Twinkie's headed to L&D (update #5)
May 2, 2016 19:40:49 GMT -5
Post by NariaDreaming on May 2, 2016 19:40:49 GMT -5
Hey guys, I just got a message from twinkie0612. She's gushing blood and headed back to L&D. I'll keep you posted as I hear anything, but I know she'd appreciate all the thoughts, prayers, and juju you can send.
Update #1 from Twinkie: " I am in triage and hooked up to monitors. The baby sounds good and is playing kick the monitor. The bleeding has slowed down and I am just waiting to see the doctor"
Update #2 from Twinkie: "I'm being admitted until further notice. I have marginal placenta previa and they think that is what is causing the bleeding. It was crazy this time. I was laying on the couch and felt like I was peeing myself. I quickly realized what was going on and made it to the kitchen before the next gush hit. I had to yell for my husband because I was dripping all over the place and had a big puddle at my feet. Definitely much scarier than last week. The good news is the baby is completely fine."
Update 3: Bleeding has almost stopped this morning. I am going to have an u/s today to see where my placenta is and then both my OB and the MFM will see me to decide what my plan is.
Update 4: The u/s wasn't the best. Good news is she got 8/8 on her biophysical profile. Bad news is she is measuring less than 5th percentile and her the blood flow index was greater than 95th percentile, so it looks like her blood flow may be restricted. Also they looked at my placenta and it hasn't moved since my 20 week scan. I think the placenta previa is here to stay.
I still haven't seen either of my docs, but they ordered compression cuffs for my legs to avoid blood clots, so I think it looks like I'll be here awhile. I also got my first steroid shot to help develop her lungs in case she is delivered early.
Update #5
Ok here is the full update, it's kind if long, but the doc had lots of info for me.
They still aren't overly concerned with her size, at least in relation to immediate delivery. There us enough margin of error in u/s that she could still be maintaining her growth curve, but of course it is something they will continue to monitor. That being said, she will be small. This (along with the placenta previa) youpoints to a c section delivery. With super small babies they generally require a classical (vertical) incision rather than the more common transverse incision. Small babies generally have less room low in the uterus, which makes the delivery with a low transverse incision more stressful for them. The issue with a classical incision is that all future pregnacies will all be c section (vbac is too risky) and HOM would not be advised. Seems like a reasonable trade off for me for getting her here safely.
The blood flow issues could be a cause of her small size (the other is usually nutrition, which is not a problem for me, my caloric input is good). Basically there isn't a ton of options accept monitoring it. Right now he is also switching my BP meds to procardia. Because it works by dialating blood vessles, we could also see a benefit to the poor blood flow. Procardia is also used to stop contractions, so it could also help to calm my uterus and promote "healing" from my bleeding placenta, although he explained that the placenta doesn't actally heal, instead the bleeding section clots off an dies, stoppung the bleeding. Normally you could also try blood thinners, but it could increase my risk of early delivery. Blood thinners won't cause bleeding, but makes bleeding worse in the fact that you bleed more blood. A large bleed can force them to make the decision to delivery early.
Placenta previa/bleeding has it's own set of concerns, most of which I've already covered. What's interesting is that my original diagnosis was marginal previa, but on this u/s they called it partial previa. Placenta previa typically gets better not worse, so one of them is likely a misdiagnosis. It doesn't really matter at this point since it doesn't change my treatment. With the bleeding, which they still think is due to the previa, he says typically bleeds will continue to get bigger if they reoccur. Your last is usually ypur biggest. Hopefully mine won't reoccur, the last one was big enough for me. At least I will be in the hospital if I do bleed again.
General stuff: I will be on fetal monitors twice a day minimum, I can request more if I think I feel contractions. I am still allowed to work at this point, which will hopefully be a good distraction. He wants me to continue IVIg and is ordering an infusion today. I am nervous about the cost, but it might be the difference between my elevated blood flow index on the first doppler and the normal on the second (I had also switched to lovenox, but that isn't an option). He thinks I may have a better shot at coverage because of they way they bill inpatient charges. I guess we'll see. Overall, it sucks giving up the normal 3rd tri stuff (a baby shower, birthing and breastfeeding classes, hell even being giant and having a million people comment on your size), but let's face it I was never a "normal" pregnant woman. It would be nice if my body did something right (I mean if I suck at getting pregnant, can't I at least not suck at being pregnant? ). But at least we are doing evetything to get this baby here as healthy as possible.
Update #1 from Twinkie: " I am in triage and hooked up to monitors. The baby sounds good and is playing kick the monitor. The bleeding has slowed down and I am just waiting to see the doctor"
Update #2 from Twinkie: "I'm being admitted until further notice. I have marginal placenta previa and they think that is what is causing the bleeding. It was crazy this time. I was laying on the couch and felt like I was peeing myself. I quickly realized what was going on and made it to the kitchen before the next gush hit. I had to yell for my husband because I was dripping all over the place and had a big puddle at my feet. Definitely much scarier than last week. The good news is the baby is completely fine."
Update 3: Bleeding has almost stopped this morning. I am going to have an u/s today to see where my placenta is and then both my OB and the MFM will see me to decide what my plan is.
Update 4: The u/s wasn't the best. Good news is she got 8/8 on her biophysical profile. Bad news is she is measuring less than 5th percentile and her the blood flow index was greater than 95th percentile, so it looks like her blood flow may be restricted. Also they looked at my placenta and it hasn't moved since my 20 week scan. I think the placenta previa is here to stay.
I still haven't seen either of my docs, but they ordered compression cuffs for my legs to avoid blood clots, so I think it looks like I'll be here awhile. I also got my first steroid shot to help develop her lungs in case she is delivered early.
Update #5
Ok here is the full update, it's kind if long, but the doc had lots of info for me.
They still aren't overly concerned with her size, at least in relation to immediate delivery. There us enough margin of error in u/s that she could still be maintaining her growth curve, but of course it is something they will continue to monitor. That being said, she will be small. This (along with the placenta previa) youpoints to a c section delivery. With super small babies they generally require a classical (vertical) incision rather than the more common transverse incision. Small babies generally have less room low in the uterus, which makes the delivery with a low transverse incision more stressful for them. The issue with a classical incision is that all future pregnacies will all be c section (vbac is too risky) and HOM would not be advised. Seems like a reasonable trade off for me for getting her here safely.
The blood flow issues could be a cause of her small size (the other is usually nutrition, which is not a problem for me, my caloric input is good). Basically there isn't a ton of options accept monitoring it. Right now he is also switching my BP meds to procardia. Because it works by dialating blood vessles, we could also see a benefit to the poor blood flow. Procardia is also used to stop contractions, so it could also help to calm my uterus and promote "healing" from my bleeding placenta, although he explained that the placenta doesn't actally heal, instead the bleeding section clots off an dies, stoppung the bleeding. Normally you could also try blood thinners, but it could increase my risk of early delivery. Blood thinners won't cause bleeding, but makes bleeding worse in the fact that you bleed more blood. A large bleed can force them to make the decision to delivery early.
Placenta previa/bleeding has it's own set of concerns, most of which I've already covered. What's interesting is that my original diagnosis was marginal previa, but on this u/s they called it partial previa. Placenta previa typically gets better not worse, so one of them is likely a misdiagnosis. It doesn't really matter at this point since it doesn't change my treatment. With the bleeding, which they still think is due to the previa, he says typically bleeds will continue to get bigger if they reoccur. Your last is usually ypur biggest. Hopefully mine won't reoccur, the last one was big enough for me. At least I will be in the hospital if I do bleed again.
General stuff: I will be on fetal monitors twice a day minimum, I can request more if I think I feel contractions. I am still allowed to work at this point, which will hopefully be a good distraction. He wants me to continue IVIg and is ordering an infusion today. I am nervous about the cost, but it might be the difference between my elevated blood flow index on the first doppler and the normal on the second (I had also switched to lovenox, but that isn't an option). He thinks I may have a better shot at coverage because of they way they bill inpatient charges. I guess we'll see. Overall, it sucks giving up the normal 3rd tri stuff (a baby shower, birthing and breastfeeding classes, hell even being giant and having a million people comment on your size), but let's face it I was never a "normal" pregnant woman. It would be nice if my body did something right (I mean if I suck at getting pregnant, can't I at least not suck at being pregnant? ). But at least we are doing evetything to get this baby here as healthy as possible.
