. I still haven't gained any weight but I was referred to a nutritionist. I was also told I have to drink more water, eat more fiber and I was asked if I needed relationship counceling.

*blank stare follwed by dramatic pause and quiet chuckle*

I'm still on pelvic rest. But the good news is that my activity restriction was greatly reduced. I questioned this and the contrasting advice from the previous doctor but I was told the prior restrictions were in place until the full report was done in light of my other factors. [Insert "everybody is different" pre-rehersed lecture.]

So here is "The List" with the "so far" answers I was given:

What type of placenta previa do I have? Is it complete, marginal or partial?

Complete. No measurements were indicated on the report. However, her suggestions would be the same regardless if it was marginal or not. No sex, nothing in there, no orgasm, no stimulating contractions or bloodflow to the area and nothing irritating it. I was instructed to refuse, beligerantly if needed, anything that could penetrate or arouse me; not even to let ER doctors do a pelvic exam.

My thoughts that I kept to myself: #FML

How many CM wide is my cervix? How many CM of placenta are overlapping my cervix? Is the placenta centralized over the cervix?  Is the placenta anterior or posterior? Is it leaning to one side? If so, which side? Is the placental cord single, double or presenting any abnormalities? Are there any signs of other complications such as placenta accreta, increta, percreta, vasa previa or placenta abruption? Can I have a MRI to rule out additional complications? Can I be referred to a high risk clinic or have a perinatal specialist involved in my care?

No measurements were indicated on the report. She is scheduling a follow up ultrasound for 26-28 weeks, at which point if it has not resolved, there measurements will be taken and I'll be referred to the high risk clinic in Boston for routine ultrasounds and to be involved in my care. At this point she wants to see if it resolves or improves before putting me through the efforts of extra bi-monthly appointments, walking, stress etc. As for accreta, the placenta not improving at all by 26-28 will indicate if it's deeply embedded. As for vasa, it's not a major issue if the placenta moves.

My thoughts that I kept to myself: She's right that extra appointments would be stressful and burdensome, considering I have a toddler in tow AND that it was my toddler's meltdown in radiology that prevented the measurements from being taken in the first place; cutting my appointment short and getting only the basics done. Still, it could be she just doesn't want to complicate matters for herself. She's so nice and easy going, I really can't tell her motives. (But I like that about her.)

What are the chances at present that this can resolve on its own?

At present, there is an 75% chance it will resolve itself. However, if it hasn't improved some by my next ultrasound, then the chances drop drastically.

How many CM away from the cervix must the placenta be in order to be cleared for vaginal delivery?

Her: "Off... like, way off." Me: "How much is way off?" Her: "OFF off [insert *the look*]"

Is the fetus having any growth abnormalities, deformities or anomalies?

None indicated on any ultrasound report and everything seems normal and going great otherwise.

Do I have gestational diabetes or preeclampsia? If so, how does it affect my care and are there any special precautions?
Am I at risk for blood clots or thromboembolism? If so, how is this managed?

I need a blood glucose test. Needed my HIV test (mandatory for each pregnancy). Blood pressure normal. Not at abnormal risk for blood clots at this time. Walking or moving around greatly reduce the risk of clotting.

What follow-up care will I need for the rest of my pregnancy?

I'll have a routine follow up monthly plus required tests until my next ultrasound, which will determine my care after that point. Previa is common when diagnosed before 20 weeks and in the absence of pain or bleeding, there isn't much more that can be done other than wait.

Can I be monitored monthly by ultrasound for placental localization changes?

Since ultrasounds done on previa patients are transvaginal, considering my history, she doesn't even want to risk doing an ultrasound. She doesn't want anything in there or anyone pressing on my belly - period, until the baby has good chances outside the womb.

My thoughts that I kept to myself: Although it would be nice if I could know as soon as possible if I can resume normal activities, her suggestion seems most logical actually. Something around 90% of babies born after 28 weeks do okay.

What exactly are my activity restrictions right now? What is the most weight I can lift? How much housework can I do? How much walking can I do? What kind of exercise can I do? What kind of travel can I do? Car? Boat? Plane?

• Pelvic Rest no sex, etc.
• No high impact exercise causing vigirous breathing or activities that could result in falling. no sex, etc. lol
• Don't fall. Don't bang myself into anything. no sex, etc. lol
• I can lift my toddler, just not walk around carrying him or anything. Putting him in and out of playpen, high chair, car seat, on/off slide at park etc. is okay. If he's kicking, or wiggling too much, don't do it. Don't want him kicking my belly. Okay, so this was a big improvement for me because my youngest son needs help getting in and out of things and my doctor knows my muscle tone can lift him with one arm, no strain, no problem. So I was really sad about not being allowed to do those things the past couple weeks. And I'm happy she didn't see a problem with this. No piggy backs though =(
• I can lift whatever my arm/back/chest muscles can tolerate without needing core muscles. Again, this was a big improvement for me; as I didn't want to do ALL my shopping online.
• No abrupt bending or reaching, hoola-hoops, volly ball, sports. Awe, no hoola hoop?Aweeeeeeeeee =(
• Light housework.
• Light cooking. 
• Don't travel, stay close to hospital.
• Mild exercise. Walking casually with breaks and listen to my body. Prenatal yoga is okay, so I'm gathering she's leaning toward this "impact scale." She did say mild hiking was okay, just don't push it or fall. I'm guessing that swimming is okay as long as I'm not bleeding.
• Overall, "take it easy." Overall, taking it easy is not easy for me. I am very active. So even taking it easy is torture. But not as much torture as total bedrest. So I'll take it.

How much weight gain should I aim for? Do I need to modify my caloric intake due to any activity restrictions?

I still need to gain 8-15 lbs.

Notes: So far I've flucturated around my pre-pregnancy weight. In the first trimester I lost around 10lbs. And I've gained and lost. This appointment, I lost a half pound from my previous appointment. She's referring me to a nutritionist. :-/

What do I do in the event of a yeast infection? What do I do in the event of constipation? What can I do to prevent constipation?

She's calling in a prescription with refills of yeast infection cream and fiber suppliments at my phrarmacy. However, she recommends preventing this in the first place with diet. Her personal suggestions are eating bran and psyllium every day, apple cider, yogurt, kefer, water, etc.

How should I respond to BH contractions?

Prevent them by staying hydrated and not staying in one position too long, longer than an hour or so.

Personal Theory: Almost everything I read about experience with bleeds starting while laying down or dehydrated. I'm wondering if the uterus takes advantage of "downtime" by practicing it's contractions when the body is most still, such as during sleep or while immoble. Now I'm contemplating how many women notice BH contractions or start bleeds during regular casual activity. Hmmm. I also know that the baby itself can compress a previa, so standing or sitting can sometimes act as "applying pressure to a wound." Although I've read contradicting views that the weight of the baby also puts pressure on the placenta, which could aggrivate it. Now I'm actually interested in knowing which is most detrimental.

What symptoms should I look out for? Fever? Shortness of breath? How should I respond to pain or cramping but no blood? How should I respond to bleeding? When should I go to the ER? How should I respond to mucus discharge or signs of cervical shedding?

If anything abnormal occurs, come in. If I'm not bleeding and can't come in, at least call. If I bleed, come in A.S.A.P. by ambulance if needed. Whatever happens, do not let ER doctors put anything in there or do an exam unless it's life threatening. Have them call an High Risk OB immediately. Tell them I have a previa and do not touch me.

I'm getting the idea that my doctor does not trust doctors at all, or anyone for that matter. Her whole demeanor throughout the appointment seemed as if she really wanted to emphasize that I should be not be letting anyone touch my "privacy" or my belly. He facial expressions were such that if it were legal to suggest, she would have probaby recommended I carry pepper spray. Haha. :-x

If the placenta doesn't clear, does the hospital give steroid shots for fetal lung development? If so, at how many weeks? If the placenta doesn't clear, will I need to take tocolytics? If the placenta doesn't clear, does the hospital conduct amniocentesis for fetal lung monitoring? If so, at how many weeks? If the placenta doesn't clear but there are no other complications, when will a c-section be scheduled? Are placenta previa c-sections conducted under general or spinal anesthesia? If placenta is anterior and a c-section is required, will the surgeon do a vertical incision or cut through the placenta? Can I store my own blood in case of the need for a transfusion? If so, how can I arrange that?
What procedures and policies do I need to know about regarding a c-section? What procedures and policies do I need to know about regarding the NICU?

Right now, my doctor's thoughts are a c-section is off her radar. While this pregnancy may require a c-section, may be further complicated and may not improve; she doesn't even want to think in that direction yet and suggests I don't either. She did say that if the condition persists and a c-section is needed, as long as it's not an emergency delievery, she will probably have me transferred to deliever in Boston (which could happen anyway); because they have a bigger blood bank.

My doctor is such a hippie. Granted, my kid's doctors are also hippies and I think I pick them for that reason. Despite my questions going unanswered (which is mildly peeving); she really wants me to visualize and focus on having a natural vaginal delivery. Perhaps she's right in this regard. I certainly put stock in the power of visualization and faith.

If I start to bleed heavily and am waiting for an ambulance, is there anything I can do to prevent massive blood loss or decrease bleeding? What bed rest policies are in place? (For instance, if I bleed once will I be put on bed rest? If I bleed more than once, will I be hospitalized?) Are there any special foods or drugs that are usually safe during pregnancy that I should avoid specifically? Could anything bring on contractions or increase likelihood or severity of bleeding? Can I donate my afterbirth to research? If so, how can I arrange that? What local and hospital resources do I have at my disposal? How can I get the rest of my questions answered, if they were not answered?

I can't believe I forgot to ask these questions. =( I will ask next time I talk to a doctor. In the meantime, I'll research some of this later.

Update: 19 Weeks

• By week 19, baby is around 10 inches in length and weighs about eight and half ounces.
• Baby's learns to poop. It's not called poop though. It's called Meconium so mothers don't freak out.
• Baby is covered in sludge. It's not called sludge though. It's called Vernix so mothers don't freak out.
• Baby starts to drink amniotic fluid and practicing how to break my grocery budget.
• Baby's ovaries start making eggs, which hopefully won't get fertilized until she's 30.
• Baby's senses start to take in input: taste, smell, vision, hearing and touch.
• Baby will start to learn the voices of Mommy, Daddy, Family and Wu-Tang clan.
• Baby starts to grow hair to give Mommy heart burn.
• Baby has functioning kidneys and is peeing in there. *cringes*

Here is a picture of a baby born premature at 19 weeks.

19 week preemie

145 days to go!
6 weeks to extra-uterine viability.

Update: Appointment Rescheduled For November 22nd

My appointment has been rescheduled for November 22nd instead of November 29th. My care has also been transferred entirely to my city hospital and my GYN (who's also an OB). Aside from the normal doings such as measurements, weight assessment and being told I need to gain weight; I'll get to talk to my doctor about what to do next. My city hospital is affiliated with a high risk clinic at a well known hospital in Boston. I'm going to press for a second opinion and if a no-go, then get one anyway (since I don't technically need a referral on my current insurance.)

In other news, I emailed the acupuncture clinic. The response I got was 2 sentences, not spelled correctly with no sense of professionalism. Scary. I don't know if that is because the practitioners office representative doesn't speak English well. Still, it makes me uneasy. I'm going to keep looking.