Saturday, December 13, 2014

First Trimester Placental Abruption

This blog post will have lots of details that may gross you out.  It goes along with my policy of "if it's medical, it's not personal."  Be warned.

Thursday morning, December 4th, I was exactly 13 weeks 4 days.  It was around 3:30 AM when I awoke feeling like I was wetting my pants (see, personal details already).  I was a little embarrassed, thinking this is waaaay too early in my pregnancy for that to start, right?  I mean, it's not like I have 6+ pounds sitting on my bladder.  So I got out of bed and felt a gush.  I was like, seriously?  Can I not control my bladder?  So I went to use the toilet and was pretty darn alarmed at what I saw.  There was blood.  So much blood.  In my pants, turning the water red.  Blood everywhere.  It seemed kind of watery, too.  But then there was a blood clot, not huge, but certainly big enough to be alarming.  Oh crap, I think I may be having a miscarriage.

So I got cleaned up and woke Nate up.  I told him that if I start having cramps then I'm going in to the ER (after all, bleeding, blood clots, and cramps are symptoms that are pretty hard to ignore).  At that moment I felt a tiny cramp, so I was like, "I'm going."  Of course, it's 3:30 in the morning, so who would we call to watch our kids??  We decided that Nate would stay home and I'd drive myself to the hospital.
They were able to get me back for an ultrasound after not too long of a wait.  The ultrasound tech didn't let me see the ultrasound much at all, but after a minute of taking a look at things he said, "It's squirming around in there."  Whew!  What a relief!  He was also extremely surprised that I was only 13 weeks (and 3 days) because the baby was consistently measuring at 14 weeks.  He also informed me that I have a posterior placenta (it's implanted on the back of my uterus).  Good to know.

So after taking a look at a bunch of things, he brought me back to my ER room and they started an IV.  Or I should say, they tried to start an IV.  They were successful on their third try.  It turns out my forearms have deceptively nice-looking veins, but they blow extremely easily.  I'll be warning anyone else who ever tries to put an IV in my forearm.  
This is how it looked almost 9 days later.  I also recall how it took three tries to get an IV in my forearm when I had my tonsils out.  So after five total attempts in my lifetime, only one of those attempts was successful.  Yes, I think I'll have them stick to my elbow joints from now on.

To make a long story short, the doctor eventually came in and told me that I had a mild placental abruption.  My placenta is partially detached from the uterine wall, which shouldn't happen until after the baby is delivered.  He said it could bleed for a bit, then reattach itself and heal.  Or it could detach more and more until I miscarry.  He said to go home and stay on bed rest until I could follow up with my regular OBGYN within the next week.  He was very kind about it, but basically told me not to come back unless I was losing so much blood that I was dizzy.  There's really nothing the ER could do about a miscarriage, anyway.

So I made it home around 6:30 AM feeling very relieved that my baby was still alive and glad that there was something I could do to protect him/her.  

So I stayed on bed rest, with the bleeding getting better and worse and better and worse.  Literally every other day.  I could periodically feel my uterus contract and stay rock hard for a few minutes, but I never had any cramps.  Judging by my still-existent nausea and the fact that I could literally feel the top of my uterus growing higher and higher each day, I knew my baby was still ok in there.  All the while, Nate did a seriously amazing job taking care of the boys and me.  

I saw my regular OB on the next Tuesday.  Well, I saw the nurse anyway (the OB had just left for a delivery).  We located the heartbeat (always a relief) and she told me that there's a pretty good chance that the baby will be ok.  She gave me a 90 percent chance that the bleeding will stop on its own and the pregnancy will proceed as normal.  She wanted to wait for two weeks after the beginning of the bleeding before doing an ultrasound, to give my placenta a chance to fully heal.  She also said I didn't need to be on strict bed rest, but "modified bed rest," where I can be up and about and doing things, but don't do more than what's necessary and most importantly don't do any lifting (no more than about 6 pounds, she said).  Also pelvic rest.

Since going from strict bed rest to modified bed rest, I have been having loads of cramps.  As of today the bleeding still hasn't stopped, but it hasn't gotten worse, so I'm taking that as a good sign.  But the cramps are quite painful, and since my placenta is posterior, I get awful lower back cramps.  And then there's the overall soreness associated with placental abruption.  My abdomen is just plain sore.  Really sore.  And then there's the 10-minute-long contractions that I get when I do something as simple as bend over.  That was pretty "normal" for me when I was pregnant with Russell, so I was expecting it this time around.  But I sure hope that that doesn't harm my placenta any farther.

Also, oddly enough, the bleeding is always worst first thing in the morning.  I don't know if the baby likes to kick his/her placenta all night long or what, but after a day of milling around the house things always seem slightly better (except for those darn cramps).  

So now we wait.  There's a slight chance that the bleeding won't ever stop and then we'll just have to hope that it doesn't get any worse until I can deliver.  If that's the case, I'll be lucky if I can go full-term.  So let's just hope that it resolves!

I'll keep ya posted.


Megan T said...

Wow Anna this sounds almost exactly like my bleed and hemmmorhage I had with dayton. Almost the exact same with gush of blood, pain, bed rest, everything! I quickly healed enough that bed rest was lifted but bled until about 5 1/2 months and I was a little earlier when it started, 11 weeks 6 days. The pain also lasted forever, even longer than the bleeding. Hopefully you will heal fast and bleed for a much shorter period of time. And no preemies! I was told over and over the 2 weren't correlated but now I'm questioning. I'm praying for you.

Katie Groneman said...

I'm sorry - this sounds so hard - as though pregnancy wasn't hard enough! I hope you heal up quickly! Also, the bleeding is probably worse in the morning because the blood pools up when you're laying down all night... so probably nothing to increase your morning worries.