Velamentous Cord Insertion

I had my first post-natal appointment on Friday and got the pathologist report regarding the placenta and cord. While pathologically the placenta was normal, the cord, specifically where the cord inserts into the placenta was abnormal, as my O.B. had suspected.

The cord inserted into the membranes of the amniotic sac rather than the placenta. Visually, the cord at the insertion point is much thinner than normal and attaches in finger-like tentacles rather than a solid mass. This condition occurs in only 1.1% of singleton pregnancies (occurring slightly more frequently in with multiples).

In pregnancies where Velamentous Cord insertion is present, babies are at an increased risk for Intrauterine Growth Retardation, preterm labor, congentital anamalies and fetal bleeding due to Vasa Previa (which carries a 75-100% infant mortality rate). Pretty darn scary.

Most cases of VCI are undiagnosed because regular examinations of the cord insertion point are not performed via ultrasound. In many cases a regular vaginal delivery is contraindicated because of the presence of vasa previa and cesarean section must be performed no later than 35 weeks. In a normal vaginal delivery the blood vessels in the amniotic sac may rupture, if they pass over the opening of the cervix (Vasa Previa), putting the babies live at risk. Also, if the OB decides to rupture your membranes artificially he may rupture the blood vessels as well. Delivery of the placenta following birth tends to be more difficult with VCI. I did NOT have Vasa Previa. If I had, I could not be snuggling my little guy this very minute.

Some risk factors for VCI, placenta previa, and Vasa Previa include; multiple pregnancies, in-vitro fertilization pregnancies, a history of uterine surgery, painless bleeding or a D&C.

I wish I would have known earlier in my pregnancy that I had VCI...this could have so easily gone very wrong.

baby News

I know I'd promised to post more of our summer adventures, our move, etc. But in the weeks since my last post I've run into some Pre-term labor problems.

3 weeks ago I started having some mild contractions. I mentioned it at my 32 weeks OB appointment and was sent to the hospital by my OB for a Non-Stress Test. They also did a Fetal Fibrolactin test. The FF test would indicate my risk of delivering within the following 2 weeks as well as my risk of delivering before 36 weeks.

Contractions were evident on the NST but so mild that my doctor decided to send me home without any medications to stop them. Later that evening my results for the FF test came back negative. I was told that I could resume normal, albeit lighter, activity than before but if any activity spurred a round of contractions that activity would be on my "to avoid" list for the remainder of my pregnancy.

Because Zak is out of town on his internship (and at that point wouldn't be home for another 4 weeks) I did the best I could, but I am a busy mom so there was not much change in activity, except that I made a conscious effor not to pick up Belen.

Now I am 34 weeks. I thought I should go in and do all my pre-registration stuff at the hospital. So I made an appointment. The evening before my appointment to pre-register I began having painful contractions that made it difficult to walk. that was Tuesday. Wednesday morning I got myself and Belen ready for the day, had a couple more contractions but noticed an almost perpetual pressure on my pelvis and tailbone. I mentioned this to the nurses while waiting for the woman who would walk me through the pre-registration process. The nurses immediately called my doctor who ordered another Non-Stress test. I did my pre-registration while hooked up to monitors tracking fetal heart rate and contractions. Turns out I was contracting every 1 to 3 minutes! I was 1 cm dialated, 50% effaced and at a -2 station. I was given medications over the course of 9 hours to stop the contractions and while they slowed slightly, there was very little change. Finally after 8 hours and 3 doses of medications the contractions slowed enough (2 in an hour) that I was able to go home.

So, I've been on medications to control the contractions for 2 days. They are not pleasant but since having this baby at 34 weeks is simply not on option in my mind I will do what I have to to make sure he has time to mature. I am now on complete bed rest. My cervix is dilating though very slowly and is anterior (forward rather than posterior or toward the back where it should be) so any contraction or sitting and standing upright puts pressure on my cervix causing dilation (and stronger, more frequent contractions despite the medications). I am still having contractions between doses of medications but they are not terribly painful. My pelvis is sore as it is already beginning to separate and widen for delivery. At this point, because the Fetal Fibrolactin test was negative, i have a less than 3% chance of delivering before 36 weeks. Zak will be home a week from tomorrow.

Of course I wish for all the things that a mother in my position would hope and pray for. I want a healthy baby that I can snuggle and nurse and bring home with me when I get to come home following delivery. I want my husband to be here to hold my hand, wipe my hair from my face when I'm laboring, and see his first son enter into this world strong and healthy. Please keep us in your hearts and prayers.

It's Official!

As far as we can tell from the ultrasound today we are having a

healthy baby BOY!!!

There was no sign of any problems as a result of the early issues we were having with this pregnancy (Retroplacental Hemmorrhage), he is measuring a bit small so the doctors will be closely monitoring my weight gain. So far I have gained 5 lbs. which they say is good! A benefit of doing all the cycle tracking I was doing when I became pregnant is that I know I ovulated late and my due date should have been 9/18/09 instead of 9/14/09...today he measured only a day behind at 9/19/09 so it's not a worrisome situation.

YUP!

For those of you who said BOY on our little poll, you are CORRECT! Now, we did the ultrasound at 15 weeks 4 days. Usually a bit early to tell but the nurse had trouble tracking down our busy bee on the doppler...with a nervous mommy (me) who had some unluckiness in the past...my doctor decided to do the ultrasound.

We quickly learned that the baby was just fine..his little heart just beating away and my doctor took the opportunity to peek even before we asked.

Sure enough, a couple of different angles revealed that it's a BOY! We will still have the ultrasound that is typically done between 18 and 22 weeks for a confirmation as well as for diagnostic purposes to make sure he is healthy but we are super excited to be having a boy.

Zak has already named him...we don't agree on the name but so far he's been pretty adamant that it's his name....we will have to wait and see....

What do you think?

SURPRISE!!!

I've decided now is the time to share our surprise with you, our dear friends and family!!! Are you excited? Are you at the edge of your seat??? YOU SHOULD BE!!!

Because here it is......

We have a baby on the way!!!!!

I hope you will find it in your hearts to forgive us for all the secrecy up to this point but after having a miscarriage last November I was afraid that this baby might not be able to stay with us either.

This has not been a pregnancy without complications. You can stop reading here if you don't want to hear the gory details...

Right about the same time I started having problems with the last pregnancy (about 4-5 weeks), cramping, bleeding, etc. It began to happen again with this pregnancy. After 10 straight days of dark colored bleeding I called my OB. Before I learned I was pregnant I had visited my OB/GYN to bring him up to date with my miscarriage and possible fertility issues I had been having since we last lived here. So one morning I went straight in to my OB and had an ultrasound where we saw a perfect gestational sac that was measuring right on target, a fetal pole and a tiny yolk sac..Yay! I was told to go home and take it easy. I scheduled my 8 week ultrasound as we left the office.

After another week of bleeding, I began to have some small amounts of red bleeding and called the OB's office right away. I was put on be rest. We sent Belen to stay with her grandparents in Utah for the 2 weeks until my ultrasound. That was hard but it was the only way. I knew that I couldn't go through another miscarriage...especially as I imagined the guilt associated with losing a baby when all I had to do was take it easy for a few days...I talked to her on the phone every day.

At 7 weeks I had a very scary evening with very painful cramping and lots of bright red bleeding. After about one hour the bleeding lightened, changed color and the cramping subsided. I called the OB's office first thing in the morning and went in for my ultrasound just a few days early.  I was so scared that this was going to be a repeat of my last experience...going in, and learning that the baby did not have a heartbeat and had stopped developing weeks before. It was a cruel experience. My body had been sending me normal pregnancy symptoms as it continued to retain the fetus and the placenta it also continued to produce pregnancy hormones...

This time our experience would be different. When I saw the tiny fluttering on the screen I had to ask to make sure that I was seeing correctly....the baby's heartbeat. Strong, without a doubt. 158 beats per minute, regular, normal, healthy. Our baby was okay! Measuring perfectly in size. My due date was set for September 14th. 

Not everything about this ultrasound was perfect. The doctor spotted the source of all the bleeding. He called it a Retro-Placental Hemorrhage (aka Subchorionic Hemorrhage). He said that there was still a small risk of miscarriage but he wasn't overly concerned about the bleeding. This type of complication is caused as the placenta is implanting and patching in to the vast blood supply of the uterus, blood can at times pool in that area(behind the placenta). He said that either I will continue to see it as it is expelled, my body may absorb is as the pregnancy progresses or it will hang out until I deliver and be resolved at that point. He classified it as a small bleed and took me off bed rest. As I left I was reminded to contact them immediately if I see any more bright red bleeding. I haven't, the baby seems to be growing well.

I had planned to wait until my next appointment, when I could hear the baby's heartbeat again and be comforted, to announce that we are having another baby. But, today I felt the baby move for the first time. This morning I rolled partially over on my belly and I felt a firm, swift kick. Unmistakable. I'm almost 14 weeks. I can only feel the baby when I am still. I felt Belen at 16 weeks. I am reassured. I hope now I can begin to build a relationship with this little one...one that isn't cloaked in lingering fear.

Gone...but not forgotten.

Some Sad News...

Yesterday I went to my first O.B. appointment and  learned that there was no heart beat.  The embryo had stopped developing at 6 weeks 4 days when it should have been 8 weeks 5 days.