Have you had a high risk pregnancy? I previously had three other pregnancies that went fine, other than the need for a c-section for each one. I had no idea that I was about to live through THE scariest thing of my life.
This pregnancy was a little stressful because I got pregnant right before I turned 40. For my last two pregnancies I got pregnant naturally, even though I previously had fertility issues getting pregnant with my first two. My husband and I had both read the risks of being an “older” mother, and my biggest concern was possible genetic issue. I had extensive genetic blood testing done at 16 weeks, but within a couple weeks, we got the call that all of that was fine.
Then, it was time for the typical anatomy sonogram at 20-22 weeks. I thought we had gotten through the worst of it with the genetic screening. Boy was I wrong.
After my sonogram, my doctor came into the room and told me she thought she saw placenta previa, where the placenta is covering the cervix. Because of this, she was sending me to the maternal-fetal specialist (perinatalogist) with a super duper sonogram as soon as possible. I read up on placenta previa, and I knew there was a chance since I was over 35 and had three prior c-sections. But, it didn’t seem to be a huge deal.
The specialist was able to get me in a few days later. It was nice. You lay in this really nice examining table/chair in a darkened room, and there’s a screen for you up on the wall, so you don’t have to peer over at the sonogram tech. They do a thorough scan, and then the doctor comes in and does another one. The doctor did find I had complete placenta previa, which means it was covering my entire cervix and was moving up to my previous c-section scar. Then, she noticed the area between my uterus and bladder was getting very thin. This was a possible sign that my placenta was possibly turning into placenta accreta and possibly even increta or percreta. These are when the placenta starts growing into the uterus and even further out into other organs, like the bladder.
While the doctor was reassuring and told me not to worry, I was worried. This is the kind of complication that can lead to massive hemorrhage and kill a new mother.
I was immediately put on pelvic rest, meaning I couldn’t have any sex, no orgasms (including clitoral), no exercise, and nothing inside my vagina including not even allowing a medical professional to check my cervix manually. If I did have any bleeding, I was told to run straight to the emergency room and call the doctor on the way.
After this, I began getting a sonogram every 2 weeks at the specialist and seeing my regular ob a few days later each time. Every time, it looked like the placenta was not getting any worse. Plus, the baby was doing just fine and on target at each sonogram.
At around 30 weeks, the specialist saw signs on my placenta called “lakes” or lacunae, which are pools of maternal blood that show up in the placenta. These indicate the placenta is probably growing into the uterus abnormally, but I had just a few of these whereas the typical case has many of these lakes. The doctors were still optimistic. At this point, it was recommended I never get pregnant again, and I would have a tubal ligation at the c-section.
Fast forward to 32 weeks pregnant. The specialist had me go for an MRI. This was to get the best view of the placenta to see what was really going on because up until now the sonograms were not really showing definite signs of placenta accreta or increta.
I had a bit of a freak out in the MRI. You have to have a closed MRI in one of those horrible tubes for this particular scan. I had never been claustrophic in my life, but being pregnant and just barely fitting into the tube was just a little too scary for me. Thankfully, they had these special glasses that let me look backwards at the open room and not at the tube that was a couple inches in front of my face. I was in that thing for an hour, but I was able to get through it.
The radiologist was able to see evidence of possible placenta increta. One telling sign is part of the placenta is bulging. Prior to this MRI, my perinatalogist wasn’t quite sure if we were headed to placenta accreta, but after the MRI, she was certain. She even showed me on the sonogram where my placenta was bulging.
It was at this point everyone got down to business. By my 33 week appointment, my ob/gyn decided we would be delivering at 35 weeks 5 days, and I would be having a cesarean hysterectomy. It felt like we hit the ground running.
They would put me under with general anesthesia and deliver the baby super fast, so she would not get much of my anesthesia. Then, they would not even try to remove my placenta. Instead, multiple surgeons would be on hand to stitch my uterus back up after delivering the baby, and then they would remove it with the placenta still in the uterus.
The entire hospital got involved in the planning of my surgery. My ob/gyn and her partner were going to perform the cesarean hysterectomy. There was also going to be a gynecological oncologist because he was the best gynecological surgeon if something bad came up. There was also going to be a urologist on call in case the placenta had grown into my bladder, so he could repair it.
Two days before my surgery, I went to the hospital for blood typing, so they’d have blood ready if I hemorrhaged. I would be admitted the night before to stabilize my blood sugar for gestational diabetes. Then, the next morning, I would be wheeled into radiology to have balloon embolizations put into my femoral arteries to aid in controlling blood flow in my uterus. Next, I would be wheeled into the regular operating room, not the typical c-section room, to deliver. It was hopeful that everything would go according to plan, and I’d have my baby nursing before the night.
To continue the story, here are part 2 and part 3 of my placenta increta c-section hysterectomy delivery.