I usually post my weekly bump pic today, and I promise I will, just wanted to update on how our recent doctors appt have been. Last week, I saw my OB. I hadn’t seen her since I was about 9 weeks along, so I was super excited to finally have an appt with her (I had been seeing her midwife at my last few visits). This is the OB that went through all my miscarriages, surgeries, and even recommended who to see once IVF looked to be our only option. I feel like she has been with us throughout this whole entire journey and has been rooting for us and keeping our best interest in mind each step of the way. I really do love her! Anyways, after getting caught up on how things have been progressing and doing the usual Q&A and tummy measuring, she called up her nurse and asked her to bring the ultrasound machine in. My eyes lit up at the notion, knowing that I wasn’t scheduled for an ultrasound today. She said that she just wanted to get a peek at baby girl since she hadn’t seen her since she was only 9 weeks along. I of course didn’t object, and was just bummed that Mr. B wasn’t there for this impromptu ultrasound. I swear, this baby gets her picture taken more than the hottest celebs! Everything looked great. I had an appt with the perinatologist a few days later, so she didn’t do any measurements, it was just more for entertainment purposes. She did however note that baby girl was drinking her amniotic fluid like she should, then pointed to where it was in the stomach, as well as the bowel. So cool! And the funniest thing about the whole ultrasound, was that baby b was doing yoga the entire time. Yep, yoga! She had her little right leg up and over her head and was wriggling her little toes. It was the cutest thing ever! We both laughed about how flexible she was and how she was totally showing off. I always love getting to see her, but it was even better to get to see her when I wasn’t expecting to. Did I mention how much I love my OB?
Well, the high from that appointment, and the stress free couple months I have just had, quickly came to a halt today. Man, just as I was just getting used to being a normal pregnant girl who’s only concern was what I was going to eat for dinner, what the heck we are going to name baby girl, whether I would get stretch marks, or whether I had that pregnancy glow yet…it was wonderful while it lasted. I’m glad I got to experience at least a little worry free bliss, because I have a feeling these next few months are going to bring on a whole new level of stress.
Today, when I went to my perinatologist appt, I was diagnosed with “vasa previa”. Apparently, it was something he has been concerned about and watching for a while, even though he didn’t entirely let me know about this. Bless his heart. He took one look at my file and didn’t want to give me any more to worry about until he had to. Well, as I will be entering the third trimester tomorrow (27 weeks), today was the day he had to tell me about it. Vasa previa is a rare placenta lying issue that affects about 1 in 2,500 pregnancies…woo hoo…lucky me! Basically, there a couple issues going on with my placenta. In vasa previa, the blood vessels that are directly feeding the baby’s circulation grow along the membranes or outside the placenta in the lower part of the uterus at the opening of the cervix. In a normal pregnancy, the blood vessels of the umbilical cord and the placenta are found inside the amniotic sac…safe, sound, and protected. In vasa previa, blood vessels are present at the membranes without this protection. This is most likely caused by the fact that I have a multi lobed placenta, which I’ll get to in a minute.
Here is a pic of what Vasa Previa looks like. Even though it is in a different language, you can see that the placenta is on the left, cervix is in the middle (at the vaginal opening), the blood vessels are laying and covering the cervix, and the umbilical cord is on the right.
To give you comparison, here is what a normal lying placenta looks like. Can you see how the umbilical cord goes right into the placenta, is far away from the cervix, and that the fetus’s blood vessels are in and protected by the placenta. This is what you want to see. Unfortunately, mine looks nothing like this. At least not right now.
The second issue I am dealing with is that I have a succenturiate placenta. Meaning my placenta has more than 1 lobe. Again, lucky me! Here is a pic of what that looks like in conjunction with the vasa previa. Can you see how it looks almost identical to the first picture, except there is more than 1 section of placenta, connected by the blood vessels?
Now, can the placenta and blood vessels shift away from the cervix opening before delivery? It’s possible, but not probable, especially with 2 lobes that would have to shift entirely out of the way. This would take nothing short of a miracle.
Here’s why this is so scary. When a woman with vasa previa goes into labor and the cervix begins to dilate, the exposed blood vessels that are right on top of the cervix can rupture. If this occurs, the baby will experience rapid blood loss and may bleed out and possibly die within 2-3 minutes. Besides outright rupture, the blood vessels crossing the cervix can also easily become compressed as the baby grows and drops further down in the pelvis, decreasing the baby’s blood supply and causing drops in the heart rate and nutrients and blood flow to not pass onto the baby properly. According to Dr. Google, when vasa previa is not diagnosed before the onset of labor, the chance of stillbirth may be as high as 95% (and was the cause of many fetal deaths before the technology to diagnose this condition came about). The good news in my situation is that it has been identified and diagnosed. This means there are things we can do to prevent this outcome. Thank God!
As in typical fashion, I have been googling and researching the condition like crazy since I got the diagnosis today. Not a good idea in this case, because there are a LOT of scary stories out there surrounding this condition. However, the most interesting thing I found is that pregnancies conceived via IVF are at an increased risk for this condition. I really wonder if it was because we transferred more than 1 embryo. It would make sense that if more than 1 placenta began to form, but only 1 baby continued to grow, that could be the cause for the multi lobed placenta. Then, as blood supply began to branch out and form, the two lobes became attached by the blood vessels. Or, maybe it has something to do with the medication you take during IVF, or the extra progesterone support you take up until approximately the 12 week mark. Who knows. I just find it funny that IVF patients are at an increased risk, and here I am, a lucky recipient of this condition after my recent IVF.
The good news is that this was discovered BEFORE I went full term and went into labor, where it may be too late to do anything at that point. Now that we know, we can watch it and take the necessary actions. From here, a few things can happen. Women who are diagnosed with vasa previa are sometimes hospitalized in the third trimester to ensure quick access to medical care should any of these blood vessels rupture. Also, we will more than likely give birth via cesarean section after 32 weeks, but before 36 weeks. They don’t want to go past 36 weeks, because then the baby will be too big and will probably, most certainly, crush those blood vessels.
Of course this poses problems, concerns, fears, and questions about having a premature baby…but at least the baby would be born alive and is much safer than trying to deliver naturally, where the risk could be death. I’ll admit. I have been grieving most of today. I am mourning the healthy and full term delivery I had hoped for, but am trying my best to just keep my eye on the prize at the moment. A healthy mom and a healthy baby are all I care about right now. Please say some prayers that God will guide the doctor’s hands and decisions as we move forward. Or better yet, that there will be a miracle that takes place before my next appt and those blood vessels move. Before today, I found myself wanting to be pregnant forever, taking it all in and not wanting to miss a single thing. Now I am finding myself just wanting to make it as far as I can but wanting the baby to be out and safe. Not sure what the next few months will bring, but I am hoping and praying for the best. I know that God is in control of this situation and that He can make this baby arrive safely, in His time, and just as He planned.
I go back to the perinatologist in 3 weeks (I will be exactly 30 weeks at that time). We will know more after that appointment as to what the next step and course of action will be. Please keep us in your prayers.