Accreta questions (long)

[angeldoll33]

Hi,
My name is Paula, I am 31, and have 3 children 6,4, and 2. When my first was born, it took about 25 minutes after delivery to pass the placenta, I then bled for about 10 weeks after delivery (not heavy the whole time, like a 10 week period). When my second was born, the O/B (not the one who delivered my first) started pulling onthe cord after 5-10 minutes, pulled the cord out, and manually extracted the placenta. 12 weeks of bleeding (same intensity as previous pregnancy), had an U/S, discovered a little placental retention, left to resolve on it's own, which seemed to, bleeding stopped at 16 weeks post partum. I should mention tht both pregnancies were excellent, no sicknes, no problems, full term, both babies over 8 lbs. Third pregnancy was terrible. bleeding at 8 weeks, hemoraging at 14 weeks (told I was having a miscarriage, turned out to be placental abruption)Bleeding resolved, came off bed rest at 18 weeks, membranes ruptured at 25 weeks, on and off bleeding, but small amounts. baby induced at 33 weeks, 4'6, and healthy. Placenta took about 25 minutes to appear. In all three case, I needed my stomache 'massaged' to help shrinking. They think it is a 'mild' accreta problem, but they won't commit to any other diagnoses or prognosis.

My family is done, but I have a dear friend who can not have children (her ovaries were radiated for cancer treatment in close area) and I would love to surrogate for her. Everything I am reading is scaring me half to death though about my mortality if I do. I am willing to lose my uterous, if I have to, I have no need for it after this anyway, but I am terrified of not being around for my own children. Any idea if what I describe sounds like a real risk? Is my possible problem with accreta (maybe?) sever enough to not take the risk?Any thoughts and ideas are greatly appreciated! I have found alot of info on accreta, but nothing close to what I have had. Is it possible to just have 'sticky' placentas? or does this sound like a true accreta? Will it get worse with each pregnancy?

Sorry this is so long, but I have a ton of questions. I really want to be a surrogate for my friend, but if there is a fairly highchance tht it may kill me, I may have to re-think my plans......Please help!

Thanks,

Paula

[coachjodi]

Paula,

You are truly a dear friend!! I'm afraid your question is difficult to answer and I suggest that you consult with an OB specialist before making any decisions. That being said, most mortalitys with placenta accreta occur because the doctors don't know what they are up against, they rip the placenta out which causes the mother to hemmhorage and before they can get the bleeding under control, she dies. I sincerely hope, for your sake and mine [img]wink.gif[/img] that if the docs know the history, they can be adequately prepared to deal with it effectively. The fact that you might lose your uterus is indeed a reality and more likely than you dying. It sounds like your experiences were more like "retained placentas" which I guess is a mild form of accreta. Yes, it will probably happen again and the first thing you should do is request a sonahistogram so that they can take a look at the inside of your uterus. If they find a lot of scarring, I would seriously consider the risks in carrying your friend's baby, not only to you, but to the baby as well.

I hope this helps. Please keep us posted!

[angeldoll33]

Thank you so much Jodi,
I am in the process of getting a consult with an OB. My family doc (whom I trust) has given me the green light to do this, but said that my risks are a little higher since my last baby had all those problems during pregnancy. I was very fortunate with him though that with all I was going through on the outside, he was very happy and content inside. [img]smile.gif[/img]

I just would so love to help my friends. They have done IVF (unsuccessful), and the husband is reluctant to invest that kind of money again, so I would pretty much be their only opportunity now. (I should mention that this is my idea, they had not even considered surrogacy before I mentioned it).

can you tell me about this sonahistogram? Is it painful ect? Thak you again for helping me out on this. Best wishes,

Paula

[coachjodi]

Paula,

The sonahistogram was very uncomfortable for me. The doctor said it hurt me more than it would hurt others because of the scar tissue that I have. Basically they shoot some liquid into your uterus to expand it and then look around with a probe (like an internal ultrasound only your uterus is expanded). It felt like really really really bad menstrual cramps. Luckily it only lasted a few minutes and the doc was very gentle with me. It allowed them to see where the scar tissue was and the shape of my uterus. If you have a lot of scar tissue it significantly increases your chance for placental abruption because the placenta won't be able to attach succesfully (ironic isn't it?). Otherwise, some of us just have sticky uterine walls I guess.

Please let us know how your appointment with the OB goes. If you do decide to go ahead with this I would love to hear how everything goes so please keep in touch!!!!

Jodi

[angeldoll33]

Hi Jodi,
Thanks for your help. To be honest, I plan on going through with this unless there is a fair chance I could die, or a fair chance the baby wouldn't make it.I am not sure how far I want to take things diagnostically right now. My friend has been through so much medically with the cancer and the IVF, and she has told me it was terrible. I told them that it isn't right that having a baby shouldn't be costing them their savings, and that it shouldn't be so uncomfortable. I have told them about my last pregnancy, and explained that my risks are a little higher for difficulties, and that anyone can have miscarriage ect, so to be prepared for the worst and hope for the best. I think they all ready have learned that the hard way. (She was pregnant from the IVF for about 1 week, then lost the pregnancy) We are planning on a traditional surrogacy (fathers sperm, my egg), with an at home insemination, and have decided to start trying in March. I have a cruise planned for feb (don't want to be sick on board) and it gives us both plenty of time to make sure we are all on the same page, as there are alot of little details to consider. We are in Canada, surrogacy is NOT common here, and even the lawyers have no idea where to start! lol
My husband is a wonderful man who is extremely supportive, as we both think the world of these friends.
I will let you know how things work out, and what I find out from my O/B. Thanks again for being there!

Paula

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(just in case)

[pmciufo]

Paula,

You are a wonderful person for doing this! Both my sister-in-laws offered the same after
I had a stillborn (unrelated to the accreta I had) but I was able to get pregnant again and have a 5m old girl.

Jodi offers wonderful advice which you may want to think about and ask your dr for their opinion. At the very least I would get an MRI around wk 35 or 36 to determine if you have an accreta. Then they can plan for a transfusion or hysterectomy (if you agree to this). The main thing is that you and your dr have no surprises.

Good luck to you and bless you for giving your friends such a wonderful gift.

-Paige

[angeldoll33]

Thanks Paige
That is wonderful that you went on to have another baby! Did you have an accreta with both your pregnancies? How did thigs work out after your little girl was born? I have to say that I am optomistic, as I have 3 healthy kids, and carried them all, so I naturally feel that of course, it will be the same this time.My life is important though, so that is one risk I can't take.
I will have to see what the O/B says. my family doc has said that if I do get pregnant, he will refer me to the high risk guys, since the problems with my last pregnancy. It is weird, but my gut feeling is that I do have a mild accreta problem, and because of the manual extraction I have scaring. I feel in my case though that that is probably the reason I didn't lose my son, is that the accreta kept the placenta from ripping right off early on. I will keep you updated! Thanks again for the kind words!

Best wishes,

Paula

[pmciufo]

Paula,

I did have accretas with both pregs. The first they left the whole placenta in after trying to do a d&c. It was stuck and manual extraction wasn't working. I was transfered to a larger hospital where I met my now new dr (high risk). He left the placenta in since I wasn't bleeding. We don't know completely why we lost our daughter Samantha. She was stillborn at 37 weeks. She looked perfect and an autopsy turned up nothing. They think I may have passed a blood clot through the placenta.

Second preg was full of problems - bleeding, diabetes, placenta previa and thanks to the MRI, accreta was discovered. I had a mild accreta and delivered Allison via c-section. Everything turned out wonderful and both me and my dr was prepared for anything. As scary as it was for those 9 months, I really liked my dr and knew that he wanted only the best for me. He went above and beyond. He will deliver our next child if we are blessed to have that chance again.

What ever you decide will be the right decision for your family. Make sure that you feel 100% confident with your new dr - it makes all the difference.

Best wishes for you.

-Paige