Can someone tell me about abruptions?

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cindync
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Re : Can someone tell me about abruptions?

Postby cindync » Tue Jul 09, 637985 2:47 am

I have had two placental abruptions. With my first pregnancy, I went to the bathroom and there was a gush, I thought my water broke, there was so much, I looked in the toilet and the water was completely blood red...it was all blood. I took an ambulance to the hospital. I gushed several more times. When I got there, they confirmed by u/s the abruption, but daughters heartrate was fine. They attempted to induce me the very next morning, when the contractions started, the gushing started again. They were bringing me in then for an emergency c-section, but then on the way there her heart rate did start dropping, they shoved my husband out of the way, he had no idea what was going on. I had to have the section under general anesthesia, she needed to be out. The heart rate dropping and the bleeding from me increased.

All was fine after. She came home with me a couple of days later. I did not need any transfusions or anything, which is amazing, because I think there was a lot of blood, I felt it gushing out. I do not think I will ever forget the sound or feeling of it. I guess I will never know if I had PE with that pregnancy or not. It was never mentioned....but I do remember being really swollen.

I did not experience any weird pain or feeling with the abruption when the initial blood broke free. Just felt like I had to go to the bathroom.

I had an abruption again with my son. I did not bleed out as I did with my daughter. I do remember a week or so before I had him a really weird feeling inside, like a pain, but not normal and i almost went to the hospital but I did not. I guess I am extremely fortunate that nothing happened. Anyway he was an emergency csection (but not under general) as well due to severe pre-e, IUGR, and decels. The abruption was not mentioned to me until after I had him. I often wonder if the pain I felt was from the abruption. I think my abruption with him was not as bad as with Devin, but probably another day or two and it would have been really bad. They told me he would have survived in me maybe another day or two max.

I have read that placental abruptions are pretty rare, even with preeclampsia. I have no idea why I have had two, I know once you have one, the chances increase a bit the next time. No one ever gave me any reason for the first one....I can only think that I did have PE. The limited medical records I have from my first pregnancy indicate increasing bp's and trace then +1 protein at a couple of visits....so my guess is I did, but not severe. Perhaps since I went in with the abruption that was the main focus?

Good luck to you!

alaskamommy
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Re : Can someone tell me about abruptions?

Postby alaskamommy » Thu Jun 27, 637985 3:57 pm

Caryn - you nailed it: "nervewracking." Even though I'm sure a lot of that is my own doing. =D

Kara - wow, thank you for all that information! I was kind of surprised that no one wanted to check to see if all these contractions were actually doing anything. Never had them this early before, not even BH. With the urine, it's very random, any time of day, and a dark one can be followed 20 minutes later by a clear one, which mystifies me. I will ask for that PIH panel, as well as the BPP. Now that I think of it, once when I was in L&D and had a pretty good contraction while they had me hooked up, the baby's heartrate went way down. The nurse said it was no biggie, probably just the way I was reclining. Now, of course, I wonder if all these contractions are related to baby not being as active. I have made up my mind that I will call tomorrow and ask to be seen before next Wednesday if possible. They do have a 4D U/S machine in their office so maybe they can do that.

Thanks so much!

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Re : Can someone tell me about abruptions?

Postby kara » Thu Jun 27, 637985 3:05 pm

Christina,

It is good that your 24 hour came back at 104, generally anything under 150 is considered normal, but those levels can change, so make sure you ask about having another one done in a week or two. You already have blood pressures that are dangerous enough by themselves. PIH and GH can be just as serious as PE, so don't feel like you have to discount your concern. I'm not a doctor, and in no way have a medical background, but contractions at 28 weeks seems very premature to me...especially if they are 7 minutes apart. Have they checked your cervix to see if you are dialating or effacing at all?

If your urine is darker it usually means it's more concentrated. Do you notice it at times like when you first wake up in the mornings, or are holding it for awhile, or just randomly?

The blood they drew with your 24 hour is to check creatinine levels. This is normal but only pertains to your kidney function. The lab work you might ask about having drawn is PIH panel, or PE panel. This will check your liver enzymes and function, and platelet counts, as well as other standard blood counts like white blood count. Some people have wacky blood work but little protein, others have perfect blood work but crazy blood pressures...it is sometimes not as textbook as the docs like to make it seem so keep on top of them to test you and follow baby.

A biophysical profile is through ultrasound and shows how baby is doing and responding, movement, practice breathing, and fluid levels. The doctor scores the baby on each of these items. I can't recall at this time what a good score or bad score is, but if you are having decreased baby movement it would be something I'd ask for. If baby is doing fine, then you just keep doing what you are doing. If baby is not doing as well as he should then they can take steps to ensure he remains healthy, even if that means medications or early delivery. From my personal experience alone, I was delivered at 31 weeks for "fetal indicators". Essentially I was spilling a lot of protein, and wealked in tot he hospital with crazy blood pressures, but they went down to normal as soon as I was in bed, but baby had stopped growing at 29 weeks and was running seriously short on blood/oxygen/nutrients. It was determined that she was MUCH better off outside rather than in, even at 2.5lbs. I never had a BPP (biophysical profile) and now I know that I'll have them fairly frequently the next time since baby showed distress before I did.

Hang in there and keep rooting for yourself and your care. Many of us here know that we have a good instinct and intuition about our bodies. If you think things aren't right, keep bugging those docs and getting those tests until you are satisfied. :-)

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caryn
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Re : Can someone tell me about abruptions?

Postby caryn » Thu Jun 27, 637985 2:25 pm

I'm glad the protein came back below the diagnostic threshold, at least -- at 28 weeks, the more time you can buy, the better.

The bloodwork was hopefully for what they still often call "PIH labs", to check on your platelets, liver and kidneys and make sure they're managing the strain of pregnancy.

Subsequent pregnancies are nervewracking to watch from the sidelines, let alone actually do. [:D]

alaskamommy
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Re : Can someone tell me about abruptions?

Postby alaskamommy » Thu Jun 27, 637985 6:49 am

Hi! I just called and got the results from my 24-hour: no UTI and the protein was 107, which she said was well within normal range. I know it's not PE unless it's >300, so that's' really good news. Still, whenever I get up for more than 5 minutes the contractions start and so does the pain (although it's NOTHING like what you describe, mamajett. yikes, how terrifying!). The midwife said not to worry about contractions unless they hurt, although when I told her I had gone from "modified bedrest" as prescribed to "almost complete bedrest" on my own just because that's the only thing that keeps my BPs down and contractions from starting she said that was a good idea from this point on. She also said with the headache if it didn't go away with Tylenol to try a LITTLE BIT of caffeine, so I had a half cup of coffee. Woo-wee, did that wake baby up, although it put me out for about an hour - go figure! And it didn't help the headache either, LOL.

So part of me feels silly now, since the 24-hour came back fine, although I still have this feeling of dread, like waiting for the other shoe to drop. I still have the pitting edema, spots and stars and headache, but the midwife says that's all from the labetalol. Nevertheless, if the contractions come back again like last night, or if I don't feel baby move for a long time like yesterday, I am going to go in and have him checked out. And I still have no idea why sometimes my urine is rust-colored (not cola-colored, it's not quite that dark) and sometimes it's totally clear.

I'm not really sure what the other tests are that I should be asking for. Averyannsmom, you mention a biophysical profile and bloodwork - they did draw blood when I turned in the 24-hour, but I have no idea what it was for and so forgot to ask about it.

My gut is telling me something is wrong. My midwife is telling me not to worry. I know I'm in good company in this respect at least - I am hearing this from a lot of us. Thank you so much to all of you for your support. It means a lot.

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julie f
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Re : Can someone tell me about abruptions?

Postby julie f » Thu Jun 27, 637985 3:19 am

Just wanted to echo the other ladies and check in on you?

kara
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Re : Can someone tell me about abruptions?

Postby kara » Wed Jun 26, 637985 8:28 pm

Christina, Deep breath. You have every right to be concerned about all things pregnancy related! I'm not an expert on abruptions, but what I will tell you is that contractions of ANY kind, no matter how close or far apart, are concerning at 28 weeks adn should warrant a trip to L&D. In addition, the dark colored urine, if not a sign of a UTI, could be sign that your kidneys are no longer functioning as well or efficiently. Here at the PF, we say that dark colored urine (think cola colored) is a "get yourself to the hospital now" sign. The itching, panic attack/anxiety, adrenaline, nervous system things are VERY concerning as well. These would all be related to central nervous sytem involvement, which is a progression of the disease, and one of the signs we tell people to watch for. If I remember right you have Gestational hypertension and are on BP meds, right? That you are having pressures of 147/107 unless you are on strict bedrest at all times, the midwife should not be dismissing high pressures like that. When on BP meds and pressures still fluctuating it sounds like the meds aren't doing their job as well anymore. BP meds do a lot of good things, but they cannot halt the progression of PE. It's true that as baby gets bigger, and there is less fluid for him to move around, and the movements tend to get less, HOWEVER, at 28 weeks baby is not that big, and should have plenty of room to move and flip unless you are short on fluid. Are you doing kick counts everyday? I'll include a link on how to do kick counts at the bottom.

The pain in your lower left side sounds like it could be ligaments stretching from your growing belly, but that is really something for the doctor to decide. When will your 24 hour urine results be in? With all the symptoms you are experienceing, and If I were your sister I would want you to get in to L&D to get checked out - blood work, biophysical profile on the baby, pressure check, and have them check your reflexes and look for clonus (this will help show central nervous system involvement). I think I wouldn't leave until that 24 hour urine was in and all the other test checked out. Please update us!


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heather j
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Re : Can someone tell me about abruptions?

Postby heather j » Wed Jun 26, 637985 8:26 pm

When I had mine, I didn't have bleeding initially. I just felt intense URQ pain, and I couldn't catch my breath. I paced around the house for about 10 minutes and told DH we needed to head out (the hospital was about 30 minutes away). Less than five minutes into the ride, I was squatted down, balled up in the floor, and could hardly breathe AT ALL. It was very, very intense. By the time we got to the ER (took about 15 minutes), there was bleeding and I had a section about 30 minutes after arrival. My experience felt nothing like *a* contraction; it felt like one singular contraction that didn't release, if that makes sense -- hence my inability to breathe. I say stick the bamboo shoots under your nails and go! Abruption or not, you shouldn't be sitting around in pain and someone (hopefully the folks getting big money to care for you and your baby) should investigate it! Best wishes!

usmcaviatorwife
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Re : Can someone tell me about abruptions?

Postby usmcaviatorwife » Wed Jun 26, 637985 8:07 pm

If I were you, I would go into labor and delivery...it is better to be safe and overly cautious, than sorry. Your symptoms warrant a trip to L&D in my opinion. Keep us updated on your situation!

lynnekay
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Re : Can someone tell me about abruptions?

Postby lynnekay » Wed Jun 26, 637985 8:02 pm

Christina,

I don't have any advice regarding abrutptions, but I did want to send you a note of encouragment to call your midwife or dr and discuss your concerns. You might be over-reacting (who would blame you!!!), but than again you might not be over-reacting and possibly your body is sending you signals that you need to listen too! The only way to find out is to be seen and evaluated again. As you know, PE can be stable on day and WHAMO it can strike without warning the next day. So please, continue to be an advocate for your babies health and your own :-)

Take care and keep us updated...


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