Placenta Accreata Support

[Accretamom]

Dear Sultanategirl,
I too recieved the methrotraxate intraveniously after the birth of my first child. Since her birth was so traumatic for both of us, I can't really tell you if there were any side effects. I know that it took me a good five weeks after her birth to get feeling "normal" again. I did have some hormonal shifts that kept me edging towards miserable menopausal symptoms (night sweats, mood swings, etc...) and was given a weekly hormone shot to regulate my system back to normal. The shots were slightly painful on injection and left me bruised for days, but I only took them for 5 weeks. Since I nursed my child on demand, I didn't have another period for about four months. I was told by my OB/GYN that I should have an immediate hysterectomy and that there would be a serious risk to both me and any fetus should I try again. I was not deterred. I did my research and discovered a high risk physician in my area that agreed to treat me. He was wonderfully reassuring and said he believed under a watchful eye that I could have another shot at motherhood. I was so relieved. Approximately a year and a half after my daughter's birth I did begin to have some low pelvic pain whenever I engaged intimately with my husband (really painful!), stretched to the side or bent over. I also began having some degree of difficulting with bowels. (Sorry, not pleasant to mention) I went to see my specialist who immediately ordered an Ultrasound of my pelvic area. He discovered adhesions and a few fibroid tumors and I was in surgery two days later. It was outpatient but the discovery was that the birth trauma had left scar tissue all over my reproductive area. Adhesions that even connected a part of my colon to my uterus and ovary. No wonder it hurt! But, within weeks of my surgery, I was fine. I decided a year later to try for another baby. I went in for an ultrasound again and my doc said "go for it." Which we did. I tested positive four weeks later. I saw my physician once a week for the first three months, then once every two weeks until my eighth month. At that time, I saw him twice a week until my three week due date. At my three week due date, he gave me an amniocentisis and said the baby's lungs were developed enough for a healthy delivery. I scheduled his C-section for the next day. The next morning I went in for my cesearean and after a peaceful birth, my physician told me while still on the operating table that it was necessary to perform a hysterectomy because the placenta accreta was deeper with this pregnancy and there was little left of my uterus. I agreed to his suggestion and a hysterectomy was performed. After a few days in the hospital, me and my newborn were released. Although I did go through a period of elation for my healthy newborn, I also experienced a deep grief over the loss of my uterus and the ability to have bear any more children. I expected that these were normal feelings and shared my feelings with my physician who confirmed that my feelings were valid and I needed to give myself time to heal, both physically and emotionally. It was both a joyous time and a sad time for me. Many of my friends and a few family members simply told me to count my blessings, which I did, but I could not deny my emotions either. So, I grieved. But, in time I healed. It's strange the feeling that I have now writing this...I feel a little of those emotions coming back. I remember even feeling that I felt cheated somehow. That my body somehow betrayed me. But, I didn't give up and I pray that neither will you. I just remember my mother in law telling me to be good to myself. To nurture my body, to care for myself. She reminded me of what trauma I had endured and helped me to understand that our bodies are extraordinary and we should take good care of ourselves, especially when we want to bring another being in this world with us. Sultanategirl, you had this painful experience and it is going to take some time for you to heal. Give yourself this time. Seek the help of your physician for your physical well-being, and give your body some rest so that you can grow stronger physically. Mostly, take all the time you need to heal yourself emotionally. There is no right way or wrong way to grieve. We all grieve differently and we all grieve in our own time frame. Grief can't be rushed. I don't believe that one ever recovers from the loss of a loved one, particularly a child, but you can heal enough to discover that life is about living the best life you can, loving and being loved by those you share your journey with, and finding the strength within yourself to grow from each trial that you endure. I'm praying for you and will keep you in my thoughts for healing. When you feel strong enough, seek what you desire. Until then, be good to yourself and give yourself time to heal. And, I'll keep checking back in case you want to talk some more. You are in my prayers tonight.

[nervousnelly]

Some of you have such horrible stories, especially losing children and miscarriages. I am so sorry to hear that, but wanted to give a bit of hope to those of you in this situation.

Last year I had a perfectly normal 1st pregnancy up to 30 weeks when I developed preclampsia and my left side began swelling. At 36 weeks my blood pressure went crazy and I was hospitalized. They held out til 37 weeks then induced labor. After 25 hours of natural labor, I delivered a perfect 6 pound baby girl. It was then that problems occurred. The placenta was not detaching, I hemorraged, kidneys began to shut down, all the worst. A specialist was called in, I was knocked out and a D & C was performed. My hemoglobin got down to a 6 and I was weak for about two weeks, but came through fine.

I did research to find out what my future child bearing years could hold and the limited info out there is scary. Maternal death, emergency hysterectomy's, difficulty getting pregnant again. . .I was certain that I'd never have any more children, but 9 months after my daughter was born, I got pregnant again.

We are now at 27 weeks and everything is going well. I have started the left side swelling again, but my blood pressure has been fine. Just last week a second sono has been scheduled because I grew 10cm in a month and the doctor wants to find out why. I'm not sure if these things can be attributed to placenta accreta again or not. My doctor says I do have a significant chance of having this happening again, but not to expect it - the placenta could attach in a different place and everything will be fine. Also, there is no reason to prepare for this to be our last child, she says that hysterectomy's are not typically the cure for the problem. . .

Anyhow, I have been very scared and worried about the outcome of this pregnancy, but it won't do any good because so far as I know, there is nothing they can do to detect or prevent this problem. For the record, they say this is not genetic, but my mom had the exact same thing happen to her when she delivered me. . .

<font color="#a62a2a" size="1">[ July 26, 2005 03:00 PM: Message edited by: nervousnelly ]</font>

[Accretamom]

Sultanategirl and nervousnelly,
Well, we definitely have a common ground. I was told by my specialist that he hears of this happening more in women that go post-term (which I did with my first, ironically, have a history of placenta previa, or previous C-sections. He believes that the root of the problem is adhesions, a sticky scar tissue. But, he admits that some patients just develop it for reasons unknown. True, there is no test to my knowledge still that can detect it. But, it has been 18 years since my youngest was born and I'm sure that there must be more information that is available to the medical field. I firmly believe that the key to having a healthy pregnancy and delivery in this type of situation is to be confident in your physician and educate yourself. If you are unsure of your physician's experience or ability, seek a second physician or third until you find the confidence in one. It is about team work and a highly educated and skilled physician. I think that finding one that specializes or least has experience in these types of high risk pregnancies is most important. Nervousnelly, your physician is correct...hysterectomies are not always the outcome and should not be the cure. In my case, after two accreta births, there was simply nothing left of my uterus to support another birth. I did retain my ovaries and still ovulate with no periods. I failed to mention earlier, I had no prior abdominal surgeries before my first pregnancy but I did have endometriosis. This is what caused my pelvic pain and contributed to scar tissue being formed. Although I had never been treated for it before my first pregnancy because the pain was so minor, it did become a greater problem after her birth. This was discussed by my OB/GYN as a probable cause of the placental attachment. After nearly losing my life and that of my first born, I was really grateful that I found another physician that took great care of me and was ready for the challenge of a second pregnancy and delivery.
I came across a study that was published recently that gives quite an insight into placental issues. It can be found at: www.cmnh.ca/papers/science.pdf
Of course, it is not meant for the lay person as we are, but for the medical society and can be confusing to understand. But, a fascinating read still.
As I said, education and confidence in your physician is certainly the best starting point. Taking good care of your body, being in tune with your bodies response signals, eating right, and maintaining a reasonable level of fitness is of the utmost importance. Being pregnant and having a normal delivery is traumatic enough on a woman's body. Women like us are not the general population and therefore should take extra care of ourselves to prepare for such a strenuous and emotional ride. I hope that each of you are gentle with yourselves. You both are women of strength and courage and hopefully will see the value in that itself. We as women seldom take the same amount of care of ourselves as we do our spouses and family members. That should be changed. If you want to remain strong, you must put yourself first and take that extra care. You are both worth it. Remember, it is only natural to try to obtain as much information as possible and I for one am a huge advocate for self education, but often what you discover on some websites are simply put there for shock value. Take it all with a grain of salt. Remember this too, each one of us is different and our bodies will respond differently to physical challenges, so don't assume that what happened to one woman will automatically happen to you. Try to stay positive, ignore the horror stories and focus on a positive outcome for yourself. My story had some scary moments for me and my baby, but we are both fighters and focused our energy on recovery. You both would benefit by doing the same. Focus your energy on yourself, staying healthy and strong, and keeping a positive attitude. It will amaze you when you discover what strong women you both are and what you can do. My prayers are going out for each of you and your families. Stay faithful, believe in your bodies healing power, and be gentle with yourselves. I'm hopeful for both of you and will keep coming back to get updates on my new friends. Take care beautiful women.

[sultanategirl]

Dear Accretamom

Before I forget please what is the name of the high risk obstetrician that handled your case? I'm currently on a holiday in Houston where I have some family and I would so like to get in touch with the physician that saw you through your battles.

I also want to say that you are an inspiration to me and I pray for God's blessings on you and your family, I pray especially that you will continue to give hope to so many like me who have just come out of this life changing experience and don't know where to turn. I want to thank you and everyone that has responded because since you guys sent your posts I have made a remarkable mental recovery.

Nervousnelly please take care of your self and your baby. I know it is a struggle to do this in our world with pressures ranging from financial to members of our family but like you and I know, your life and the life of that child mean more than all those pressures. Even as I type this message I know the struggle I have gone through and am still going through to get the people around me to understand that I need time to recover but you must prevail in this especiall for your baby. I find that in most of the experiences the accreta comes with other complications so please listen to your body and don't take anything for granted. As Accretamom said and experience has thought me ask questions all the time and gather as much knowledge as you can so you can prempt any problems. Doctors as I have learnt don't know everything.

[Accretamom]

Sultanategirl, his name is Robert L. Jacobson. His website is: http://www.houstonmfm.com Log on for more information.
I'm not sure where in this big city of Houston you are visiting, but he is on the northwest side of Houston. I would advise that you get him to refer you to a specialist in your hometown if possible so that you can get the finest care you deserve. He is a compassionate and highly skilled physician.
I'm keeping you in my prayers. Hope your visit in Houston is fruitful and memorable. And, remember this...the humidity is great for your skin. (ok, bad for the hair, but great for the skin!)

[Accretamom]

Sultanategirl, I forgot to tell you...best wishes. Let me know about your visit and if he can refer you to a top-notch doc in your hometown to give you the care you need and deserve. Maybe you can him be an advisor on your case or perhaps you may just want to come to Houston for care. Either way, I know you are destined to get the care you need and can only grow stronger from this experience. Remember, educate yourself (doctors are not gods and second opinionis, even thirds are your right), stay optimistic and healthy, and create a real team between you and your health care workers by communicating effectively (keep asking questions until you get the answers you need to reassure you and your spouse). Take care beautiful woman.

[nervousnelly]

Dear two,

Here is the thing that bothers me the most. I agree with Accreta mom, we can't be too worried about what happened to another woman because we are all different. The problem is, I do research to be prepared for the future and find certain info, and then when I talk to my doctor (who is a family practitioner) she says the info I am discussing with her just isn't right. She has referred me on to an OBGYN, the one that saved me following my first delivery. So at least this time I will be in different hospital with specialists that are prepared for my situation. I see this OBGYN next month and am anxious to get her take on my situation.

At my mom's suggestion, I got on the Mayo Clinic website and asked for some info. They were unable to give me any on this topic but referred me on to Medline Plus, where I copied and pasted the following for you to read:

"What is placenta accreta?"
Placenta accreta is a placenta that implants too deeply and too firmly into the uterine wall. Similarly, placenta increta and percreta are placentas that imbed themselves even more deeply, into uterine muscle or through the entire thickness of the uterine wall, sometimes extending into nearby structures such as the bladder. These disorders, which occur in about 1 in 2500 deliveries, are most common in women with placenta previa and in those who have had a previous c-section or other uterine surgery. Like placenta previa, these disorders often cause ******l bleeding in the third trimester and frequently result in the birth of a premature baby.

"How are placenta accreta and related disorders treated?"
In these disorders, the placenta does not completely separate from the uterus as it should after delivery of the baby. This can lead to dangerous bleeding after ******l delivery. The placenta usually must be surgically removed to stop the bleeding, and often a hysterectomy (removal of the uterus) is necessary. When placenta accreta is diagnosed by ultrasound before birth, a cesarean delivery immediately followed by a hysterectomy often is planned in order to reduce blood loss and other complications in the mother. In some cases, other surgical procedures can be used to save the uterus.

OK, it's me again. Now, once again this info supports my fears of a hysterectomy being performed which will take away our hope of having four children. (We do feel blessed to have the 1.5 we have. Lord knows that is more than some people get. . .) This also says that placenta accreta can be diagnosed through ultra sound, which my doctor says is not true. Maybe if it has grown through the uterine wall it can be detected?! I just get tired of the mixed messages. . .

Hope you are enjoying your ridiculously hot life and vacation in Houston! (My husband is from Midland by the way. . .) Thanks for listening ladies.

Nervous Nelly

<font color="#a62a2a" size="1">[ July 28, 2005 10:54 AM: Message edited by: nervousnelly ]</font>

[sultanategirl]

Dear Nervousnelly

The definition of Placenta Accreta in the Medline Plus website is correct but I disgree with the recommended treatment for this condition. For most practitioners and depending on the severity of the placental attachment a hysterectomy is the easy way out because it takes care of the bleeding and of the placenta which refuses to detach.

But there is another solution which I believe if applied in the right circumstance gives you a chance to save your uterus. That is to keep the placenta inside the uterus and treat the patient with methrotraxate which either dissolves or absorbs the placenta and IV antibiotics to prevent any infection. Though the degree of placental attachment normally determines if they use this procedure, I think you should find a doctor that at least is willing to try to save your uterus instead of writing it off at the first chance they get.

Please continue your research in this area and find a specialist physician that has experience in this field and has tried to save other womens uterus in this situation. Also you have to realise that there are a number of doctors, even specialists that have not treated someone with this condition or tried to use methrotraxate so it may help to ask the doctors you meet with what their course of treatment would be after the delivery of the baby. It would be good to find one that will try to save your uterus without of course endangering your life.

This is a tough process and I will not try to diminish what you're going through but please realise that at least you have the information that many wish they had when they were pregnant. Use this information as best you can and leave the rest to fate or God if you believe in Him.

I wish you all the best, please keep us posted on your progress.

[sultanategirl]

Dear Accretamom

Thank you for the information about your OB/GYN. I called him this morning and booked a pre-conceptual counselling for Monday evening. I'm really looking forward to meeting the brave doctor that had faith in your ability to conceive and saw you through till the birth of your baby.

I'll keep you posted on the outcome. Thanks again for everything.

[sultanategirl]

Nervousnelly

Oh yeah I forgot to tell you that my doctors say you can detect an accreta by looking at the blood flow pattern from the uterus to the placenta. Though this is not very specific information and I don't know the name of the test that shows an accreta but I know that doctors can detect an accreta the doctor just has to know what they're looking for and how to find it.

Once again good luck.