Yesterday baby boy’s MCA scan showed that he is probably anemic and needing his first blood transfusion. His MoM was around 1.49 and Dr. Trevett wants to play it safe and go ahead with an IUT. After the scan yesterday I was given my first steroid shot to develop baby’s lungs in case he has to be delivered tomorrow. I’ll have my second round of steroids today. I think the procedure will be around 7:00 tomorrow morning (August 2nd) in Atlanta. I just realized that August 2nd was Nora’s due date 🙂 Hopefully it won’t be baby boy’s birthday! I will be 28 weeks 4 days tomorrow and baby weighs a hefty 3lbs 5 oz so that is comforting. The bigger the baby, the easier the transfusion is for the doctors, and a bigger baby is also helpful in case he has to be delivered early. My husband Josh and I went back and forth about whether to have our IUTs in Houston or in Atlanta. We feel like the baby is a good size, it’s not an emergency situation, baby isn’t in distress, the cord insertion is in a great spot so Dr Trevett should be able to reach it easily, so we are going to have the IUT in Atlanta with Dr. Trevett. He feels confident doing this transfusion, and would tell us otherwise if he didn’t, so we feel like we can trust him with our little man.
Since I’ve never had an IUT in Atlanta there are obviously some details about the procedure that I won’t know until the procedure happens. Every hospital and every MFM has their own protocols and procedures and does things slightly differently. Dr. Trevett does try to follow Dr. Moise’s protocols in general. I will be given a light sedative but will be awake for the procedure. The anesthesiologist will be there, ready to deliver if anything goes wrong with the baby. If that happened he would just put me under general anesthesia and do an emergency c-section, no time for an epidural or anything like that. So, once I’m sedated and in the OR, Dr. Trevett will make sure the donor blood is all ready and he will put a needle through my uterus, through the placenta and into the umbilical cord, hopefully, then he will give the baby a sedative and a paralytic. I think he said he also might do this by just putting the needle into baby’s thigh, but I can’t remember. It might depend on baby’s position tomorrow. Either way, baby is paralyzed so that he won’t move during the procedure, which is very important for this boy since he is ALWAYS super active during ultrasounds. We definitely don’t want him grabbing the needle or kicking it once the transfusion starts. Once baby is paralyzed Dr. Trevett will draw a tiny bit of the baby’s blood and have it tested to find out baby’s exact hematocrit and hemoglobin. Once he has that number he will know how much blood to give the baby and will start the transfusion. They will keep a close eye on baby’s heart rate to make sure he doesn’t start having decelerations or start going into distress. Once the blood is in, they will go in a second time and stick the needle into baby’s abdomen to put extra blood there as a reserve for him to absorb over the coming days and weeks. This is called an intraperitoneal transfusion. Once that is finished they will take the needle out and the procedure is over. At some point they will check he baby’s ending hematocrit, I’m guessing after they finished the blood transfusion in the cord but before they take the needle out to put blood into baby’s belly? Anyway, those are the basics as far as I know.
After the procedure is finished they will monitor my contractions (if I have any) and baby’s heart rate for a while to make sure he’s ok. They will also wait until baby’s paralytic wears off and he is moving like normal before they discharge me. I’ll probably be on bedrest for a day or two and Dr. Trevett will do an ultrasound 24 hours after the IUT to check on baby. Usually, if a baby dies as a result of the procedure (which is possible) then the baby dies within 24 hours of the IUT so that is why they recheck after the 24 hours. Those 24 hours are the MOST nerve-wracking of the whole pregnancy so please pray that the baby is active for me and that God fills me with peace.
Yesterday on the four hour ride home I felt my anxiety growing and it was hard for me to fight back tears while driving. Lucy never moved again after her IUT and died 8 days later. I know a lot of babies who have passed away because of this procedure and I was thinking about them on the drive home. Of course, I know MANY more babies who have had the procedure with no complications and they are thriving now, one of them being my two year old little beauty, Nora. When I got home I was tackled by Nora who immediately asked where baby brother was. She said she wants to rock him and hold him. I lifted my shirt up and showed her that he was still in my belly but told her that he would be here soon. I can’t imagine breaking the news to my kids that their baby brother didn’t make it. I had to tell the boys that the baby was getting low on blood and needed a blood transfusion. When I was going through this with Nora I could be more vague because they had just turned 4 and 6, so I told them Nora needed a shot to feel better and they were fine with that. Now they are older and understand the danger more. They have more questions and need more details (especially my oldest, Liam.) Liam asked, “So when someone loses a baby, do they get another chance? Another chance to have a baby?” I wasn’t sure if he meant another chance to have another baby, or another chance to have that same baby. I just told him sometimes they do get another chance to have another baby, but not always. He looked anxious but I tried to reassure him with the statistics, that baby could have up to a 99% chance of surviving the IUT tomorrow. We also reminded him that Nora had the same procedure, FIVE times and is perfectly healthy. She was skipping around, singing and bubbling joy all over the house last night and I couldn’t stop kissing her. When I looked at her and held her I felt my worry melt away, because she DID have this procedure five times and she is perfect. I am reassured by her presence and the reminder that God is fully capable of doing anything and He has a plan for this son of mine. Didn’t He say, when we were struggling with the idea of trying to conceive one last baby, “LET ME BLESS YOU”? And once I was pregnant, didn’t He say clearly, “This pregnancy will be a peaceful one and I want you to enjoy it.” This morning a sweet woman from our Facebook group sent me some verses to encourage me. The first one was a special verse that God gave me right before I got pregnant with Lucy, right before I unknowingly stepped onto this roller coaster of trying to grow our family.
Romans 15:13 May the God of hope fill you with all joy and peace as you trust in Him, so that you may overflow with hope by the power of the Holy Spirit.
I love that I don’t have to conjure up the hope for myself somehow. He will overflow my heart with hope by the power of the Holy Spirit. I can trust Him to provide the peace, hope and the courage to trust Him right when I need it. Please pray with me that God will protect and strengthen our son tomorrow when his safe and cozy world is suddenly invaded with needles and medications. Pray that God will fill Dr. Trevett with peace, confidence and wisdom during the procedure. Thank you all so much for your support. I will try to keep everyone updated!