Preterm Labor: September 10-16

September 19, 2010

After getting home from work on September 10, I went to my parents house to pick up Irene.  Nothing out of the ordinary had happened all day.  I felt great- and was excited for a quiet weekend with Peter and Irene.  Mom and I were chatting at the table while Irene was upstairs with my dad- totally oblivious to the fact that I had even arrived.  I ran to the bathroom, and was stunned to see that I was bleeding.  It wasn't a ton of blood- but at this stage any blood was scary.  I paged my doctor, Amy Huibenhua, and within 2 minutes she called me back.  After describing what was happening, she told me to go to Alta Bates and get myself checked out at the triage area of labor and delivery.

Mom and I said hi and goodbye to Irene and my dad and rushed off to the hospital.  Peter was stuck in Friday evening commute traffic so he was going to meet us at the hospital.  By the time I walked into triage, my doctor had called them and they were waiting for me.  They quickly got me hooked up to a bunch of monitors: one to measure contractions and one to measure the baby's heartbeat.  Baby looked great, but I was contracting every two minutes- not that I could feel them.

As soon as Peter arrived, they took me down to ultrasound and discovered that I was 4 centimeters dilated and that the amniotic sac was bulging out of my cervix.  Baby was looking great, but this was very concerning.  Of course, the ultrasound tech didn't say anything to us, so when they wheeled me back up to the labor and delivery floor, I was shocked when they told transport to put me in my room!  I started to panic a bit- cause i knew getting assigned a room could only mean bad news.

We were taken to Labor and Delivery room 8, and my nurse Tamara explained that they needed to put me into a bed that was in trendelenburg.  What that means is they want to use gravity to help keep the baby inside, so they place you at an angle where your head is lower than your feet.  They were also going to start me on a magnesium sulfate drip to try and stop the contractions.  So into bed I went and there I stayed.

The next morning they did a bedside ultrasound which showed the sac was still bulging and that I was now dilated to 8 centimeters.  The perinatologist, Dr. Weiss, and my doc came in to talk to us, and brought nothing but one difficult decision after another that we needed to make.  Thank god for Peter as he kept it together, and was able to process everything that was being said and make the hard decisions.  I was off in my own world trying to stay calm and tune everyone out.

Our first decision was do we try and hold on to the pregnancy, make it to Tuesday (4 days away).  This would allow the baby to reach 24 weeks and have much greater survival chances or do we give up the pregnancy, deliver at 23 weeks and know that the baby would not survive.  An added complication to this was the fact that we didn't know if we were having a boy or a girl- and the statistics are much different depending on the gender.  Once it was explained that whatever choice we made I was going to have to deliver a baby, we decided to see if we could hold on.

So for a total of 6 days I lay in bed in trendelenburg, being pumped full of drugs, suffering from terrible headaches and back and hip pain.  In this time, I was surrounded by the greatest nurses I have ever met: Tamara, Jen L, Jen T, Beth, Phylis, Nora, Crystal, and others whose names escape me.  With these amazing women, I would not have been able to hold on to the baby as long as I did.  I will never be able to thank these women enough- they will hold a special place in my heart forever.

Before things got really exciting, Irene visited me a few times:

Irene lying in bed with mommy

Irene lying in bed with mommy

Irene feeding mommy

Irene was feeding mommy jello (aka eating as much jello as she could)

So, on the 5th day, my nurse Beth was worried that my water had ruptured.  There was a lot of discharge and it resembled amniotic fluid.  This new complication took my situation from serious to dire.  My doctor ordered another bedside ultrasound.  This time, the results were mostly good.  We were able to see that that the sac was intact and had moved back into the uterus- however the cord was now located right at the bottom of the sac close to the cervix.  This meant if the sac ruptured, the cord would be sucked out and compressed and I would need a crash c-section (ie: baby removed within 3 min of the rupture).  At this point I was put more more restrictions: no food, no fluids and no movement without the help of a nurse.

Come Thursday morning, I was just not feeling right.  Beth was watching me again, and she too did not like what she saw.  I started to have contractions again, and they became more and more regular.  By 4 pm, Beth had called the OB on call Dr. Wharton and he ordered yet another ultrasound.  This one showed that the sac had moved back out of the uterus, the cord was now in the sac outside the uterus, and the baby was in the breech position.  Luckily Mike and Stephanie Ross as well as my parents were with me at this time.  Peter and Irene arrived right before the ultrasound.  After she and I had a quick visit, my dad whisked her away for some special Yayo time.

Irene's last visit before her brother was born. She brough the class toy, Rocky the Racoon to see me.

By 6 pm, the decision was made with the help of Beth and Dr. Wharton that the benefits of keeping the baby inside were now being out weighed by the dangers.  We gave he go ahead for the c-section and by 6:30 I was in the OR.

To my relief, Tamara, a nurse I trusted and was bonded to was assigned to take over my case in the OR.  She is an expert at keeping me calm, and the trust I had in her really gave me a ton of comfort.  Peter and I had a quick discussion about what he was supposed to do once the baby was out- stick to the baby's side and let Tamara take care of me!  By 6:35 the spinal was in, I was prepped, the NICU team was assembled and Peter was led into the OR.  He and I had a quick discussion on names: Samuel William if it was a boy and Hazel Lillian if it was a girl.  The c-section seemed to take forever, and then suddenly you could hear a tiny cry.  The doc told Peter to stand up so he could see what we had- a BOY.  Quick kiss on the forehead and Peter was gone- following little Samuel William up to NICU.

This left me in the delivery room to get sewn up so I could get to recovery and then get upstairs to see Sam.  The one thing I remember clearly was the phone ringing in the delivery room and Tamara telling me that Sam had weighed in at 1 pound 12 ounces.  What made this stand out so much was my doctor stopped in his stitching tracks, leaned over the curtain and asked Tamara to repeat the weight.  He was so stunned at how big Sam was he didn't believe it.  He then spent the rest of the time he was stitching me up mumbling about how Sam was twice as big as he thought he would be.

I was sent to the recovery room and after 2 and a half hours was well enough to be wheeled into Sam's room to see him.

[…] in a hospital bed laying like that than since I was first admitted to the hospital and put into trendelenberg for six days. This time, I was transported not to the NICU, but to the delivery room just in time to […]
[…] in a hospital bed laying like that than since I was first admitted to the hospital and put into trendelenberg for six days.  When the recovery room nurse sat me up on Wednesday it flashed me back to my arrival in the […]

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