Tuesday, October 2, 2012

Vasa Previa

**Reader be warned.  For those who stumble, trip or otherwise inadvertently google their way onto this blog, the posts on this topic will be brutally honest and probably a bit graphic.  This post is in NO WAY meant to give medical advice nor am I a medical professional.  Any medical details are my recollection and understanding only.**

I truly still don't really know where to start with this story, but as per Zazzy's suggestion I'm just going to start typing and see where things go.  I did make one modification to her suggestion and am accompanying this post with a glass of wine.

Vasa Previa.  Don't google this unless you're ready for some graphic results.  The most helpful medical definition of Vasa Previa in my opinion is the one from the International Vasa Previa Foundation's website: "Vasa previa is a rarely (1:2500) reported condition in which fetal blood vessel(s) from the placenta or umbilical cord crosses the entrance to the birth canal, beneath the baby. The condition has a high fetal mortality rate (50-95%). This can be attributed to rapid fetal exsanguination resulting from the vessels tearing when the cervix dilates, membranes rupture or if the vessels become pinched off as they are compressed between the baby and the walls of the birth canal."

In short and in not nearly as pretty terms, this means that when a woman is pregnant there is a slim possibility that some of the baby's blood vessels could get in the way of the exit door and if there is enough pressure on those vessels and they burst (as would happen in a normal birth), the baby has an incredibly high likelihood of bleeding to death.  The way it was described to me when I was diagnosed and finally got someone to tell it to me straight was that I was essentially a ticking time bomb and a proximity risk.  If I was too far away from a hospital when (and it was not a matter of "if", but of "when") the blood vessels ruptured, there would be absolutely no time to save the baby.  As it was also defined by the nurses, the window of time before the baby "bleeds out" is incredibly small, hence the high mortality rate.

This definition is far more harsh than ANY I ever gave any of my friends or family when my diagnosis was provided to me.  Of course they could have googled it and I'm sure many did, but I don't know that I ever let on how slim a chance it was that my son was going to survive.  Perhaps it was my own coping mechanism for dealing with things.  Every time a nurse entered the room, the first question she would ask me is, "Have you had any bleeding, any at all?"  Multiple times a day people would inquire as to the state of blood in my underwear.  Of course the thoughts crossing my mind were about how would I know if I was bleeding?  There have certainly been times in my life where I haven't known that my period has started until that moment of going to the restroom and "Ta Da!"  With the super slim window of saving a child from bleeding to death, how was I going to make it to telling a nurse that there was a problem in time?  That thought lived in my mind daily.  That thought drove me to accept that the truth was I wouldn't be bringing my child home, so I probably shouldn't get my hopes up.

But I'm way ahead of myself.
"What was I thinking??!"  I was 36 years old, had a beautiful, happy 8 year old daughter and was pretty comfortable in my life.  Apparently when a biological clock decides to tick, it does so loudly and then stops abruptly after it gets its way which leads to a clarity of thought otherwise known as a major wake up call.  When I found out I was pregnant with my second child, the clock stopped.  HELLO!   All of sudden all of those things that I'd conveniently forgotten about came rushing back.  Daycare, diapers, teething, sleepless nights, boogers, tantrums, baby food, breast feeding, and on and on.

Once I got my head around having a second child we were fairly happy with the idea.  We'd convinced big sister that it was going to be neat to have a baby brother and had even gone and done one of those early ultrasounds where you find out the gender before the actual medical ultrasound is scheduled to do so.

Before we even got pregnant I had sought out the OB/GYN I had when Alanna was born.  It was almost a deal breaker for me to have another child without having him as my doctor.  When I look back that was probably the moment we saved baby Archer's life, even before he was conceived.

Doctor V. is a cautious man and tells it like it is.  I'm not sure if this is how he is with all of his patients or if I've just gotten through to him that I'm a "cut to the chase" kind of girl.  With Alanna there was an issue found in utero that resulted in several second level ultrasounds and an MRI prior to her birth.

When I came to him after becoming pregnant with baby Archer, he suggested that if I'd like to have a second level ultrasound out of the gate because of my prior history as well as my age (haha) that he would most certainly approve it.  I said yes.  Alanna's condition really wasn't hereditary and frankly I wasn't worried, but when they offer you an upgrade just like moving up one class of vehicles when renting a car you take it.  After all it was an opportunity to find out more information about the baby with a better quality picture and it wasn't any extra work on my part; I was going to have an ultrasound regardless.

At my initial ultrasound appointment, they identified that I had Placenta Previa which is where the placenta is in the wrong spot either by a little or a lot.  At the time it wasn't a big deal.  Worst case scenario it would result in a C-Section if the placenta didn't pull up and out of the way of the cervix.  Best case as the uterus expanded and grew, the placenta would move similar to being stuck on the edge of a balloon on the inside and birth would be normal delivery.  They advised to not worry and come back in 6 weeks to see where it was at that point.

This seems like a good stopping point for the evening.  Then I can pick up with the diagnosis ultrasound visit and resulting hospitalization and birth of baby Archer.

2 comments:

  1. I remember looking up Vasa Previa at the time but I don't remember it being so clear about the risks. I can only imagine living with that risk, being afraid to connect to the baby growing inside of you for fear that he wouldn't survive.

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  2. From what I had found at the time it was almost like a taboo topic. You just don't openly talk about babies bleeding to death as a part of childbirth.

    Of course in re-reading this tonight with fresh eyes, I want to point out that the statistics for Vasa Previa almost completely reverse if it is diagnosed in time to follow the proper protocol. So instead of a 50-95% mortality rate, there is a near 95% survival rate. Those statistics are wonderful and they're what I held on to in all of my conversations with friends and family. But they're never really statistics that I personally embraced. I kept coming back to the improbability of beating the original odds.

    And thanks for reading this and for your support. It's surely not the most entertaining or light thing I've written.

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