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Placenta Accerta

August 16, 2018

When I hear news of another baby, or pregnancy to a family unit, I do feel a pang of hurt.  I no longer have the choice to add to my family, or more the point, never got the choice to say yes or no.  It could be literally a case of life or death.

 

I had two miscarriages before having my first born.  Both losses were blighted ovums and were discovered during the second pregnancy to be caused by an under active thyroid.  I needed a d&c and to wait the recommended three months before trying again, and also for my body to get used to thyroid support medication. We saw a fertility specialist on our GP’s referral, but he didn’t seemed to think it was an issue, as their policy was to wait until 3 miscarriages, before investigating.

 

After waiting the three months, we were fortunate enough to fall pregnant again and I am extremely grateful that my pregnancies were natural, reasonably normal and healthy to a degree.  On the day of the 12 week scan, we had seen baby on the ultrasound screen and all seemed well.  But, that evening I was out at a school trivia night with close friends, some of who we were telling our exciting news. About 25 minutes into the night, I felt a warm gush, and knew I was bleeding.

 

I told my husband, and he saw it had come through my clothing and was dripping onto the floor.  I had to some how stand up in room full of people, and make my way to the toilet.  Luckily my best friends and sister were there, and they helped usher me into the ladies amongst my sobbing and bleeding everywhere.  I was scared as hell as I knew the amount of blood and clots could not be a good sign.  I had to use my husbands jacket to cover me and we set off straight for the hospital, which thankfully was less than 2 kms away.

 

I was sure this was miscarriage number 3, but baby had other ideas. 

 

There it was, oblivious  and kicking away, but right next to it there was a large black space, and the doctor advised he was sure it was a sub chorionic hematoma.  Common in pregnancies and often after the bleed, they heal and there are no further issue.  The doctor was worried at how much blood I'd lost and the size of clots, but referred me back to my GP and hospital for monitoring.  The hospital had noted it on my file and requested extra scans at intervals during the pregnancy, but they weren’t overly concerned.

 

I really only started to relax into being pregnant, and feel it was all happening, around 25 weeks. I had had some further light bleeding on and off but nothing of concern for the hospital.

 

I went into labour at 41+ 3, all going as well as can during a first labouring.  At around 26 hours in, I called for the epidural.  Baby’s head was tilted and the head midwife had informed me that she had called the OB just to come and ensure a course of action, if baby didn’t get into position by the time I dilated to 9cms.  Just as the OB came in, baby had moved into position, so she said she would wait around and stay in for the birth. 

 

Baby was finally born after another 8 hours, ironically on Mother’s Day.  The actual birth went fine. We had a daughter and she was as squishy and slimy, but cute as a button.

 

I recall the midwives giving the injection for the placenta, and that’s when I felt like throwing up. I told them I felt funny, they took the baby of my chest, I watched them hand her to my hubby, and I passed out.  I came to vaguely, hearing the OB yell, ‘I don’t have time prep for surgery now!’.  As I was being wheeled down the halls, I recall the ceiling lights flicker by.

 

I woke, and was later informed, I had been out for 14 hours.

 

My blood pressure dropped dangerously, during the operation, and a few times after in recovery.  I very vaguely recall my husband coming in with my baby, and a nurse asking him to try to get baby to feed, because it may help rouse me.

 

When I finally woke somewhat properly, I was hooked up to soo many tubes and drips.  My hands hurt sooo much, because I had passed out and lost a lot of blood they tried to insert canulas, but could not find veins.  I remember a nurse half joking with me that most women after birth complain their vaginas hurt, not their hands!

 

I was told the next day what happened, by the OB. She was nothing short of amazing.

 

I had Placenta Accreta.

 

The placenta fuses to the uterine tissue and in some cases, bladders, bowels and stomach.  I was a lucky one, because it stayed within my uterus, but I had scarring internally so perhaps that’s why it developed.  She advised that I had a Baraki balloon inserted as they wanted to save my uterus, allow me to try for more children and breast feed.  The balloon would help with the uterus contractions over the next few days when establishing feeding.  I had lost 3 litres of blood and was currently hooked up to blood transfusion number 4, and was expected to have 3 more.  I could barely move and my hands still hurt! The OB also went on to explain that had I not had an epidural it may have been worse, as after they couldn’t find a vein, they were able to use the line in to put me under, and get to action sooner.

 

Baby girl was fine and had been suckling from me so the midwives were happy, as she showed no signs of distress. Somewhere in between ICU and coming too, my husband had asked me what we would name our daughter, but he didn’t want to announce it in case I didn’t remember, didn’t like it or worse, something happen to me.  My husband had been in the delivery room when I passed out, and said there was a lot of mess and blood.  The staff had even kept one midwife out of the room, as she was pregnant and they didn’t want her to see how much blood there was.  In his line of work he has seen a lot of blood, so wasn’t overly phased by the sight, but he knew I had lost a lot.

 

We were advised to wait at least a year to fall pregnant again. We kind of waited 2 years, and fell pregnant easily but not with massive fears.

 

I knew this would be my last, so tried to enjoy it as much as I could. I was monitored heavily, and had regular scans to check for scar tissue and further damage, but it was a textbook pregnancy otherwise.  Birth also was fantastic, and under the guidance of the same OB and her team, felt nothing short of safe.

 

Around 6 weeks post birth I did have a heavy bleed and clots again, and it was then she advised me, that I would not be able to have anymore children naturally.

 

There was too much scar tissue, which was rupturing due to breast feeding (contractions in the uterus).  Although in my second pregnancy, the sac and placenta were located in a totally different place, it had stretched the previous scarred area.  I had to have an emergency D&C, and it was discussed, if she started operating and that I kept bleeding, potentially a hysterectomy.  Thankfully I stopped bleeding, and they saved my uterus once again.

I am still one of the lucky ones.  Placenta Accerta is one of the highest causes of maternal mortality.  It is unknown why it happens, but there are links to IVF and D&C treatments attributing to the cause.

 

I often get asked however if we will add to our family, or if I want to try for a boy.  Usually it comes with some well meaning banter, until I say I can’t have anymore children, then it turns sour.  There is often the gentle probing of 'why' and 'modern medicine', etc.

 

I am blessed and beyond grateful, but sometimes I just imagine what if (but then get scared shitless at the mere thought!).

Mandy is the founder of The West Creatives, a collective of women in the

west of Melbourne who run their own businesses.  You can follow her here.

 

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