High Risk OB Consult


A few weeks ago I had an appointment at the Regional Perinatal Center in CNY.
 I just needed some clarification on the events that took place the day the Zabies were born 
and what that meant for us moving forward. 
I didn't go the the RPC when I was expecting the Zabies 
but due to the rarity of my situation {read here and complications here},
they consulted with the Chief of Obstetrics and Gynecology when I was on the table after they delivered the Zabies. 
Dr. Silverman is also the Regional Perinatal Doctor. 
So when I had detailed questions about the risks involved in becoming pregnant again my OB quickly referred me out to the RPC. 

I felt conflicted about my meeting with Dr. Silverman but had a lot of detailed questions I needed answers to. 
I didn't have to wait long before they called me back and was quickly seated in the consult room. 
The nurse was asking all of the initial questions when she realized that my patient history was a little more involved than most. She had a lot of questions about my situation. While I was explaining my history Dr. Silverman walked in and took over the appointment. 
He sat behind the desk and said, "So, I hear you're thinking about doing this again?"
I told him I was there for clarity on the situation. 
He had a medical student with him and was explaining to her, and the nurse, what happened the day I delivered.

"Mrs. Zabek was admitted for preterm labor, 90% effacement and dilated to 4 cm. She never experienced painful contractions and after one bolus of saline all contractions stopped and she was then only monitored every 12 hours for 48 hours. She was in the beginning stages of being discharged and she experienced a tetanic contraction. Doctors pushed terbutaline twice and Baby A was in d-cell. They moved forwarded with a STAT C. When they opened her up there was a lot of blood. They got both babies out and started searching for the bleed. Then they found a ruptured vessel of the posterior portion of her uterus...." 

It was like deja vu hearing it all over again. 

"Mrs. Zabek lost over half of her blood volume."

"So the question at hand is: is pregnancy contraindicated?..... Absolutely NOT!"

What? Why? I had been praying and coming to terms with the fact that we would have to have a gestational carrier for future pregnancies. This was not the information I was expecting. I really was just there to better understand why the rupture had happened. 

He explained it to me further and this is what I learned, 
"I've seen this exact same thing once before in my career, almost 10 years ago. Patient had undergone IVF treatments to gain pregnancy. It was like looking inside of the same belly. The vessel rupture was exactly the same. What we think happened is that when the embryos were being transferred back into the uterus the uterine lining was punctured and those embryos implanted deeper than normal causing the uterine wall and extra vessel (which is normal during pregnancy) to be weakened resulting in the rupture."

He continued to explain to me the risk factors and how he feels that the likelihood of it happening again is lower than 8% since it is kind of a freak incident and thought to be caused by IVF. He told me clearly that he recommends for women to never become pregnant again on a daily basis due to maternal death risks and that is not his recommendation for me. 

I walked away confused and torn.
Elated, scared, hopeful and nervous. 
I want to have more children but the risk scares me. 
To say I have been praying about it may be the understatement of the century...
I pray about it all the time. For God to help me to recognize the right path to take and to put the desire in my heart to do the right thing. 
The kicker?...
Dr. Silverman said he thought we wouldn't have a problem conceiving on our own since we have had one successful pregnancy!! 
Apparently, fertility rates go up after being pregnant and delivering successfully in couples who have a history of infertility. 

Since I have been praying about this, I have literally had 10 friends announce pregnancies.

A sign? Maybe.

Until I feel confident in our path, I will just keep loving and adoring these two little ladies.
They are truly a blessing.

...and of course I'm praying...every. single. day.

I am so thankful that the decision is now between me, my guy and our Heavenly Father. 

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