Bedrest, fun! (or not…)

August 12, 2010

Pregnancy 1

It’s been a little while since I’ve posted. Largely because there just hasn’t been much to report. We’re still in the 1st trimester where not a whole lot happens. I mean, B has progressed up to the size of a lime, but that’s about it.

Until last night.

Remember that spotting I had around week 6 (that triggered an early ultrasound visit)? The finding on that was that the bleeding was caused by a small sub-chorionic hematoma, or SCH. An SCH is fairly common in pregnancy, and is basically when the placenta detaches a bit from the uterine wall resulting in a bleed (thus hematoma). When these are small, they often go away on their own — the body reabsorbs the blood and the placenta heals back up to the uterine wall. I didn’t have any more spotting after that first ultrasound, so it was reasonable to assume that healing is exactly what happened.

This next bit is going to be TMI, so don’t read it if you’ve a weak stomach.

Last night around 10 PM I started to gush blood. No pain, just bright red blood running down my legs as I ran (well hobbled) to the bathroom. You learn when you’re pregnant to inspect any blood with a fine-toothed comb (or at least eye). There was no tissue in the blood (I.E.: this didn’t appear to be parts of B) and that was good and helped me not to panic too much. The gush stopped almost as suddenly as it began, and I paged our CNM.

CNM called us back and was wonderful. She suspected the SCH right away, but said that for now, if nothing else happened (no more bleeding, and no cramps) then we should just leave well-enough alone, which I agreed with. So I desperately tried to sleep last night with little luck.
I had at least one more bleed in the middle of the night (though it was smaller) but then at noon today I had another gusher. Time to call CNM again!

This time, given the amount of blood, we decided it was time for another ultrasound to see a) if the baby was still kicking; b) where the blood was coming from.

THE GOOD NEWS: B is still kicking! And boy is s/he ever! That little one just didn’t want to stay still for any pictures that our very patient ultrasound tech wanted to capture for us. We got to hear the heartbeat, still nice and strong at 158 BPM.

THE NOT-SO-GOOD-NEWS: That SCH? it didn’t heal — it got bigger. Quite a bit bigger. Not as large as some I’ve heard of now that I know what to go and obsess about on the Internet, but nothing to sneeze at, either.

So… WELCOME TO HIGH-RISK PREGNANCY! I feel like I should be given a welcome gift, or something.

Basically, we’ve got a few possible outcomes now:

1. The SCH bleeds out and heals itself.
2. I pass the entire SCH and then heal.
3. I pass the entire SCH and the placenta fully ruptures from the uterine wall. If this happens any time soon, we’ll lose the baby. If it happens after 20 weeks, then we may have a shot at bringing a serious preemie into this world.
4. The SCH just gets bigger and the rupture is big enough that it a) affects the baby’s growth and nutrition negatively; b) causes one of those full ruptures mentioned in the last item.
5. The SCH never entirely heals, but doesn’t get any worse and just complicates labor.

Obviously we’re hoping for door numbers 1 or 2 or 5 (in that order!).

What can you do about an SCH? Well, it can’t be removed… there’s really nothing to be done except wait and give your body every chance to heal itself. For me (recommended by CNM and I concur) this means “full pelvic rest” which is basically “bed rest” for all intents and purposes. The basic idea is that you don’t want your pelvic muscles putting any strain on the uterus. Also, reclining or laying down is better for getting nutrients and oxygen to both you and the baby, so it can help heal.

No sex, no tampons – ok, easy. No stairs, no exercise, no lifting, no walking, no sitting around in chairs or cars, no vacation that we were supposed to leave this Saturday for. Not so easy. Possibly not being able to travel in October to visit family and work headquarters across the country. Also sucky.

Look, I’m lazy, and I’ll admit that I was already taking a little advantage of the 1st trimester lethargy (that’s been my biggest symptom by far). But now I don’t have a choice. And we’re probably not talking 1-2 weeks here… these things often take quite a while to heal (beyond 20 weeks is fairly common). If it gets smaller, I may start to be allowed to have a little more activity, but we’ll just have to see.

But right now I’m still thankful. Right now I’ve got ultrasound pictures of B in profile, with a little arm and little feet and a nose and eyes and ears and a flickering heartbeat. Right now B is alive and M and I are alive, and we have each other. And I’ll gladly trade vacations for a live-born child any day of the week.

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