I'm home, safe and sound. And I have the preliminary results of yesterday's MRI.
No one is surprised that the MRI report suspects "myometrial invasion"... in other words, either an accreta or increta. But I do have to put my own special twists in, so not to be outdone, this time I apparently have added a bilobed placenta into the mix.
They theorize that a bilobed placenta occurs when the embryo implants in a less-than-desirable location (in my case, likely an area that had previously been compromised by surgery and scarring). In an attempt to find greener pastures, the placenta begins to migrate toward healthier tissue and atrophy in the middle. I happen to have one lobe anterior and one lobe posterior, with a network of vessels communicating between the two halves.
Fortunately for me, my placenta is not low-lying, so I do not have vasa previa, which would be much riskier. Nor do I have a velamentous cord
insertion, which means that the umbilical cord does not insert directly into the placenta, but rather into the membrane of the placenta where it loiters unprotected for a bit before entering the placenta. Alas, I did not know until after a thorough google search that I didn't have the cord insertion problem, which caused more than a few hours of concern as words like "fetal exsanguination
and death" practically leapt off the page and danced through my head.
We may now, however, have an explanation for my strange spotting episodes over the past month or so and maybe even for the heavy bleeding incident very early on. Or not. No one can really say.
I am currently waiting for my OB and my specialist to have a phone pow-wow so we can develop a specific game plan. It should be some variation on Hannah's birth: a very planned c-section with a full OR, a couple of radiologists, a gynecological oncologist, the director of anesthesia, and a nice supply of blood waiting in the wings.
Our big questions at this point revolve around timing (balancing baby's maturity with the need to avoid spontaneous labor) and overall risk, as it may be further complicated by the bilobed placenta. But I can sleep over the next few days as I wait for those answers because that's just a variation on what we've done before.
As for yesterday's procedure, well, I'm afraid it... well, it sucked. It sucked big, hairy monkey balls, as my husband would say. The day started out just fine; we were at Texas Children's Hospital, which as you would hope, is staffed by generous, compassionate folks. We weren't asked to fill out obscene amounts of paperwork, and they even called us back for our ultrasound a half hour early! The ultrasound lasted for about an hour and a half, and the technician was lovely. We didn't learn much about the placenta, but we did learn that Baby Sister is also measuring quite large (although, we all know how unreliable those predictions can be at this stage). At 34 weeks gestation, she's measuring at least two weeks ahead, and they estimated her weight at 6 lbs. 2 oz. With six weeks left until her due date, that's pretty freakin' impressive. Of course, she could just be long-limbed with a giant noggin.
We had to wait quite a while for the MRI, but that was no big deal. There was even a humorous moment when we were preparing to enter the MRI "environment" and Todd thought he was going to have to put on a gown. I should have let him think that was the case, just to see the look on the nurses' faces.
They told me the MRI should take between 15 and 20 minutes, if everything went smoothly. But it did not. It ended up taking more than an hour and a half, including two breaks to rearrange everything. It was brutal. Awful. Really, really bad. I can easily say it was the worst non-invasive procedure of my life. I moved quickly from discomfort to outright pain, with contractions and pressure the whole time. Baby Sister barely held still for any of it and they needed fluid in my bladder, which only served to make things worse. At one point, they were actually having me hold my breath during a contraction. By the end of my third and final session in that god-forsaken tube, I was thoroughly shaken. I needed a lot of help getting up to a sitting position, and as soon as Todd was within reach I began crying.
The doctor said he was sorry that it took so much longer than normal, and then he said he wanted to do another ultrasound. By the time we were done and I'd put my clothes back on, it was peak rush hour Houston traffic. Oh, and I hadn't eaten since 9:30 that morning.
Don't get me wrong, I still prefer a thorough evaluation and I thanked the doctor. But it was really an awful thing to have to endure, and I can say that having been through some truly horrible situations, both physically and emotionally.
So, there you have it. You know as much as I do at this point. Come Thursday, after my next visit with Dr. Save-a-Ute, I should know more.