Accreta Confusion

At the 20 week scan, the tech did the ultrasound and the doctor came in to review the results with me. She noted I had placenta previa which is where the placenta covers the cervix but at this early in the pregnancy, it would likely move and not be the issue. Her words were “the issue is what the placenta is showing near your uterine scars.” The uterine scars were from the D&C and the uterine septum resection. Sometimes the placenta will attach to the uterus where that scar tissue has formed, a condition called Placenta Accreta which occurs in 0.2% of pregnancies. She had seen increased blood flow in the area of the scars and may indicate attachment of the placenta to the uterus. After delivery of the baby, the separation of the placenta from the uterus can cause massive hemorrhaging and only a hysterectomy can stop the bleeding. She asked me to come back in 8 weeks to monitor the placenta. Never once did she put a name to the condition, all she could do was tell me not to google it. I was shell-shocked and walked out of the office. Matt works at Georgetown so I asked him to meet me after. I couldn’t even spit it out without the tears rolling down my cheeks. A hysterectomy at 36? The appointment left so many questions.

Those 8 weeks were a torment. I scoured journal articles, medical sites, Facebook groups, anything I could get my hands on to understand the condition. I requested an earlier ultrasound but my doctors noted there would be no value in having one done sooner. I went into a little depression at that time and I couldn’t cope with the pregnancy. I reached out to others on Facebook in a similar situation but that only fueled my worry and my need to have a definite answer of do I have Placenta Accreta or not. I connected with another woman who was a similar age as me, had a 2 year old son just like me and had suspected Accreta just like me. We messaged back and forth talking about the scariness of it all and how we worry about our sons if something were to happen.

At the 8 week mark the ultrasound showed no signs of Accreta and the follow-up MRI showed nothing either. One of the doctors read the results to me and as I was asking him questions, he walked toward the door and had one foot out. It was like my worries and concerns were so inconsequential to him even though I would only take a few moments of his time. I requested another doctor in the practice to give me a call to discuss and she had a similar tone of indifference. I then sought a second opinion and he also felt I did not have Accreta. He commented on how unlikely a uterine septum resection was very minimally a risk factor for Accreta. I had a lot of anger at MFM for the way they handled the situation, the long lag time in between visits and the way they essentially blew off my concern. As the weeks progressed, it became easier to let go of the anger and found relief that I would have a normal delivery.

My induction was scheduled on Wednesday, May 22nd. Since I am over 35, I would need to deliver within a few days of the 40th week so they let me pick a day for the induction since my cervix was “ripe.” The morning was smooth, I had a wonderful nurse and she got me the okay to have a pretty hearty breakfast. Around 9 they started the induction process and I basically got to hang out in bed, eat breakfast and watch TV. If you have a toddler, you’d understand the joy in that. The labor progressed well and by mid-afternoon I was having full on contractions. The epidural didn’t work so well on one side of my body so I felt much of the birth experience which wasn’t what I signed up for but I powered through it. I gripped onto the railing, took deep breaths and looked at my husband for the strength I needed. I was shaking from the pain but with each push I could feel her coming and when I was able to touch her head, the joy you feel gives you a renewed energy to keep going so that you can hold that tiny baby in your arms. And finally she was out and on my chest. I felt pride and love and such a connection with this hairy little girl we made. Then the doctors moved on to the next part of labor, delivering the placenta. It was a bit of time before the doctors and nurses started talking about the placenta. Even though my uterus was contracting, the placenta wasn’t coming out. They continued to have me push but I was so enthralled with my little girl, I wasn’t worrying, there was still time for it to come out. After 20 minutes, maybe 25 minutes the placenta came out. I had pushed and I think my doctor tugged a bit on it to help it out. That’s the moment where things started to change.