Wednesday 26 May 2010

Yesterday was hard

Yesterday was hard. Had stomach pain so was worrying something was happening. But so far today I feel okay. Feeling more positive today though there isn't anything to be more positive about!

Friday 21 May 2010

Steroids and a little scare

So it has all been happening.

I am 24 weeks and 1 day pregnant. Made it to viability, if our son is born now he will be registered. We are thinking of a name for him.

I had my first round of steroids yesterday. Everybody said it would be a painful injection in my buttocks. In actual fact it wasn't painful and was in the very top of my thigh. The appointment took ages because they did all the tests they would normally do today yesterday.

Today was supposed to be a quick in and out appointment. But no of course it didn't work out like that. I started to lose pink/red fluid. Diluted blood. I was sent to Labour and Delivery where the wait seemed endless. They did everything they would normally do in Day Assessment only with more waiting. I also had to wait until my blood results came back... hours later they let me go home as all was well.

Tuesday 18 May 2010

23 weeks and 5 days pregnant (18 days since rupture / pPROM)

Again I'm waiting to go and see the consultant at 4 today. Last Friday after we said we are going to continue the pregnancy he called another consultant in (I seem to have 2 at the moment) and they were both trying to get me to talk about my feelings on steroids and resuscitation but at the same time saying these things weren't an option until I got to 24 weeks (this Thursday) so I just ended up saying if it's not an option now and you think it's unlikely I'll make it that far (which they did) then can I just wait until next week to talk about it. So I think they will discuss these things today. That is providing all my test results have come back okay.

Saturday 15 May 2010

We are not making a decision

We have not made a decision... we're not going to make a decision. We are going to let nature take it's course. Our son has a 10% chance of survival and we are going to give him that chance.

So I continue as I have been. Appointments twice a week at the Day Assessment Centre. They will take blood samples to check for infection and do vaginal swabs once a week to check for infection. I will continue to rest at home. Take my temperature regularly.

And hope...

Tuesday 11 May 2010

No decision yet

We didn't even think about our decision until we dropped M off at nursery this morning. What followed was a terrible hour or so where we discussed the options and couldn't decide. Do we continue with this pregnancy even though it is unlikely to end well?

We couldn't reach a decision.

So today we saw the consultant again and asked more questions. What chance is there that we will get a healthy baby? Less than 10%.

What sort of disabilities can we expect? Cerabal palsy is very likely if he is born after 24 weeks but before 28 weeks. He is likely to need lifelong care from us.

What is the termination procedure if we decide to go down that route? Be warned before reading this I was shocked - feel free to skip... At 23 weeks there is a chance he would be born alive so they would want to stop his heartbeat to save him any pain before birth. This involves an ultrasound scan where they insert an injection through my stomach to the baby to stop his heatbeat. They then watch for 3 minutes to ensure the heart has stopped. I would then be sent home after taking a tablet and asked to come back for the induction process a couple days later. What follows is pretty much a normal induction process. The whole process would likely take 4 days.

I was shocked on hearing the termination process. I just felt i could not allow anybody to stop our son's heart. Not if he has a chance no matter how small. I worry about continuing the pregnancy. What if we continue and he is subjected to a lifetime of painful operations and procedures? How would having a severely disabled brother affect our other son? How will it affect our relationship?

We asked the consultant what he would do. He said he would continue with the pregnancy and that if we get to 28 weeks then the risk of disabilities goes down and they should be able to assess lung function within about 6 hours of birth.

No decisions were definitely made but I think we both knew on getting the consultant to answer the questions that we had to continue the pregnancy.

Monday 10 May 2010

Scary bleeding

I was in tears earlier convinced I was having a miscarriage. Went to Labour and Delivery thankfully they found a heartbeat. They do not know why I am bleeding but because the blood is diluted with the amniotic fluid they are not concerned. I had the usual blood tests and a swab and was sent home.

Luckily my mother was here, so we were able to leave M with her while we went to the Hospital.

Friday 7 May 2010

Fetal medicine consultant

Today we saw a Fetal Medicine Consultant. He did a detailed ultrasound scan and told us all the facts about what has happened to us. I have what is known as premature preterm rupture of the membranes (pPROM). Normally when this happens women go into labour within three days of rupture. However when they don't they can carry on the pregnancy for days or weeks before they go into labour.

He did a scan. He was looking at the level of amniotic fluid left around our son. He said they look for a deepest measurable pocket of 2cm or above and I didn't have that. I had about 1.5cm. He said that lung development goes through a critical stage between 18 and 24 weeks and fluid is needed during this time. If there is 2cm or more lungs should be ok. So our son's lungs are unlikely to function. He did say because we had fluid for part of the period the lungs might be ok. There is no way to tell until birth.

He gave us the option of termination. He agreed to see us in a few days to think about it. He explained it is likely I will go into labour sooner rather than later and so as well as lung issues our son would have prematurity issues. Cerabal palsy is highly likely if we deliver around the cusp of viability (24 weeks).

In the meantime I am to take my temperature regularly during the day. I will go to the day assessment clinic at the hospital twice a week. They will take blood samples and check my white blood cell levels and crb levels, if they go up it could be a sign I have an infection. Once a week I to have lower vaginal swabs again to check for infection. Twice a week they will also check the heartbeat and do the normal pregnancy checks of blood pressure and urine.

The consultant told me not to have baths, just wash with water, no trousers, cotton underwear, change sanitary pads regularly.

So have to rest, not moving around much. We are going back Tuesday to discuss what we want to do.

It is so awful I cannot imagine what to do or how to cope. We are so close to 24 weeks and a little hope, 13 days away... On the day after my waters broke I had 6cm fluid now just 1.5cm.

Below is a link to a leaflet on pPROM  aimed at women who's waters have just broken:

RCOG pPROM Leaflet

Tuesday 4 May 2010

21 weeks pregnant and waiting to lose my baby

I got out of hospital today. I spent 4 nights there waiting to lose my baby. But I am still pregnant, 21 weeks and 5 days today. Here is what happened in hospital.

Early Saturday I called my mother. We were supposed to be meeting my parents later that day. We were going away to the coast of Doset for the bank holiday weekend. My parents staying in their caravan and me, S and M staying in a self catering cottage. My grandmother was also going to be there.

I told my Mum I was in hospital and cried a lot. I couldn't get the words out. Some how she understood and said she and my Dad would come to look after M. I thought that I would be in labour any minute and wanted S with me. Later my parents, M and S were all at the hospital with me. It was an odd almost cheery experience. S was there with me again that evening and stayed until around 9. Saturday came and went and nothing happened.

They did scan me on the Saturday at my request. The doctor had said it was pointless but did it any way. I had around 6cm of fluid.

Nothing happened on Sunday either. The doctor said that I would be able to go home if nothing happened on the Monday. Essentially to wait to miscarry. S was at the hospital whilst he went through everything. But the following day I saw a new consultant. She wanted me to stay another day. I was upset. I wanted to go home.

Finally after a long wait I was allowed home around lunchtime today. I have to take my temperature a lot. Call if it goes above about 37 degrees. Call if my fluid loss smells, goes yellow or green. If I get intense pain or bleeding. If I feel flu like symptoms I should also call.

Because I have gone so many days without infection they now do not know precisely what will happen. The most likely scenario is I will either go into labour or be induced because of infection and my baby will be too young to survive. They won't be able to help him.

Sunday 2 May 2010

Finding out my waters had broken (pPROM)

This is what happened on Friday when I found out my waters had broken (known as pPROM).

I had Friday off work. M was in nursery all was fine. I went to a maternity shop and tried on loads of clothes and got some jeans and tops. I had a good day. S came with me to pick M up from nursery and then we met some friends in the pub. I left early with M. Just before I left I popped to the toilet and noticed my knickers were wet. I assumed it was discharge. So left and went to the supermarket with M.

We got home and had some food. I felt a little gush and again my knickers were wet. After a third gush i knew something was wrong. I called the Labour and delivery ward. But I was only 21 +1 weeks pregnant and they don't take women until they are 22 weeks so they said call my doctor.

It was about 9 in the evening by now. I called the out of hours GP number. I spoke to a nurse who was concerned and said she would call some people and get back to me. She called me back as did a doctor. They had terrible trouble getting anyone to see me. The hospital was eventually persuaded to see me in the gyno ward.

By now S was home. He was to put M to bed while I drove to the hospital alone not really believing I would get bad news.

At the hospital the nurse took my details. It took ages for a doctor to see me. I asked the nurse if she sees this happening a lot, she said no i was the first case like this she had come across. Hours later... They had me lie on my back for ages then examined me doing a sterile speculum exam. The junior doctor told me I had lost my waters and was about to go into labour (later I found out this is known as pprom), then he just left me. The nurse gave me something to wear and antibiotics. I called S saying I would call again if I went into labour.

I tried to sleep but couldn't. I cried and cried. I could feel my baby moving and he was going to die soon. It was also my first night away from M. I had told him I would see him when he woke up and now I wouldn't be there.

After a few hours a more senior doctor came to see me. She was lovely. She took my blood. She said there was still hope and that months ago she had seen a women who's waters broke at 22 weeks and whilst I was being diagnosed with pprom earlier that evening she had helped deliver the women's baby by c-section and the baby was ok.