Birth of Isaac Benjamin - 19th December 2011
32+2 weeks, W:1.9kg, L:44.3, HC:31cmFirst of all, this might be long!!
I had experienced pre-eclampsia in both previous pregnancies, so the decision to have a third child was not made lightly. We wanted a 3 year age gap so 3 months and 1 month prior to TTC I had a full health check, bloods and blood pressure done and I came back with a clean bill of health each time. Everything you read about PE says that it is either milder or non existent in subsequent pregnancies so we had our GP's blessing to try for a baby. We fell pregnant second cycle but when I returned to my GP with a positive test, my blood pressure was really high. I started on medication at this time which was about 6 weeks along. From that day I suspected things weren't going to be great. Even with severe PE last pregnancy combined with HELLP Syndrome with my second, the symptoms didn't begin until 34 weeks. My GP referred me to a high risk ob straight away based on the blood pressure and my history.
From 8 weeks along I have seen my ob at least weekly and we developed quite a good relationship. Not a single week has gone by ever where I haven't been at the hospital at least once. From about 18 weeks I have been there up to 3 times a week. This isn't so bad because I live about 400m away from the front doors!! At 14 weeks I had my first admission into hospital and by that time my medications (multiple by this stage) had increased several times. I was told that to be on so much medication, with such early signs of PE it was not a great and that I had to prepare for the fact that baby may need to be delivered before the 'safe' 24 weeks to protect myself.
At 20 weeks I flew to Brisbane to have a fetal echo done on bubs heart due to complex congenital defects in a previous child. During that scan they found that the heart was ok, but I had a condition called Bilateral Uterine Artery Notching. This meant that blood flow to the baby in both the right and left uterine arteries was resisting. I was told that eventually it would cease resisting and reverse completely, causing the baby to go still. They said delivery would probably happen from 25 weeks and 30 being the absolute best case scenario. I would need scans fortnightly to check the blood flow through these vessels.
The problem with that was my hospital was not able to perform these scans. It is quite specialised and next to no hospitals test for it, nor have the equipment to do so. The notching is an audio sound not a visual thing and only research hospital have that kind of equipment. All my hospital could do was growth scans to test for IUGR and assume that if bub wasn't growing properly then the notching was getting worse. I have read on other forums (all overseas) where others have had this condition. They all had babies under 30 weeks, still births or previous unexplained still births so it was quite scary. Not a lot is known about why some women get pre-eclampsia, but the recent discovery of this notching may be a cause and certainly reason for high blood pressure.
Anyway, I was hospitalised around 4 more times due to my blood pressure with many more overnight stays in the obs unit without actually being admitted. I was at the hospital literally ALL THE TIME!! My ob referred me to the Mater Mothers in Brisbane as even though they could manage my condition, it was inevitable I was going to deliver early and there is no NICU in Central Qld. If bub had have been born before 34 weeks back home, he would have needed to be transferred with the Royal Flying Doctors. We've been there, done that with our second and didn't fancy it again so we played it week by week and I headed down to Brisbane in late November at 29 weeks.
I was at the new hospital just as often as my old one. My father drove me up most nights because my BP was so high. The first few times I was sent home with medication increases (MORE!!) but my body didn't respond. On the 14th of December I was admitted again and I just knew that this time I wasn't coming home without a baby. They played around with my medication a bit more to try and keep bub in longer. I was told there was really no more scope for further medication increases or additions though and that if my body didn't start responding, delivery it would be. I was on the maximum dose of 3 meds, and was on a supervised dose of another which exceeded the maximum dosage. I also had various other meds that they randomly brought me all day that were one offs to bring the BP down quickly as well as meds through the drip. No quicker had I swallowed one lot of pills, another arrived!!
On the morning of Monday the 19th of December the nurse came in to do my usual 2 hourly obs and the blood pressure was up around 190/125. I had doctors in and out all day and a few of them mentioned delivery briefly. I didn't really take them seriously though because other doctors would say "no, I don't think today is the day but we do have to watch you." Because I wasn't asked to fast, I assumed that it was all a bit of hypothetical talk. At around 3:30pm though, I was just laying in my hospital bed reading when about 6 doctors walked in. They said that my bloods for that day had come back and they I needed to go for an emergency C/S straight away. I asked if I could take a shower first but was told absolutely not, I was experiencing kidney insufficiency and in complete liver failure. I then began to throw everything in my suitcase but they said "no, we have to go now... no time for that either and someone would pack my things for me." I was high risk for both seizure and stroke and . the next thing I was being wheeled to theater.
From there things happened so fast I barely remember the details. I did manage to keep my phone with me though and told DH that our baby would be born soon. Of course, he was not there for the birth.
The C/S was fairly straight forward but I do recall it taking about 4 times as long as my last one. They said there were some complications with the bladder stuck to the uterus with scar tissue so they had to pull it away which was delicate. Bub cried a very soft and quite gentle cry when he came out and it was nice to hear as our second didn't cry and that was a bit scary. Bub was then taken to NICU pretty much straight away. From theatre I also went to the Intensive Care Unit over at the adults hospital as I (despite still feeling fine still at this stage) was still exceptionally unwell.
I spent 2 nights in the Intensive Care Unit. Despite feeling great all pregnancy, this was the first time through the entire ordeal that I was, felt and knew how incredibly sick I was and how serious it was. Up until then, it's hard to believe you are sick when you feel fine. I couldn't get my head straight, and the world was like a fish bowl. When people spoke to me, they echoed. I was vomiting (which REALLY REALLY hurts after C/S) and my body wouldn't work. I couldn't even move my jaw to eat a biscuit. I had a canula in each hand with anti fitting medication and magnesium going through. I also had a central line and an arterial line. The most painful was a second by second blood pressure monitor that was inserted through my wrist to half way up my forearm. I also had a button which would let me have morphine every 5 minutes. I needed this because they scanned my kidneys about 5 times several hours apart and they had to roll me on my side to do it which was excruciating straight after C/S.
Anyway, I got out of intensive care on day 3 with full kidney and liver function. They said they were glad they delivered when they did because I might not have been so lucky. My blood pressure has also come down a lot and I am now on 4 pills a day from about 30 something!! As far as bub goes, well he is perfect.
I met him on the afternoon of day 3 and we gave him a name that night. Being born at 32 weeks he has needed some assistance but he has done super super well and come off CPAP literally weeks ahead of schedule. He is a very healthy baby and we don't need to worry about him at all. He will be in the NICU for about 6 more weeks but that is just growing time... he isn't ill. After having a critically ill cardiac baby and putting him through 2 heart surgeries in his first week, it's so nice to have a healthy baby. He was 1.9kg born which is apparently huge for a 32 weeker too so he would have been a big boy full term!!
To be honest, things have worked out great. At first I was told I would not make 24 weeks, then they said 30 weeks was best case scenario so 32 weeks is wonderful.
We are so happy to have our little boy.
Well, that's pretty much it. Sorry it's long but on a final note I do want to mention that I was asked if I would consider donating my placenta for medical research. Despite pre-eclampsia being the number 1 reason for maternal death world wide, not much is known about why it happens. Uterine Artery Notching is only a very very recent discovery in the medical world and they want to study my placenta to understand it more. Of course I had no plans for it so I agreed. During delivery I heard them make a big deal about getting it on ice ASAP and it was apparently being flown down south. I feel really good about this because if I can contribute to saving one baby from being born early or still, then what an incredible honour to participate.
Thanks for reading.
Bek: 33
DH: (Rob) 32
Luca Adam: Natural birth in Jan 2006, 3.6kg & BF for 22 months!!
Elliot Robert: Emerg C/S in Dec 2008, 2.8kg & BF for 29 months!!
Isaac Benjamin: Emerg C/S in Dec 2011, 1.9kg (32+2) & BF for 5 mths + with early help from Mothers Milk Bank!! 