Sunday, February 23, 2014

Vasa Previa and Our Plan

Hey everyone! I haven't posted in awhile and between Facebook and Instagram don't really feel a need to anymore, but I do want to document this vasa previa stuff we're going through for three reasons:
  1. To be able to keep anyone who's interested updated on everything, but with more info than I would do on Facebook.
  2. I've appreciated reading other women's blogs who have experienced this, so I want to share my experience (it's so rare that it's hard to find much info at all). 
  3. To document all of this for myself. 
Our blog seems like the best place to accomplish these things.

This first post will be a general overview of what it is. In the future I might do more posts about my emotions with it, more facts I've found, what I'm thinking, etc. Who knows. But for now I'll just give this explanation (that way family and friends who are curious about it can find out what it is, but then won't need to come back to read until baby actually comes, but those who are going through this and want all the details - like I have been wanting - can have that).

So, for those who don't already know, at my 20 week ultra sound appointment (I'm currently 21 1/2 weeks) I was diagnosed with a condition called vasa previa. 

Since I've researched this for hours and hours, I feel I have a pretty good handle on what it is, but let's see if I can actually explain it correctly.

Vasa Previa
(I realize a lot of you know what these different medical terms mean, but I'll explain them for those who don't.)

placenta and fetus diagramFirst of all, a normal placenta (the baby gets nourishment through this) and umbilical cord insertion looks like the picture to the right. It is on the upper back of the uterus (where the baby is) and the umbilical cord goes right into the middle of it. The perinatologist (baby expert) said to think of the placenta as a mushroom top and the umbilical cord should go right into the middle of it like the mushroom stem. Mine doesn't look like that.
I have what is called velamentous cord insertion. The umbilical cord inserted into the side of the placenta instead of the middle and the blood vessels that are usually fully protected within the umbilical cord are going crazy all over. They are within the fetal membranes (basically what makes up the amniotic sac - what ruptures when the "water breaks").

This wouldn't be a huge problem and happens in 1 out of 100 pregnancies, but my placenta is also lying low, close to the cervix (opening where baby will come out) and so those unprotected blood vessels are between the cervix and the baby, as it shows in the image below. 

What that means is that if the baby were to be born vaginally, his body would break the blood vessels (which contain his blood) and he would bleed out in a matter of minutes. That could also happen if I were just to go into labor and the blood vessels were severed. 
Another possible complication is that as he grows bigger he could compress those blood vessels and cut off his circulation and nutrients.
The Plan
Because of these things there is a plan in place. The plan is that I will be on hospital bed rest at 32 weeks and deliver via c-section by 34 weeks (my due date is July 2 and 32 weeks is May 2). I'll need to be in the hospital for constant monitoring of the baby to make sure he's not compressing the blood vessels and in case I go into early labor. 
I also need to "take it easy" this pregnancy, which I will, but in reality there isn't any research saying that this is necessary this early on. It's just being extra cautious. As my OB said, I'm still a mom and have to take care of my kids, but if there's ever someone else around to lift and hold Emma (17 months old), they'll need to do it.

I will be working with both the perinatologist and my regluar OB. They will keep in contact with each other to make the best plan. Luckily, both of them have had experience with vasa previa. From my research I've learned that many have never dealt with this before. It's quite rare. Depending on where you look they say it's 1 in every 2500-3000 pregnancies. So we got lucky ;). One perinatologist on a forum was saying that he sees about 6000 women a year for ultrasounds and such and he sees about one case of this every other year. Crazy! So yeah, I'm extremely grateful that both doctors have experience with this.

I'll be going in for extra monitoring to make sure I don't need to go in to the hospital earlier and to check on the baby's growth. Around 28 weeks they'll do steroid shots to get his lungs growing. Even with this they say to still plan on the baby being in the NICU for at least a week, perhaps longer, who knows. I'm hoping that since my other babies have been so big and healthy that he will be bigger and stronger than the average 34 week old :). I'm also hoping that the doctor will end up deciding that I'll be okay to wait till 35 weeks.

Obviously, things could change as time goes on, but that's the plan for now.
As difficult as this is we're mostly feeling extremely grateful for the ultra sound techs who spotted this! It's not a routine thing to check (since it's so rare) and it was barely caught.  If anyone has great ideas for thank you gifts to give them, let me know! So even though things will be a bit complicated/stressful during the month of May and we'll have a sweet little preemie, this is the best outcome for our little boy and we're feeling extremely blessed to have discovered it. 
If you have any questions about any of it, feel free to ask! I'm finding it therapeutic to talk about it (especially since it's consuming my thoughts at the moment).

Everything really should work out, but we could still use prayers. :)


Telfords said...

That is amazing that they caught it! I'm glad that the doctors know best how to handle the situation for you. We will be praying for you and your sweet baby! Wished we lived closer to see other more.

Amanda said...

I hadn't heard about this, thank you for the info. I will keep you in my prayers. I'm glad you have doctors who know how to help you!

Marlou van Dijck said...

Hi Bethany, what a wonderfull way of handling your VP pragnancy, to 'talk' about it in a blog. It's like a personal diary for you, the people around you and later on, for your baby too. It is also a way to educate others about this dreadfull complication. You do explain it very well here.
It is so good to see that you're so well taken care of by your doctors. We often see that women have to fight to get the proper care for their VP-pregnancies.
Good luck to all of you Bethany and please keep us posted! Love Marlou

Mike & Aubrey Janowicz said...

Wow! Thanks for sharing your experiences & thoughts! I've definitely been curious, especially with also being pregnant...hey I think your baby just wanted to come before mine :) Now I'm the last one out of those cousins who I know are pregnant in the fam...:) I'm so grateful the doctors found out and will be able to help you the best they can! What a relief that must be, although still stressful I'm sure! We will keep you in our prayers!