Wednesday, 5 October 2011

My Rock and Hard Place

I am 27+2 weeks pregnant and am being asked why the Doctors are leaving me in this situation, why won't I be induced.  I will try to explain.

Being induced becomes a bit of a legal nightmare after 24 weeks.

To clarify I am over 27 weeks pregnant now yet the baby is not deemed viable because it is under 500gm (roughly 430gm).    At the same time cannot be considered 'incompatible with life' which would allow you to opt for selective termination or Termination for Medical Reasons because it does not have any diagnosed illness apart from being just too small.

Furthermore, because there is a slim possibility that the baby would survive the birth, if it did would have a high probability of being brain damaged not to mention have heart damage due to the enormous strain caused by severe growth restriction (IUGR) along with all the other conditions that accompany premature birth (moderate or severe cerebral palsy, bilateral blindness, bilateral hearing loss requiring amplification) this in itself is a huge risk.

Thanks to my condition, I grow my babies healthy right to the tipping point but never quite make it over, it dumps my baby just before the 'viable' line  I can see it, it is only 50gm away.

Sadly 50gm is too much, my baby can't put any weight on now the placenta is so clogged up now by all the junk (medical term histiocytes) I fired at the intervillous space (the space in between the finger-like vessels  of Mum and placenta) that's where the space should be full of free flowing nutrient-rich blood, which then flows to baby (click on link above and behold the empty, clear space) it is probably now looking like a car park of histiocytic junk, this is the face of what is killing my baby Chronic Histiocytic Intervillositis.

What this means.  So the basically not enough blood is getting through, hence reverse Dopplers or Reverse End Diastolic flow.  Reverse flow normal indicates the need for immediate delivery, leaving a baby in the womb with this finding means the baby is conserving all the blood it does receive and trying to direct it to vital organs, in a bid to survive.  Everything is sent to the brain and heart, but this is unlikely to be enough and is sure to result in brain and heart damage.  This is also why the fluid levels drop, (often expressed as Oligohydramnios or anhydramnios) there is no more peeing from baby.

So what do I do? 
1)  Wait until baby shows signs of distress and then the heart fails (this could be days, couple a a couple of weeks)? Does this not seem cruel?   
2). Do I deliver and hope that the little doesn't make it through labour or survive a little after and pass away in my arms?  
3). Will I be responsible for pushing for an induction which could result in a severely disabled baby?  
Three impossible choices like last time.

I am what is considered to be between in a real rock and hard place scenario. 

2 comments:

Catherine W said...

What an impossibly difficult situation and such a cruel position to be in, just at that tipping point for viability. You and your beloved baby are in my thoughts xo

aMuminwaiting said...

I have been thinking about you and your baby since you contacted me on my thread. If one good thing could happen in this crappy word then it should be that your baby is saved. In this horrific situation I can't believe you are expected to make these terrible decisions, it should be taken out of your hands so you don't have that burden on top of everything else you have to deal with. My experiences of losing my babies does not compare with yours but I know that I blame myself for everything. It's cruel for care providers (seems like a contradiction in terms sometimes) to put you in a situation where you will blame yourself no matter the choice made. I hope your immediate suffering is over soon but I know the pain will stay with you. I'm so sorry and I know that isn't enough.

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