Thursday, March 6, 2014

Vasa Previa Update: 23 weeks

(To find out more about what vasa previa is and what our original plan was/is click here for the first post.)

We had our second appointment with a perinatologist today. It was a different one than we originally saw because the first one was out of town and we really needed to go this week. I’m glad to get a second opinion on it, though, so it was actually a good thing that we saw someone different.

It was an interesting appointment.

First an ultrasound tech checked baby’s size, the amniotic fluid and such. Everything looked good (baby weighs 1.5 lbs at 23 weeks and is in the 46th percentile)! Then the doctor came in.

He started out by telling us that it really isn’t always necessary to be hospitalized with vasa previa and that he wasn’t sure he would recommend it for me. And that delivering so early (by 34 weeks) might not be necessary either. You’d think this would make me feel better, but it actually kind of stressed me out. The guidelines for vasa previa say that you need to be hospitalized for constant monitoring between 30 and 32 weeks and deliver by 34-35 weeks.

He just seemed very nonchalant about the whole situation.

Then he did an ultrasound and looked at the placenta and blood vessels.

His tone changed pretty quickly.

Apparently from the ultrasound pictures he looked at from my 20 week appointment, the vasa previa didn’t look that bad. After doing the ultrasound himself he started talking about hospitalizing between 30 and 32 weeks (and maybe sooner!) and saying that most likely we’d do the c-section by 34 weeks. Big change from what he was saying when he first came in!

I guess that what’s over the cervix isn’t just a wimpy little blood vessel, it’s a great big portion of the cord. And it’s definitely not going to move. I’m glad to know what we’re dealing with. I’ve read stories where doctors were unsure whether or not there actually was vasa previa and they were just guessing on what to do because of it. Some outcomes were pretty sad because they guessed wrong. It’s good to know for sure and to have both doctors agree on the course of action.

I’ll start being monitored closely as soon as I get back from visiting my parents in London. I’m not sure how often at first, but from what he said it sounded like every week or 2. They’ll monitor the baby’s heart rate as well as check to see if my body is showing any signs of labor. Luckily, my body isn’t showing any signs of it at this point.

I thought that week 28 was when we’d really want to start the big-time monitoring because the baby would be so big. He said 26-27. (Although, when I first asked him, before he did the ultrasound, he said baby’s size probably wouldn’t be an issue and to not worry about it. He changed his mind on this also after doing the ultrasound and baby will be monitored a lot.)

So everything might be moving up, time-wise. Who knows. I’ve never done pre-term labor before and my body really doesn’t do much until the last couple weeks before delivery. In fact, I never had braxton hicks or any contractions until the actual day I went into labor with the other three, so hopefully my body does the same this time.

I asked about pushing back the c-section to 35 weeks (this is common for vasa previa) and he said maybe and that if my cervix wasn’t seeming to do anything at all, then we might, but that in his experience by 34 weeks (and often sooner) parents AND medical staff were so stressed out by the situation that they chose to deliver then. So we’ll see. At this point I’m just hoping for at least 34 weeks. I even bought 2 little preemie pajamas and some preemie diapers this evening (they’re so little it makes me get all teary-eyed). I’m feeling more of a rush to get prepared than I was before this appointment. I also have all of the Easter basket stuff bought and plan to get them put together and ready to go soon, since who knows if I’ll be home or in the hospital then. Crazy!

We did find out that the placenta is on the back, which is wonderful! It’s in the correct position for the c-section. Two of my last three pregnancies the placenta has been anterior (on the front of the uterus), which isn’t a problem, but it’s not the norm either. If it had been anterior this time it would have made the c-section much more difficult because there would have been the risk of cutting baby’s blood vessels while making the incision and of having to deal with the placenta. Phew! (BTW, the placenta should attach at the top and back of the uterus. At least 3 of my 4 placentas have attached in an abnormal place. Weird.)

Both Joel and I liked this doctor (I like the other one, too). He was definitely no-nonsense as far as giving any false hope. He let us know that sometimes, even when you’re in the hospital things can go wrong. He kept talking about lightning striking and how you hope it doesn’t, but you can’t prevent it. He also said that in reality, it would be up to us and how we felt on when we would be hospitalized, but 30 weeks or sooner might give us peace of mind. But again reminded us that just because we’d be in the hospital, it didn’t guarantee a good outcome.

While I didn’t love hearing this, I’m glad he’s being real with us. I understand the risks. They scare me, but I know that whatever is supposed to happen, will. We’ll just do everything in our power to ensure the best outcome. (And we’ll keep praying A WHOLE LOT!)

I also got the impression from this doctor that I don’t necessarily have to take it as easy as the first specialist said. Which makes me feel better. I’ve been taking it easy, and will continue to do so, but won’t stress out about holding Emma or doing regular household tasks as much (or about spending hours walking around London). I think overall I’ve gone from feeling like a ticking-time-bomb that could go off any minute to feeling like a ticking-time-bomb that has at least a month before going off. I’m less worried for right now (which is nice), but more worried for later on (though I’m sure it’ll all be fine).

And I’m still just feeling EXTREMELY grateful that they caught this! While the whole situation is scary and quite a pain, we’re very blessed that we know and can do something about it.

The absolute best part about this appointment was that we got some awesome shots of our sweet baby boy! He was face down with his hands on his face last time. This time he was face up and looked as if he was posing just for us. The ultrasound tech got a bunch of pictures because she said it would be a shame to miss such a great opportunity. Here are a few.




It was so fun because this is the first time we’ve had a 3D picture of one of our babies.

I love it! 

He’s so so cute! Just look at those adorable lips!