23 Weeks and Pregnant with Placenta Previa Percreta

I'll admit, I've had better days.  Heck, let's go even further and say that these past few days have been really, really, REALLY ROTTEN.  I've cried at least once every single day since Monday (it's currently Friday as I write this) ... the day I found out that I could die.  Awesomeness.  Here's the thing though ... I'm not writing this blog to get sappy violin strings pulled out for me.  Anyone who knows me understands that I'm not one of those "woe is me, feel sorry for me" people. No. This blog is my way of processing and making sense of this crappy curve ball that's been thrown at my family and I, as well as bringing awareness to this horrible condition that's affecting more and more women with potentially devastating results.  Here's the thing though ... in order for me to work out for myself what's happening to me, to my body that I have absolutely no control over, I need to write whatever's on my mind, nice or ugly.  Yes, while I completely believe in positive thinking and attitude adjustment, along with "hope floats," I also subscribe to the process of accepting, no, embracing your fears as a way to move forward.  Only by realizing my problem can I work on a solution, or at least some sort of mitigation.  I'll apologize in advance for anything that makes you uncomfortable.

I was diagnosed with placenta previa percreta on Monday, November 4, 2013 through an obstetric sonogram, and confirmed 100% three days later.  Although it rolls off the tongue like an item on a tapas menu, placenta previa percreta is actually two different but related conditions. A previa is described as when the placenta is abnormally placed near or at the cervical opening of the uterus -- lying right at the edge, or partially or completely covering the cervix, blocking the any chance of a vaginal delivery.  

A previa is also a huge risk factor for placenta percreta, or accreta.  Placenta accreta is a rare and one of the most severe obstetric complications where the placenta attaches itself deeply into the muscular layer of the uterine wall, most often over scarred portions due to C-sections or D&Cs.  Immediately after childbirth in normal pregnancies, the placenta usually peels off on its own accord from the superficial uterine lining.  Because accreta cases can't easily detach, there's a huge risk of maternal and fetal hemorrhaging during delivery, an almost certain hysterectomy required, and in some cases, death.  Let me say that when doctors and medical literature say that the risk of bleeding out is big, they actually mean huge, massive amounts of blood loss.   A percreta is the most severe form of accreta, affecting 5-7% of all accreta cases where the placenta actually grows through the uterine wall to the outside and starts invading other neighboring organs like the bladder.  Lucky me!  I should be playing the lottery!  Thankfully in my case, doctors don't think the placental blood vessels, while they're right smack dab on the exterior wall of the bladder, have invaded the organ yet.  They'll continue to monitor me closely to make sure it doesn't happen. But then again, even if it happens, what are you gonna do anyway?

What kills me is that what was once a rare 1 in 2500 phenomenon has risen to an incidence of 1 in 500 due to the increasing number of C-sections, a good number of them elective.  I've had two Cs, as well as two D&Cs thanks to a couple of horrific miscarriages.  Guess that makes me scarred to the hilt and ripe for percreta, eh?  My doctor has told me that because I have both, I have a super high chance of bleeding and delivering another preemie.  He hopes I can hold out to at least 30 weeks  If, by the grace of God, I can hold out longer, he'll still take the baby by the time I'm 34 weeks because the risk of hemorrhaging is less and the situation is more controllable.  

My OB is putting together this cracker jack team of specialists to help him out with surgery ... a gynecological oncologist, a urogynecologist, an anesthesiologist, a couple of maternal fetal medicine specialists, and a neonatologist.  But that won't the entire caboodle.  The fact that I'm delivering at a major teaching hospital means that I'll most likely have 50 or so people, mostly observing in the OR. Yay again.

Some time in the next week or so I go in for an MRI to check out the extensiveness of the damage, as well as get steroid shots to help maturate the baby's lungs and brain.  I'll feel so much more relieved once I get those shots.  At some point I'll be placed on bed rest.  My doctor had originally given me a firm, "24 weeks and you're out," as in FULL bed rest where I can only get up to go to the bathroom, but now I think he's had time to relax a bit and realize that's not realistic for me.  Not with 4 kids any way.  If I don't bleed, I get to stay home on moderate bed rest.  If I start like a stuck pig, then it's off to the hospital for "in-patient management" I go.

So I've had a few days to digest this. Obviously, I'm a jumble of emotions.  First, I'm pissed ... it's the nasty Scorpio in me peeking out and raising its head ... but angry at whom?  At my husband for knocking me up again? At myself because I didn't say no?  At my body for doing yet another thing that it wasn't supposed to do?  (I shouldn't make this comparison, but here goes ... I'm beginning to realize what cancer patients go through when they're first diagnosed.)  I'm pissed at nothing and no one, yet everything and everyone.  It's no one's fault that this happened.  I needed those C-sections to deliver my younger two, otherwise they wouldn't exist now.  I needed to have those little nuggets of malformed babies taken out because they weren't coming out on their own.  So I have no one, nothing, to blame for this thing that is going to cost me my uterus, my cervix, and possibly my bladder.  But I'm still mad that it's happened.  I'm mad and sad that my Little Boy Blue is going to come early and will most likely need NICU time.  I wouldn't wish a tour of the NICU on my worst enemy.  It's like being in a foreign war zone where you don't have a gun to protect your baby or yourself and you can't speak the language.  You're so at a loss of what to do for your baby, and have 100% faith that other soldiers can make it work instead.

Another feeling I have is obviously fear but that's to be expected and I won't go into that much today because I don't want to be a complete bummer.  The most profound feeling, though, is this love that I have for my kids and my husband.  When you're told a few times that you might die, you start looking at the world in technicolor.  I want to grab hold of my babies whenever they're near me and run my fingers through their hair, breathe them in, and keep repeating how much I love them.  It's because I might lose them and I want to imprint them onto my soul.  I told my husband, Wayne, last night that we had to make sure that he was in the OR when the baby was delivered and that I was awake when it happened. I said that before they put me under to do the rest of the surgery that he had to put his face right above mine because I wanted his to be the last thing I saw.  

Okay ... enough sappiness.  I'm going to try to post every day to chronicle this whole shebang.  There aren't a lot of support groups or blogs out there about placenta accreta/percreta.  With the increase in C-sections being performed, there are going to be a lot more women like me going through the same medical process and emotions.  I want them to know that they're not alone.  It's a sisterhood of sorts ... a sick one at that ... but one nevertheless where we have to glean support from one another.  I'll try to be as real as I can without sounding too crazy ... but if I come off that way, it's probably because I had a particularly hard day.  I'm usually a pretty cheerful person and can put the rainbow spin on anything.  If you choose to follow this journey with me ... bear with me.  It's my first (and obviously my last!) time through it.  

xo,

L