A New Perspective

Husband and I soon learned that there is a difference between acknowledging the worse case scenario, and actually preparing for it. Although the perinatologist couldn't definitively determine if an acreta was present on the ultrasound and was recommending an MRI, we both knew it most likely was there, or if not present now, it would become an eventual acreta. Cue the launch into research mode. We kept reminded ourselves that everything would be planned with my delivery with all the necessary professional and equipment in place. Yet I read one chilling statistic in an ACOG bulletin; Be mindful that even with a planned delivery, the mortality rate with a placenta acreta is still 7%. Husband found the original research article that produced that statistic and discovered that it was published in 1996, which was offered us some comfort, but not quite enough. Husband recommended that I contact my parents to invite them out before the delivery date. 'If for some reason you didn't make it, they wouldn't get over it if they didn't see you beforehand." I spoke with my parents and filled them in on all the potential complications with a placenta acreta. My mother started crying. It was the lowest moment of my pregnancy, if not of my life. I couldn't help going back to some of the deepest and darkest places during my infertility days. Why did we not pay any attention to all the obstacles the Universe kept throwing at us? Maybe we really weren't supposed to procreate and now we're being punished for defying natural law.

I wasn't in a particular hurry to have the MRI performed. Yet, in one business day, my insurance issued authorisation for the procedure and I received a call from the imaging department with a next day appointment. It makes you wonder how serious a condition is when bureaucracy moves this quickly. The MRI itself wasn't too bad, although,  I admit I had an emergency dose of Ativan to use if needed. I also wasn't too anxious to receive the results. I figured the MRI would either confirm the presence of the acreta, but even if it didn't show anything now, it wouldn't mean that is still couldn't become an acreta.

We met with my OB on the day after my MRI. She viewed the films with a radiologist as did the perinatologist and they all compared notes. They all agreed that there is no evidence of an acreta. No abnormal lacunae were detected. The location of my placenta noted that the edge of the placenta is right at the internal os of the cervix, with a lip of placenta tissue overlying the os. Although it was described as a likely persistent previa, it seems to be much closer to resolving than previously noted on the ultrasound. Both my OB and the radiologist feel that an MRI is more precise for determining placenta location, as an  ultrasound is more operator dependent. The perinatologist doubts that the previa will resolve, but he admits he's been wrong before.

This was by far the most encouraging news we've heard. At this point in time, we're looking at a C/section at 36 weeks if the previa persists. If by some miracle it resolves, we can proceed with an induction between 37 and 38 weeks to try for a vaginal birth. Although I know that my cervix would probably be unfavourable at that gestational age and I could be tortured for a few days just to lead into a C/section for a failed induction, but for someone who was preparing for a hysterectomy, it was unbelievable just to have a conversation where a vaginal delivery was on the table. Of course, things could change by the time we have our next ultrasound and we could be revisiting the acreta scenario again, but for now and the next few weeks, we're going to celebrate this news as a victory!

So, remember how I feared my fertile friends would be too keen to share their know-it-all expert advice? Well, sometimes it turns out they can be pretty helpful. Myrtle sent me a text suggesting that we should start looking into day care centres as we would probably need to secure a place months in advance. We had discussed looking into doing a Nanny share with our friends Amy and Sheldon, as they had one with their first child. Every other week, the Nanny and the other child come to your house. While it would be incredibly convenient on the weeks where everyone descends upon our place, they live in the next town over. It's in the opposite direction from my work and the commute would involve some of the most mind-numbing, infuriating traffic ever. The transport could easily consume two hours each day. Location was upgraded to a priority feature for our day care search. Lo and behold, we found a reputable centre within three-quarters of a mile from our house. We could walk there if we felt so inclined. I made an inquiry and learned they had four spots available in the time we need. We attended an open house and were impressed with the cleanliness and organisation. I put my obstetrical skills to work and sized up the gestational ages of the other expecting couples and estimated that there were five couples including us looking at the same time frame. Husband slipped out to get our cheque book, as it is only a two minute drive to our house. We put down a deposit and our child, who is not even born yet, is enrolled in day care. Did I mention how convenient the location is?

We received some more good news, as the HOA finally approved our requests related to our garage project. After a month on hold, work can continue! Additionally, I passed my glucose test with flying colours and I'm trying to avoid needing a transfusion with a solid haemoglobin at 12.8. Wow. We're racking up almost as many wins as the UCONN Women's Basketball team.