Posts from — May 2012
Bottle Feeding
I had all intentions of breast-feeding. I bought my breast pump, storage bottles and researched the best things to eat while breast-feeding. I had decided to breast feed long this time than with my first son. His breast-feeding was interrupted in the third month because of a dental emergency. After 10 days he wouldn’t take the breast again.
This time around however because of all the medical complications it just wasn’t happening despite my efforts. So formula it is. But I can tell you with a newborn if you are not a confident as a mother you would go crazy as everyone as some piece of advice or criticism. With bottle feeding you can see the look of horror and judgement on other mothers faces when they see you pull out a bottle. They have no idea as to your circumstances but they immediately judge that you are a bad mother or trying to be fashionable etc by bottle feeding. It’s not nice at all. You get it at the doctor’s office and wherever you go.
Bottle feeding and finding the right formula for your baby is trial and error. Yes you may have to throw away or if you are lucky like me with three friends with new babies give away formulas that don’t work. Its an expensive process. Dr’s recommend anything Enfamil and for me the first time it did not work and my son went on Lasco Soy and because its not a brand name people look down on it. But my son is healthy and doing well. So this time around after starting with the Enfamil as my son was premature etc. I went with what was recommended. After weeks of griping and hours of dealing with a screaming baby each night and stomach issues seven weeks in I am now on Lasco Soy. Stomach issues and griping gone.
Well the Lasco Soy isn’t as cheap as it was when I had my son but its cheaper than the Enfamil and it has now allowed my son to sleep longer and me in turn.
Also ours grandmother used to boil the bottles in a pot and they think its absurd this thing call a sterilizer. Let me tell you its the best thing since slice bread. I used it with my son before and nothing happened to him and will continue this time around. Older person will think you are lazy and that the bottles aren’t being cleaned enough. Trust me as long as you follow the instructions for your sterilizer it is. I use Avent everything, as I trust Avent as I used it before.
All in all trust your instincts, do your research and do what suits you best.
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May 10, 2012 1 Comment
What Is Placenta Accreta?
Placenta accreta is a severe obstetric complication involving an abnormally deep attachment of the placenta, through the endometrium and into the myometrium (the middle layer of the uterine wall). There are three forms of placenta accreta, distinguishable by the depth of penetration.
The placenta usually detaches from the uterine wall relatively easily, but women who encounter placenta accreta during childbirth are at great risk of haemorrhage during its removal. This commonly requires surgery to stem the bleeding and fully remove the placenta, and in severe forms can often lead to a hysterectomy or be fatal.
Placenta accreta affects approximately 1 in 533 pregnancies.
Variants
There are multiple variants, defined by the depth of their attachment to uterine wall:
| Type | Description | Percent |
|---|---|---|
| placenta accreta | An invasion of the myometrium which does not penetrate the entire thickness of the muscle. This form of the condition accounts for around 75% of all cases. | 75-78% |
| placenta increta | Occurs when the placenta further extends into the myometrium, penetrating the muscle. | 17% |
| placenta percreta | The worst form of the condition is when the placenta penetrates the entire myometrium to the uterine serosa (invades through entire uterine wall). This variant can lead to the placenta attaching to other organs such as the rectum or bladder[2]. | 5-7% |
Diagnosis
Placenta accreta is very rarely recognised before birth, and is very difficult to diagnose. A Doppler ultrasound can lead to the diagnosis of a suspected accreta and an MRI will give more detail leading to further suspicion of such an abnormal placenta. However, both the ultrasound and the MRI rarely confirm an accreta with certainty. While it can lead to some vaginal bleeding during the third trimester, this is more commonly associated with the factors leading to the condition. In some cases the second trimester can see elevated maternal serum alpha-fetoprotein levels, though this is also an indicator of many other conditions[3].
During birth, placenta accreta is suspected if the placenta has not been delivered within 30 minutes of the birth. Usually in this case, manual blunt dissection or placenta traction is attempted but can cause haemorrhage in accreta.
Risk factors
The condition affects around 10% of cases of placenta praevia, and is increased in incidence by the presence of scar tissue i.e. Asherman’s syndrome usually from past uterine surgery, especially from a past Dilation and curettage,[4] (which is used for many indications including miscarriage, termination, and postpartum hemorrhaging), myomectomy,[5] or caesarean section. A thin decidua can also be a contributing factor to such trophoblastic invasion. Some studies suggest that the rate of incidence is higher when the fetus is female.[6]
Treatment
The safest treatment is a planned caesarean section and abdominal hysterectomy if placenta accreta is diagnosed before birth.[7][8]
If it is important to save the woman’s uterus (for future pregnancies) then resection around the placenta may be successful.
Conservative treatment can also be uterus sparing but may not be as successful and has a higher risk of complications.[8] Techniques include
- leaving the placenta in the uterus
- intrauterine balloon catheterisation to compress blood vessels
- embolisation of pelvic vessels
If the woman decides to proceed with a vaginal delivery, blood products for transfusion should be prepared.[9]
References
- ^ Wu S, Kocherginsky M, Hibbard JU. Abnormal placentation: twenty-year analysis. Am J Obstet Gynecol 2005 May;192(5):1458-61.
- ^ Miller, David A. (2 November 2004). ‘Accreta Obstetric Hemorrhage‘ High Risk Pregnancy Directory at ObFocus. Accessed 25 January 2006
- ^ Mayes, M., Sweet, B. R. & Tiran, D. (1997). Mayes’ Midwifery – A Textbook for Midwives 12th Edition, pp. 524, 709. Baillière Tindall. ISBN 0-7020-1757-4
- ^ Capella-Allouc, S.; Morsad, F; Rongières-Bertrand, C; Taylor, S; Fernandez, H (1999). “Hysteroscopic treatment of severe Asherman’s syndrome and subsequent fertility”. Human Reproduction 14 (5): 1230–3. doi:10.1093/humrep/14.5.1230. PMID 10325268.
- ^ Al-Serehi, A; Mhoyan, A; Brown, M; Benirschke, K; Hull, A; Pretorius, DH (2008). “Placenta accreta: An association with fibroids and Asherman syndrome”. Journal of ultrasound in medicine 27 (11): 1623–8. PMID 18946102.
- ^ American Pregnancy Association (January 2004) ‘Placenta Accreta‘. Accessed 16 October 2006
- ^ Johnston, T A; Paterson-Brown, S (January 2011). Placenta Praevia, Placenta Praevia Accreta and Vasa Praevia: Diagnosis and Management. Green-top Guideline No. 27. Royal College of Obstetricians and Gynecologists.[page needed]
- ^ a b Oyelese, Yinka; Smulian, John C. (2006). “Placenta Previa, Placenta Accreta, and Vasa Previa”. Obstetrics & Gynecology 107 (4): 927–41. doi:10.1097/01.AOG.0000207559.15715.98. PMID 16582134.
- ^ Committee On Obstetric, Practice (2002). “Placenta accreta Number 266, January 2002 Committee on Obstetric Practice”. International Journal of Gynecology & Obstetrics 77 (1): 77–8. doi:10.1016/S0020-7292(02)80003-0. PMID 12053897.
External links
- Placenta Accreta and Percreta: Sonographic, MRI, and Surgical Correlation at OBGYN.net
- Placenta Accreta at ForParentsByParents.com
- Placenta Accreta Diagnosis and Management at Expecting-Mums.com
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May 9, 2012 No Comments
Pregnancy & Delivery
It has been a while since I have logged in to write. Reason being I had a very difficult pregnancy and a near death delivery. I have come away with three
life lessons:
1. Trust your instincts
2. Know your body and never be afraid to call your OB over something that others think is trivial
3. Trust in the creator or God whoever he may be to you as when all things fail he will see you through
My pregnancy from the beginning was painful. But my doctor sent me to do a ultra sound which showed nothing. I had done a previous c section so they thought the pain from that was due to that c section cut. But in my mind I knew something was wrong. I kept feeling this pain in my left side that as time went along got worse. Still no explanation after two ultra sounds. So I thought maybe I am just overreacting. But I noticed signs along the way that everything was not ok.
Based on past experience and what was happening I registered at UWI just in case something went wrong I had an option. Let me tell you the hours spent waiting to see on OB on your app.t day was crazy. I would have a 3pm appt and had to go at 12pm just ensure I saw the doc early to get back home in time to pick up my son from school. After three appts. and less than satisfactory care and concern I gave up and returned to my private doctor who answered my every call and concern during the entire process even though I was registered elsewhere. Let me tell you that was the single most best decision I ever made as it was life saving.
36 Weeks on from the night before I started having pains I waited a while but by the next morning I knew something was wrong and rushed to the hospital. Long and short I had my son via c section but then found out during surgery what the issue was, placenta accreta which led to further complications and an additional surgery and time spent in intensive care and after many efforts the docs telling me they had done all they could do, there is nothing more that can be done. But thanks to my doc he tried everything and thanks to alot of prayers I am alive to tell the tale.
I seriously want to say a big thank you to all the nurses on the maternity ward at Andrews Memorial. In the last moments when everyone thought the end was near she held my hand and prayed with me, I just felt a calm come over me. Also to Dr. Walcott my OB and Dr Murray my anesthesiologist and Pediatrician Dr. Miller for taking care of my son all the days he spent in the hospital and to all the assistant surgeons and to my 2 ICQ nurses . They stuck with me to the end and back. Spending countless hours at the hospital with me through the days. I would never be here without them.
I am happy to say my 5 pound baby boy is now 10 pounds at 7 weeks.
Below are some pics of the joys of my life:
My son at the hospital waiting on during one hospital visit. He was such a trooper
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May 9, 2012 No Comments
