accreta. cesarean hysterectomy. delivery by 37 weeks.
2-vessel cord. anterior, low-lying placenta. growth restriction. marginal cord insertion.
‘you could wind up with 4 healthy babies without a mommy.’
this pregnancy took a very quick turn for ‘all things scary’ and while we’ve spent the last few weeks/months praying for change it simply has just become worse. i’ve cried. a lot. from fear  to guilt and back to fear… my cheeks are tear-stained and yet, despite all of it, there is still SO MUCH good news in all of this.
…let me back up…

i’ve never had an ‘easy’ pregnancy or delivery.
from vasa previa that landed myself on bedrest at 19 weeks, hospital bedrest at 28 weeks and was life-threatening for lila, which ended in an emergency c-section at 31 weeks…
to an attempted {and ‘failed’} VBAC when i contracted the chorio infection with miller and he wound up in NICU on antibiotics after yet another c-section….
that’s 3 pregnancies {an early miscarriage with an angel baby}. 2 c-sections. 3 babes {twins}.
but with the go-ahead from all of our doctors, none of the complications put us at any higher risk for repeated complications. the water ultrasound prior to us attempting to conceive showed a healthy uterus to ‘house’ a healthy pregnancy.

my ob prefers my anatomy scan at 20 weeks to be done by a maternal fetal medicine specialist {high risk} due to the previous vasa previa {not to be confused with placenta previa…they are completely different} so when we went for our anatomy scan at 20 weeks to check on our sweet baby girl, we quickly earned ourselves a frequent flyer card back to high risk very quickly.

2 vessel cord: some basic anatomy… a baby’s umbilical cord in utero has 3 ‘vessels’ comprised of 2 arteries and 1 vein that is encased in a sheathing that runs from baby’s ‘belly’ to the placenta delivering nutrients, oxygen, blood, etc. in baby girl’s case, she is missing an artery so her umbilical cord only has 1 artery + 1 vein making for a 2 vessel cord. complications can include heart, kidney and growth ‘problems’ which warrants monitoring throughout the pregnancy. the amazing news is that baby girl seems to be completely unaffected and is measuring a full 2 weeks ahead of schedule AND all organs look perfect. PRAISE GOD.
marginal cord insertion: another term that loosely falls under the umbilical cord/placenta abnormality realm… the cord should be inserted directly into the middle of the placenta {which should look like a deflated ball} and baby girls’ is off to the side, which can also cause growth complications.

anterior low-lying placenta: the placenta can attach itself anywhere in the uterus but baby girl’s is on the front of my belly, which in and of itself doesn’t cause too much concern except it is ‘low’ and is lying right over my previous c-section scars. again, not a huge problem except it can change plans for a repeat c-section. given that knowledge though can help them plan delivery.
accreta: aka, bad news. that really important placenta that we found out is anterior + low lying is now growing too deeply into my uterus, which doesn’t effect baby, but it does cause major problems for mama. when it comes time for delivery, if the placenta sticks to the uterus, there is no safe way to remove it without the concern for significant bleeding causing an extreme emergency very quickly.

so what does all of this mean???
the recommendation is a ‘complete’ cesarean hysterectomy at time of delivery including uterus, cervix + tubes with the plan to leave ovaries….at gestational age of 36-37 weeks.
the basics are that we will go in for a scheduled c-section, baby girl will be delivered, the cord will be clamped, cut + stitched then placed back into the uterus. zach will go to be with baby girl, then, they will immediately begin to remove the uterus before it has time to detach which could cause significant bleeding. because a hysterectomy is normally completed when the uterus is so small and contained, it is usually a fairly routine surgery…but because i will hopefully be 37 weeks pregnant, my uterus is SO big and vascular, invading virtually everything in my abdomen making this more complicated than usual.
i will meet with ob/oncology because they will be the ones performing the hysterectomy due to the complicated nature and the fact that they are THE BEST at surgery and the GOOD NEWS is that if we follow ‘the plan’, we have the best chances for an ‘uneventful’ delivery.
the hope will be that i can stay awake during the hysterectomy so i won’t have to come out of anesthesia but that’s to be determined.
i will continue to have ultrasounds at high risk and follow up with my ob, meet with oncology and solidify our plan.

for now, i’m praying for peace. if i’m being very honest, i still struggle with the trauma of the twins’ pregnancy/delivery and i was so hopeful that this would be the easy pregnancy/delivery we’ve hoped for….but the finality of this surgery is hard to swallow. it’s not that i don’t feel blessed because hear me loud and clear, i feel beyond blessed for these beautiful little babies we have been given. but a hysterectomy was not in the plan, nor should it be for a woman at 31 years old. each appointment has brought so much information to try to understand, questions to ask, and up until recently, i had never even heard of accreta…let alone the fact that if we pushed it we could wind up with 4 healthy babies without their mommy…and that ‘alternative’ isn’t even an option.
there is so much light…baby girl seems to be unaffected and if we follow the plan, she should be very safe and zach should be able to do skin to skin with her until i’m in recover…. so while i have my moments, i’m trying to focus on all the positives and simply find joy through the remainder of our pregnancy. i’m doing all the things i ever wanted to while pregnant and heavily relying on my support system to help us get through the details of it all.
i have no doubt that god already knows the outcome. he already knows the details and it’s simply in His timing.

here’s to the next 3 months… grow big + strong, sweet girl.