Hello, my name is Marianne and I am a post PP mom. My story reads like this: I was remarried three years ago and my husband and I decided we would like to try to have a baby. I already have two sons, Nathan 17 years old and Aaron 11 years old....and I was turning 39 years old. We were unsuccessful trying to conceive naturally and I went to an OB/GYN to start all the procedures for infertility. I am an RN in a NICU and had worked in the same hospital nursery as a nurse for 11 years. I knew many doctors and had access to all the info I needed concerning pregnancy, delivery, and I had seen EVERYTHING that could possibly happen to preemies and full-term newborns. I began my infertility treatments with medications to mature my eggs and began trying to get pregnant in January 1997, in April 1997 my husband's job transferred him to Europe. In the middle of a cycle and medications we moved to Holland. I was frantic to obtain an OB/GYN as soon as possible. I found out how difficult it is to get an appointment with a specialist. The waiting list for a regular appt. was 4 months away. I found a family physician right away and pleaded with her to get me in to see the OB right away and told her of my story and the medication schedule. She was not happy to be placed in this position and said I should just stop all my medications for this cycle and wait for a regular appt. with the OB. I begged louder and longer and she called the OB herself...guess she felt sorry for this crying American woman. Then I was sent to see what she called the "best" OB in Holland specializing in infertility. I arrived at her office with big hopes only to find out the medication and treatment schedule in Holland was much less agressive and much more subdued. I was sad to think I had been going "gungho" with this and now I may be held back to allow "nature to take it's course on it's own". I was started the next menstral cycle with the regimine of drugs for infertility they use here in Holland...and by the second cycle of these I was pregnant. I could not believe it!!! I was asked my history, my "advanced age of 39", my previous two vaginal deliveries of my sons, and no problems before, during, or after, made it look like this would be a "breeze" of a pregnancy. Most all deliveries here in Holland are done at home by midwives unless there is a predetermined problem. I was given a choice whether I would like to deliver at home or in a hospital. After the past 11 years as a NICU nurse I had seen anything and everything go wrong in a delivery, even with a supposed full-term, normal, healthy infant. I was very decided that home births were not good for me. It is so much safer, no matter how many well, vaginal deliveries you have had and no matter how good the doctor says the baby seems to be inside of you, to deliver safely in a hospital, near all doctors and NICU equipment and nurses where EVERY second can count following a delivery, then after you and the baby have recovered from the delivery, you can go home and enjoy your baby. I was given a list of midwives in my neighborhood to call to pick one to do my monthly weight, BP, and belly check, but a doctor at the hospital would deliver the baby when it came time. I chose one within walking distance to my house. I think because I already knew too much of what to look for and what could happen, I had so many questions concerning this pregnancy. The Dutch doctors do not do routine ultrasounds during the pregnancy unless something has occurred to merit one. I asked my midwife to schedule an amniocentesis for me as I was over 35 years old and the chance for chromosome abnormalities of the baby increases after that time and chances something could be wrong goes up considerably each year after that. I was sent to Amsterdam to a university hospital for my amniocentesis at 14.6 weeks gestation. I insisted that I have (NOT a student) but an "old" doctor that had done thousands of amnios, as your chance of miscarriage is lessened from the amnio procedure if the doctor's experience is a greater number. The doc did a preliminary U/S before the amnio and said everything was fine and that I would hear from the hospital in 3 weeks to find out the result of the amnio. I was sent home to lay on the couch for 24 hours and nothing strenuous for 48 hours as all the amniotic fluid that was removed (about 20 cc) is completely remade and replaced within 48 hours. About 7 hours post amnio procedure as I lay on the couch I felt a gush of fluid in my panties. I quickly went to the bathroom thinking I may be bleeding or losing my baby (after waiting so long to get pregnant), only to find that the fluid on my panties was clear and no blood was there. I called the OB on her emergency number and she said that some amniotic fluid can be lost following the amniocentesis and if I lost anymore or bled to come to the emergency room ASAP. I was to go to her office the following day to have it the fluid looked at via ultrasound. There was no more fluid loss and my husband and I went for the ultrasound and everything looked fine, including the amount of amniotic fluid around the baby. I asked at every midwife monthly appt. to be scheduled for a "diagnostic ultrasound" to check fully the development of the baby: if there were four chambers in the heart and if the blood flow was normal through the heart, if the valves were functioning normally, if the spine was well developed and closed (an open spinal cord is called spina bifida and can be a very bad birth defect), if her kidney, lungs, liver, bladder, and brain were all developing normally, all of which can be picked up on ultrasound before delivery. The midwife kept telling me that they did not do routine diagnostic ultrasounds but of course I insisted until she contacted the doctor who specializes in diagnostic ultrasounds at the hospital. I got an appt. but not until my 28th week of pregnancy. At 18 weeks gestation I got the news that the baby had no known chromosome abnormalities and was a girl. Well, were were so excited after raising two boys. (also we had been looking for names for boys and girls in a book with 10,000 baby names....now we knew we could narrow it down to only 5,000 to choose from) I had a normal pregnancy til my U/S appt at 28 weeks, when we went to see Dr. Boot, the specialist. He check all I asked for and gave me the great news that the baby was developing normally. I asked if he would use our video tape to record the U/S (if you take your own blank video with you to all your ultrasounds they are usually happy to record the whole thing for you while you are having the U/S, it is great fun to watch later) he did and I asked him if he was going to check the placement of the placenta, yes, he was of course going to check it. Oh look, the placenta is totally convering the cervical opening, he says to us, see???? Well, sure glad I INSISTED on having this diagnostic ultrasound, I would not have known until I hemmorhaged that I or my baby could have been in trouble. He scheduled a second diagnostic ultrasound at 33 weeks gestation. I was told to take it easy at home, no big lifting....I had not had any bleeding or signs of trouble yet so I was not put on bedrest. I had another ultrasound at 33 weeks and the placenta previa was still complete and I was scheduled for an ultrasound at 38 weeks. At 7:00 a.m. on the morning my pregnancy was to turn to 36 weeks, my husband left for work, as usual, to drive the 45 minutes to his job, and my 11 year old was about to leave on the bus for school. I was folding laundry that should have been folded the night before (you all know how that is)...when I felt a really warm gush in my pants. I anxiously told my son to go next door to get the neighbor (who, by the way, only spoke Dutch) and I got to the bathroom to see lots of blood....okay, NOW I was scared. It seemed like an eternity before my son and the neighbor returned (of course, it was only a couple of minutes and the language barrier didn't help) I later found out from her husband (who does speak English too) that she thought my son was saying that the baby was being born in the bathroom.....hee hee. Anyway, she called my husband on his mobile phone which he then called the ambulance to come and pick me up at the house. Everyone arrived at the same time....my husband turned around, he had only been driving 10 minutes so he wasn't far away...pulled up at the house the same time the paramedics pulled up in the ambulance. The gurney they needed to transport me on would not go up my walkway so they had to collapse it to get in in the house. My neighbor helped me change clothes and fill my pants with a giant towel and get up on the gurney, which they had to collapse and carry to the ambulance (and now it was pouring down rain on my face as I was being carried to the ambulance. No coat and being a little bit "shocky" from blood loss. My husband and son followed the ambulance in our car (my son was happy to miss a day of school). I was afraid not know the amount of blood lost and what my vital signs were and not knowing if the baby was okay. After a very bumpy, twisty, winding ride to the hospital (Holland has VERY narrow, curvy roads), we were in the emergency room and taken right up to the maternity floor. My husband got lost on the way. So, by myself I managed to talk to all the Dutch speaking people and explaining that I was 4 weeks early for delivery and that I had complete PP. I got to the floor and was prepped immediately for surgery, IV in, meds given to dry up my mouth and an injection to keep my stomach calm during surgery...now my husband shows up. He was too afraid of the blood and the sounds he was about to hear in the operating room and was not prepared to go in with me....funny then, no one gave him a choice, they just assumed he was going in with me....threw scrub uniform to him, told him to hurry, get dressed and get in there!!! He did do fine, by the way, did not faint or anything....the doctor told him if he did faint, they would just pick him up off the floor following the entire surgery. I was given a spinal anesthesia with morphine in it to help with the post surgical pain and it took effect immediately. Now, the decision was (with the hospital staff) whether to call the night doctor in to do the surgery, or the new, fresh, well-rested day shift doctor to do the c-section....well, by now, you know me...I insisted on the day shift surgeon, and I got her. It turned out to be the first doctor I had seen in OB, the doctor who helped us with our infertility. The baby was born 10 minutes later, with an apgar score of 9, and 10. She weighed 5 lb. 2 oz. and felt like a miracle when I held her for the first time. Her lungs were fully developed (there was no time to test them before surgery) thank God she was fine, small but fine. The OB told me that she had wanted to cut a little high on my abdomen because the placenta was so far to the front and it is far too vascular to cut into (big bleeding can occur if it is cut) she said she ended up cutting into it anyway, but I would be given a transfusion when I got out of recovery. Recovery went well and the baby and I remained in the hospital 6 days following delivery. The baby lost 200 grams the first couple of days after birth, but began to gain steadily after my breast milk came in. She did not have to spend any time in the NICU. She did get jaundiced (as most preemies do because of the immaturity of their liver and their inability to handle the breakdown of red blood cells) but her level never rose high enough to warrant bili light therapy. Our baby was born at 36 weeks gestation on April 24, 1998. We named our daughter Maegan Elizabeth. She is the light of our lives and is now a healthy 10 month old. You are welcome to write me via e-mail at RNMercy@hotmail.com if you have any questions about my pregnancy or delivery or preemie questions. Thanks for letting me post my PP story. (3/23/99) 

On 1-25-99 day 1 of week 32 I started to bleed in the middle of the night. My husband travels for work and wasn't home. I had my neighbor come over and watch my 3 boys then I drove myself to the hospital. They monitored me for a few hours and since the bleeding had stopped just sent me home. 

 

Two days later on 1-27 I got up to get my 5 year old ready for school and discovered the bleeding had started again. Again my husband still out of town. Same neighbor came over and watched my boys and I again drove myself to the hospital. This time my OB came over and admitted me. 

 

Later that afternoon I had an U/S and it appeared that I had a marginal placenta previa. I stayed overnight in the hospital the bleeding stopped and I went home on 1-28. On 1-29 had a level II U/S with a peri where it was discovered that I had a COMPLETE pp. Home to complete bedrest immediately .The plan was to do an amnio in week 36 to check fetal lung maturity. The perinatologists that are affiliated with my hospital are there only 1 day per week so amnio done week 36 in anticipation of scheduled C-section on 3-1 day 2 of week 37. 

 

Scheduled my amnio on Tues 2-23 at 9AM. Husband again out of town but due back late that evening around 11:30PM. I was having my amnio when I happened to remark to the peri that if her lungs were good I'd be having her on Monday 3-1. He said if her lungs were ready there was not a reason to wait until Monday. It was just more time to wait for me to have another bleed. He said you should have this baby tomorrow or the next day! 

 

Went home and went back to bed to await the call about amnio results that afternoon. I took a nap and basically just watched the clock. At around 3PM OB called and aid she was ready how about having her tomorrow. I said OK and he said he would call the hospital and set it up and give me a call back. So I waited some more. At 3:30 he called back and said 1pm tomorrow be there at 11. I was very excited so I called my hubby and told him we would be having her the next day. He was scheduled to take a flight home at 6PM that day. Then I started calling friends and relatives giving them the good news. Well lo and behold at around 5:30PM I felt like I had wet my pants. So I stood up to go into the bathroom. I was wearing white pants and I saw more blood than I have ever 

seen in my life. Called my neighbor who took me to the hospital. Got up to L&D and told them I had a complete previa and was bleeding heavily. I have never seen so many people spring into action so quickly in all my life. My memory gets a little hazy here but I remember being prepped. IV put in belly and part of pubic area shaved catheter inserted signing a bunch of forms and being taken to the OR. It was so cold in there. While in there my torso from below my breasts to my knees was swabbed with batadine.The anesthesiologist came in and got me ready for my general no time for an epidural. Then my OB came in they put me under and the next thing I know I wake up in the recovery room feeling not so hot. 

 

Nathalie Marie was born at 6:35PM . She is truly a miracle baby. By the time OB had me opened up her entire placenta had separated from the uterine wall. Doc said she had maybe 3 minutes before she would have been in real trouble. She also had 2 knots in her umbilical cord. As for me I continued to have uterine hemorrhaging and my doc was considering a hysterectomy when he finally got the bleeding to stop. I lost quite a bit of blood and became anemic as a result. The little miss weighed 6lbs 4oz and was 19 1/2 inches long. Her apgars were 9 & 9. I finally got to see her 3 hours after her birth. I called my hubby on his car phone at around 10:30 and gave him the news. I honestly don't think he'll ever get over not being there for all that happened. Nathalie is 4 weeks old today. She is my last baby and is well worth all I went through to have her. 

Anyhow with my sixth pregnancy, I went to my OB at 7 weeks and everything seemed to be fine. We discussed genetic testing (which we declined) I guess thinking that would be our only worry during the pregnancy. Wrong ! At 7 weeks 3 days, I started having severe cramps then they subsided only for me to have my first bleed. It was a big one and I thought for sure I was having another miscarriage. At the doctor's office they did a vaginal ultrasound and saw the baby's heartbeat and said everything appeared ok. I continued to bleed slightly off and on until 12 weeks. At thal point they were not sure why I was bleeding- they said I could have miscarried a twin. Knowing my schedule at home, my doctors just told me to take it as easy as possible and no sex. 

Everything was going well until the morning of Christmas Eve when I started with some contractions and then some spotting. Iwas 18 and 1/2 weeks at this point. I went for an u/s which revealed a complete placenta previa. My doctor told me no traveling, no sex, and I hope you weren't planning on cooking tomorrow! So, I went home on Christmas Eve with my five children and on bed rest. Boy, did my husband get a work out!

Things were rather uneventful and in February I went in for another u/s. This time they sent me to the Perinatologists. They had mentioned that with a complete previa and five previous c-sections, I was at high-risk for placenta accreta. We had never heard of that and to this day I wish I hadn't. I was 25 weeks 6 days when they did the u/s. The u/s showed that I still had a complete previa and it looked suspicious for accreta. The one thing in my favor was my placenta was posterior (in the back, further from my old scars). As all of the u/s did this one too revealed that my baby was doing great! By the time we left the perinatologists office, we were very much aware of the seriousness of the situation. They had mentioned the threat of bleeding to death when they tried to remove the placenta and that a hysterectomy might be necessary if accreta was found. 

At 30 weeks, my doctor started me on the steroid shots for the baby's lungs to develop quicker. He also did a quick u/s in his office which revealed still a complete previa. At this point, I began going to the doctors twice a week to get my beta-methosone shots. At 32 weeks, we went out to eat and when I went to the bathroom I saw a little bit of blood. I called my doctors and they said for me to get completely off my feet for a while and call if I saw anymore. 

At 32 weeks, we went to the perinatologists for what would be or last u/s. The u/s confirmed that I still had a complete previa and they were 90% sure I had placenta accreta, increta, and percreta. The tone of the u/s at almost 26 weeks had been serious- but now they were really talking to us. Talking about saving my life- by performing a hysterectomy to keep me from bleeding to death. We left their office to go to my doctors office about two miles away. He gave me my beta-methosone shot and then told me he was sending me to the hospital. He told me to go home and pack, bring lots of reading materials because I was going on total bed rest other than bathroom privledges and a quick shower every other day- which I would lose if there was even as much as a drop of blood. The u/s showed that I had still had complete pp (of couse) and it had attached to my uterus and had grown completly through it to my bladder and was wrapped around my right ureter. He said the findings of the u/s had him too concerned to have me at my house-about 50 minutes from the hospital. The two hospitals close to our house, he said were not prepared to save my life. When they admitted me they put a seven inch catheter (mid-line) in my arm, in case I started to hemorrage. The neonatalogist came to talk to us and said that at 32 weeks with all the steroid shots that the baby should be fine. Plus the u/s revealed he was 5 lbs. Everyone was thrilled about that. 

Intially, they were going to perform an amnio to check for lung maturity at 34 weeks. But, then they decided to bypass that, because they said they couldn't wait any longer- my placenta was growing like a cancer inside of me- they said. Even with it being posterior intially, it had curved around for a large portion to be in the front now. 

I was very fortunate, no bleeds in the hospital some contractions a couple nights, and some pain where they said the placenta was growing into my bladder. Which I had had pain like that since about 27 weeks which is when we think the placenta began to grow through to my bladder. So each day they monitored Tanner to make sure the placenta was doing its job for him. It was thank God for that. Everyone of the anesthesiologists, perinatologists, and neonatolgists met me within the frst couple of days in the hospital so they could talk to me, reassure me, and get to know my history. One anesthesiolgists told me that they could handle this, ( I was at the hospital that delivers the most babies on the east coast) they were prepared and they knew what to do. That made me feel good because we knew that the mortality rate for mothers with percreta is 20%. The Friday (Good) before the surgery was scheduled all the Doctors, nurses perinatoligists, neonatoligists etc, that were going in for the surgery met for a practice run. They did this since every second counts, to make sure everyone knew their job and where to stand. At times this has been truly overwhelming, as this was not the way I would have planned my " Five minutes of fame."

We made it to the scheduled day April 14, 1998 without any major problems. We decided to name our baby Tanner Austin and I had taken care of his birth certificate and everything before they took me in to surgery. They could not have done anything better or been more prepared. My doctor delivered Tanner who was taken to the NICU and put on CPAP (continuous positive airway pressure to help the lungs expand) for the first 24 hours. He was 5lbs 12oz, 18 1/2 inches. Tanner spent a week in the NICU. Then the Gyn Oncologist took over to repair me. The perinatolgist that read my u/s was right on the money-the placenta was everywhere. They had to do a hysterectomy, take 1/3 of my bladder, but luckily the placenta peeled off of my right ureter. 

Well, Tanner is almost a year old now and he is doing wonderfully. We have truly been blessed again! The memory of all we went through is still fairly fresh in our minds and we consider Tanner to truly be a miracle. It was with the help of my family,friends, and many, many, many prayers that we made it through with a positive outcome. Not to mention the many wonderful doctors and nurses that took care of us. Thank you for posting my story. (4/12/99)

Sincerely, Kim

A sonogram was done at 5 weeks (just to make sure everything was okay and we were thrilled to see a beating heart! Then at my next u/s at 16 weeks, in June, the doc said the baby looked good but that it looked like my placenta was low. Not to worry, blah, blah, blah, as they usually move up, but to be on the safe side, we'd do another u/s at 30 weeks. So between now and then, just the usual restrictions. Everything was fine and dandy, no bleeding at all (thank God!).

Then at 30 weeks, another u/s was done, and my placenta had not moved at all. Still no bleeding, but now I was to stay home (I worked 45 miles from my home and was somewhat out in the boondocks away from a good hospital), and no sex, either (which was okay, I didn't have the energy what with my 3 year old keeping me busy). At 36 weeks, they did another u/s and still no movement. My doctor wanted to schedule a c-section for the following Tuesday, but wanted me to have an amnio to check for lung development on the day before the c-section. Well, you know some doctor's think their word should be law, but the ultrasound doctor just laughed and said there was no way to get the results in time for the C-section the next day, but my doctor did not want to re-schedule and was sure the results would be available by the time the section was to take place. My instructions were, nothing to eat or drink after midnight as the section was at 1:00 p.m. the following day. The results DID come in by the a.m., but a nurse called to say that they had to cancel the surgery as 1 of the 3 tests did not show lung maturity. I was ready to cry, I was soooo stressed out at this point. Rather than cry, I took my son, Sean, to McD's for lunch. By the time I got home and had calmed down, there was a message from my doctor saying to call right away (of course, I panicked, what if the surgery was still on and I'd eaten food, a Big Mac, no less!). Doc says that they want to schedule section for Friday as they believe the lung development would be okay by then, so I'm on for 8:00 a.m. Friday, October 30th.

When I wake up that a.m., I sadly (and very quietly) kiss my sleeping Sean good-bye and leave a little gift for him on his pillow. My husband and I arrive at the hospital at 6:00 a.m., only to have a nurse panic me (again!). "Are you scheduled for a section?" she asks, "we're packed, here." I'm telling you, there was no way I was leaving that hospital without a baby in my arms!!! I told her I was scheduled and that it was for PP, so she obviously didn't have much choice but to keep me there. They were packed, and I had to be put in a post-op room, but that's not my problem. Anyway, everything goes well, my husband looks ridiculous in his scrub suit and I'm feeling buzzed just from the epidural. Then, at 8:52 a.m., my son, Michael was born. A healthy 6 lbs 9 oz and 19-3/4 inches with Apgars of 8 and 9 and I'm able to keep my uterus (there was some concern as to where it had implanted).

I am hoping that when (and if) I decide to go for a third (I am 38, so who knows), that it will be a girl and that I won't have any of the problems I had with the other two (did I mention that with my first I had pre-eclampsia and had to be induced?). On the whole, I feel very lucky... I have two wonderful boys and they are as healthy as can be and I suffer only from the (somewhat high) scar of a c-section (still itchy sometimes) and an extra 20 lbs that just won't leave.

I pray that all pp sufferers are as lucky as me.

Barbara (4/17/99)