Our placenta praevia and placenta accreta survivor story

This year has been a real rollercoaster and guess what, it is not over yet. I am not only talking about the Covid-19 spread, the lockdowns, the travel bans, the killing of civilians by police in the States, the anti harassment movement in Egypt and .. oh well the list goes on .. I am talking about something a little more private and definitely not so high profile: my high risk pregnancy.

Being pregnant during a pandemic is definitely not easy, especially while on lockdown. I did not get any external help with my first born (his nursery was closed for 2,5 months) and I was running out of ideas on what to do with him, but it all worked fine regardless of my pregnancy. We were truly looking forward to May 4th: the day Germany eased up on the lockdown regulations and brought a new fresh wind into the country. It seemed like the hospitals had enough capacity, that the system was going to work again..and even though hospitals did not allow visits yet it kind of gave us all a little sense of security during these hard times. Never have I imagined that the 4th of May was going to be the beginning of my very private lockdown: I had my first bleed at 24 weeks due to a very rare and dangerous pregnancy condition called Placenta Previa. I knew I had a low lying placenta since week 20 but I never really took it seriously until that day. We rushed to my OB who sent me straight to hospital, where I had to say bye to my son and husband in the car since they could not come up with me to the ER. I was then diagnosed with a Central Placenta Previa (somewhere also called Major Previa) and had to stay in for about 4 days. The bleed calmed down after a day but I had random blood discharge for another while so I had to stay in until it stopped. Thankfully the pregnancy was viable at this point but who wants an emergency C section this early? The chances of survival for such an early preemie are low and even if a baby makes it, the chances of it having serious health problems in life are high. Anyhow, I got my first round of steroid shots and the hospital told me to go somewhere with a higher NICU level in the extremely likely case that it would happen again.

Fast forward a week I was sent to hospital by my OB due to a premature shortening of the cervix (no blood at this time, just some spotting). I was monitored for three days and then sent home where I was on bed rest and pretty much on lockdown. That is when our lives took a big turn.

At this point it was clear: I was on bed rest. I was starting my very own lockdown just as the country started to ease up all the COVID restrictions. I didn’t take my condition as seriously up until that point. My whole life was moved down to 100 squared meters as I could not take the stairs anymore. No more sleeping in my bed, no more showering in my bathroom, no more walks with my son and no more going out unless I had to go to the doctor. I lived on the first floor of our house: the couch was turned into a bed for me, and the guests bathroom turned into my own bathroom. It all felt like prison. It felt like I was trapped in my own body with absolutely no control over it.

Fast forward three weeks, I was admitted to hospital again following a big bleed. I got another round of steroid shots, I was given a lot of information about preemie delivery, about the NICU of the hospital I was staying at, about giving birth under high risk circumstances. It was overwhelming. It seemed like my placenta praevia was not completely covering the cervix anymore, just partially. This gave me a little bit of hope, and a little bit of strength. God only knows how much I have prayed for my praevia to clear on its own, for my health and my babys health to be ok. But my bleed did not want to stop, I stayed in a week and was released to go home after that. My anxiety was high, my fears would not leave my head. I could not sleep, every movement was really hard, my body could handle activities but I was not allowed any and this was killing me. Even harder than that was the fact that I could not freely play with my son, he felt there was something going on, he felt things were different and all I could do was cuddle up with try to explain the situation. But what can a 20 months old truly understand? He could feel, but he could not understand why things were this way. I had a countdown calendar, I was living for the day, I ticked off each day as it passed and prayed for another 24 hours to go by without further bleeds. But things did not go as smoothly.

At my 34 weeks check up it seemed like I had a slight chance to give natural birth as my placenta moved a few millimetres away from my cervix. In many countries it would not have been enough, but here in Germany the doctors gave me the benefit of the doubt and told me I could cancel my planned C section (which was booked for 38 weeks) if I wanted to. I took some time to think about it, went home, talked to my midwife, and talked to my husband. They both encouraged me: I really did not want a C section unless necessary, I really wanted to give birth naturally. It might be a painful experience yes; but it is a great one, full of adrenaline and connection to your child. Moreover; kids born naturally are statistically said to be healthier and stronger, and this is what I wished for anyway.

I felt like there was a light at the end of the tunnel and that at this point things would just get better. Little have I known..things did not get better. On the same afternoon I felt the biggest gush of blood coming out of me, went to the bathroom and it started dripping on my legs, on the floor, filled the toilet and my underwear. Once again I was rushed to labour&delivery at the hospital. Once again I had my blood drawn, an IV put in place, and once again I was away from my family. My husband was allowed to visit me once a day, but I missed my son terribly. He had no idea what was going on but he missed me too. We had several video calls a day: they were great but made me miss him even more. I did not know when I would be able to see him again, the doctors told me it might take weeks before I could go home again.

Luckily the bleed started to get weaker the morning after, and my husband came to check up on me. He wheel chaired me to the hospital ´s garden so I could breathe some fresh air, we talked about me going home soon, about things getting better…. but it did not all go quite as planned.

On the next morning I woke up to yet another strong bleed, I was given some medications, and I was monitored on a CTG a few times a day. Again, it felt like this was fading away as well. I had another scan and I was very hopeful to finally be able to go home to my family.

Unfortunately the doctor was not happy about the scan at all: the baby was doing fine but he felt there was a new anomaly around my placenta. It looked like an internal blood clot. He was not sure what this clot would turn into and decided that I had to stay for another 48 hours. Thank God I stayed. On July 16th I woke up to a massive bleed, which lead to a few other scans and check ups. This time the results were different. The head of the department came to talk to me and told me it was time to make a decision. He said I would not go home pregnant. We had to decide what to do.

There was a 50% chance that I could deliver naturally, the doctor told me if I wanted to try then they would induce birth straight away, but I would have to be monitored for at least 24 hours or until delivery (in case that occurred earlier) since I was high risk. The other alternative would be to go straight to the OR for a planned C section. I felt like I owned myself and my baby a try, and that maybe the induction was the right choice, I signed the papers and there I was: at labour&delivery again. This time the doctors took several precautions, and I was put on CTG for the entire time. There was a midwife checking up on me every 30 minutes and a doctor coming in every hour or so. After a couple of hours the contractions started kicking in, I was so happy, I felt like it was working. I was even asking whether I could be given an epidural just in case, and I was about to sign the papers for it as well.

My happiness did not last long though, 8 hours after they induced birth, I had another (this time) extremely strong bleed, I saw blood everywhere, and I started feeling numb. I knew something was wrong, I screamed and pressed all emergency buttons. A midwife rushed in and seconds later I had three doctors in the room as well. I had another two IV´s placed in and I was given medications to prevent me from puking, I was given something for my pulse and I was given medications to quickly stop the contractions. Then I was finally told that it was time to go in. There was no more waiting, no more trying, surgery was the only way as I was starting to have a placenta abruption. I could feel blood coming out of me, but I cannot remember much, I know my husbad was called in but was obviously not allowed into the OR. My baby girl was born within 5 minutes and taken straight to the NICU, whereas I was out about an hour after that. I remember feeling cold, I remember shaking, and I remember seeing the needles in my arms, but I also remember the friendly face of the anesthesist who kept telling me things will be fine, that I am in good hands and that my baby will be fine as well. I remember thinking about my son at home, about how I had to fight to make sure I could see him again, and that is when my pulse started stabilising. My family gave me the strenght I needed.

During surgery they found out my placenta had a little cut in it, which cause internal bleeding, and they diagnosed placenta accreta as well (this is a very rare condition), therefore they had to cut it out manually. Both placenta praevia, and placenta accreta occur in rare cases and could be extremely dangerous if not diagnosed before delivery. Luckily the doctors were prepared to treat all eventualities and had blood reserves for me, as well as enough specialists available. Afterwards I was told that the bleeding was very severe, and that I should consider myself lucky to be in hospital already, as we would not have made it from home.

The team has made an amazing job in saving our lives and I could not be thankful enough. God is great and has been by our side all along.

Our baby girl, Nora Elena, was born on July 16th at only 34 weeks gestation, has spent 9 days at the NICU and had 3 subsequent check ups. We are now both home and could not be happier.

It all feels like a dream, or rather a nightmare. It is over and I still cannot believe it. I am still having a hard time emotionally but my mental health is slowly getting better. I still have nightmares and need some time to process all that has happened but I am definitely grateful. I learnt to appreciate all the moments gifted to me, I appreciate my family and my friends, I love life and I am so thankful to be where I am. I am lucky, and I have been gifted. I will definitely try to give a share of what I have to those in need, and I will gift people with a smile a little more often: a smile is something we need during hard times. Never again will I understimated the power of love, the power of a prayer and the power of doing well.

There is so much to our story than what I wrote here, but I do not feel ready to go into further details just yet. Please reach out if you want to know more or if you feel like you are going through a hard time and need some support. All I can tell you is that this has been the hardest time for my family, my husband and I were on the verge of a breakdown, and my son was feeling something was not ok as well. As of now we are happy to start enjoying our life again, my son is the sweetest little brother and already loves and cares for his sister. He does tell me every now and then “mom please don’t go away, and this breaks my heart. But I am surely glad to tell him that this time I am here to stay. I guess most people will not understand the gravity of the situation we have gone through unless they experience it, but it is ok. Just please know that being there for your friends and family is extremely important, not only during hard times but always. Moral support is great, we often get caught in our lives that we forget about those in need. Maybe an elderly member of our family, a neighbour, a friend … maybe a stranger who happens to cross paths with us… there is always someone who could use a word of encouragement and a smile. Empathy is important, caring is important. Please be there!

xx

Pete


THE FOLLOWING PART WAS WRITTEN DURING MY LAST HOSPITAL ADMISSION, I DIDNT KNOW WHAT WAS GOING TO HAPPEN AS I WAS WRITING. I JUST THOUGHT OF INCLUDING IT AS IT DESCRIBES MY FEELINGS AT THE TIME. I HOPE IT HELPS SOME MOMS REALIZE THAT THEY ARE NOT ALONE DURING HARD TIMES

I am writing this part lying on my hospital bed, it is Sunday evening and I was admitted on Friday at 34+0 weeks following a bleed. Yesterday it kind of got better, it changed in colour and it didn’t´t look as fresh anymore, and started wearing off during the day. Unfortunately a warm gush woke me up this morning: fresh blood, again. So that would be my second bleed within 36 hours. Yesterday I thought I could leave the hospital on Monday, as of today I do not know when this will actually happen.

I know this is the safest place to be at and to be honest going home and waking up to such a gush would scare me even more, or maybe being home alone if it happens would totally drive my anxiety level to 1000%; however I really miss my son. Due to Covid-19 regulations I am allowed to get one selected visitor once a day in the afternoon (this is better than my first two hospital admission right in the middle of the pandemic, where no visitors were allowed at all!), it has to be the same person so I opted for my husband. They might increase that to two visitors at some point but this does not include kids, so as long as I am in the hospital I won‘t be able to see Liam, my 22 months old son. Being a mother can be extremely hard sometimes, and these mixed feelings right now make it even harder. On one hand I have to really take care of the precious baby inside of me, and on the other I have to “neglect” my first born a little for the time being. It totally kills me, knowing that I cannot do both of my kids good at the same time. This is a feeling only those who are in a similar situation will understand, FaceTime helps a little but whilst I love seeing my baby boy, I know I have to keep smiling while looking at him, try to make him feel like I am still close to him. Then, the second I put down the phone I start crying (just like I am doing now while writing down these words). I am sure I am in good hands and that at some point this struggle will end and better times will come, but right now this is very emotional, hard and nerve racking. My stress and anxiety level is quite high right now, and it is not even the fact that I don’t know when I will see my family, or when I will be able to take a walk…it is the simple fact that I am not in control of my body right now, I do not know what/when will happen. The worst of it all is that no one can tell. I am scheduled for a very much unwanted but necessary c-section at 38 weeks and 4 days; however the doctors are not confident that my pregnancy will last that long. I was told there is no point in setting an earlier date because as of now I could go into labour at any time, and every day is a win, so if I do start going into labour or if I get yet another significant bleed, I will be taken to the OR and take my baby out saving both of our lives (I hope!). This is yet another cause of anxiety for me, knowing that I could deliver anytime between now and the next 4 weeks without any kind of warning. What I do is actually set myself little targets. The very first one was set after my very first hospital stay at 24 weeks: my goal was to make it to 29 weeks. After that it was to make it to 32 weeks, then 34..and now the targets are getting shorter. As of now my next one would be to make it to 35 weeks; I will take it from there then.

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