On Monday night June 25th around 8pm I noticed that my braxton hicks felt pretty crampy and were coming pretty regularly about every 6 minutes. I had already been to L&D a couple times for the same situation and it never turned into much, so I thought I'd just try to drink more water and get some sleep and just see if they would go away on their own.
They woke me up occasionally throughout monday night. I wouldn't call them painful, just uncomfortable. By Tuesday morning they were still every 4-6 minutes so at 7am I called my OB who told me to go to L&D.
I arrived at about 8:30 and told my nurse that I was pretty sure these were just BH contractions and that it was probably nothing, but thought I'd better check. I really thought I'd be there a couple hours and then go home.
Contractions showed up every 4-6 minutes on the monitor so they gave me vistaril (muscle relaxer) and wanted to just watch me for a couple hours. The nurse checked my cervix and I was dilated to 1cm and she could feel the amniotic sac of baby A (Owen). At first the contractions slowed down with the vistaril and just as they were talking about sending me home, they picked back up to about every 2-5 minutes so the OB wanted to check my cervix again. I was 2cm.
With the cervical change, people started to get worried.
I was told I wouldn't be going home for a few days. They started me on a magnesium drip, did a gbs test, started IV antibiotics and steroid shots to prepare for an early delivery (28 weeks).
The goal was to keep me on magnesium until I could get a full 48 hours of steroids in my system for the babies lungs. For the first 12 hours of magnesium I was not allowed to eat or drink or get out of the bed. Apparently it is a central nervous system depressant and it often makes you lethargic, weak and have flu like symptoms and can decrease your gag reflex and cause choking and aspiration, so they wait to see what your alertness level is going to be before you can eat. I was SO HUNGRY. This is also why you can't get up. Not even to use the bathroom. I became familiar with bedpans and sponge baths for the first time and I have to say I'm not a fan.
The magnesium can also cause fluid retention, particularly in the lungs, so I was fluid restricted as well.
I actually had very minimal side effects compared to most on the magnesium. I got a little hot and flushed and at some points it became difficult to breath and felt like my chest was tight. I was a little sleepy but not totally out of it. I was determined to show the nurses how alert I was so by midnight they finally let me eat!
The mag wasn't as bad as I had thought it would be. The worst part was not being able to get out of bed.
WHile on magnesium, I really had MAYBE one contraction an hour. It worked like a charm! The steroids raised my blood sugar one time to 224, but it didn't last long so I never needed insulin.
On Wednesday they let me get out of the bed to sit in a chair and use a bedside commode instead of the bedpan. It's amazing how excited you can get about something like that! Those hospital beds KILL my back (not to mention peeing in your own bed).
On Wednesday I had a lot of spotting and think I began to lose my mucus plug. That night around 7pm, they decided to try to wean my magnesium from 2g/ hr to 1.5g/hr to slowly get my body adjusted to turning it off by noon on Thursday as planned. The contractions slowly started back up. First it was one every 20 minutes, then 10-15 and by the time they were every 6 minutes around 1am, they turned my magnesium back up to 2g/hr because it was most important that I got the full 48 hour effect of steroids before going into labor. I also got another vistaril at this time to slow things down. This worked and contractions went away.
At 9am on Thursday they turned the magnesium down again to 1g/hr but at the same time started me on an oral calcium channel clocker "procardia" which can be used to prevent muscle contractions just like the magnesium but without the side effects. It's less affective, but is good enough and I can go home on it.
It worked and I did not have any contractions during the weaning of magnesium or turning it off at noon.......... until 7pm. At this point they had allowed me to get up and use the restroom and take a shower. The contractions started to show up slowly again and progressively got closer and by 4am friday morning my nurse gave me an extra dose of vistaril which slowed them a little but not a lot and at 6am the OB ordered a fluid bolus and a cervix check.
On Tuesday my cervix was 2cm but had been very posterior and hard to reach (which was good). On Friday morning I was still two cm but no longer posterior at all. The nurse said that his head was very very low and engaged. She said she had to back off a bit because she was afraid she would break my water accidentally. She said she could feel his head squirming around and would be very surprised if they let me go home like that.
Well, surprise, an hour later the on call OB came in and said that since I live 10min from the hospital, that I could go home on the medications but with STRICT bed rest. I can not drive or walk around the house. I can not get on the floor to play with Corynn or go outside etc... I am only allowed to use the bathroom and take one quick shower a day and I have to go back to the hospital if I have more than 6 contractions in an hour. She seemed a little hesitant to send me but I think they were very busy with deliveries and needed the bed to be honest.
So now I'm home and doing my best not to move, taking meds every 6 hours and trying to keep these babies in as long as possible.
So that's the labor side of things.
Now for the health of the babies.
On Wednesday, the perinatologist came into my room to scan for the babies sizes and positions. First they looked at Owen and this is when we realized that he had flipped (which I had suspected about a week ago) and his head was now in my cervix, low and engaged in the birth canal. They said that the chances of him coming back out of that position are low because of how far he was and that his head was likely the cause of all this preterm labor this week. Otherwise he was perfect and healthy and measuring in the 44th percentile at 2lb 8oz which was up 10 oz from his scan two weeks ago!
So then they moved on to Eden who was still in a breech position. The tech seemed more quiet while doing her scan and I noticed while she was looking at her cord blood flow, she was staring at the same thing for quite a while but not saying anything. I got that bad feeling that something was wrong. The tech left and came back with the perinatologist who did the scan again. The peri told me that there was an issue with the blood flow in baby B's cord. I immediately started bawling so hard that I couldn't talk or breathe. I was so worried we were going to have another cord accident and this was the last thing I wanted to hear.
Once I could collect myself to hear exactly what was wrong, the peri told me that her placenta was aging too fast and causing a reduced diastolic flow in her cord. Basically as I understand it, it is normal for the placenta to age at the same rate that the baby ages. As the placenta gets older it becomes tougher which makes blood flow tougher but normally the baby is just as strong as the placenta and can handle the changes. Eden's placenta seems to be about six weeks ahead of her age and is considered a grade 2 placenta with 1 being the best and 4 being the worst. The flow in the cord is measured by what is coming from the placenta to the baby (systolic) and what's coming back from the baby and out to the placenta (diastolic). Since her placenta is older than she is, her heart is having to work extra hard to pump blood back out against this resistant placenta. This is burning her energy quickly and causing slower growth than her brother. She measured in at 2lb 5oz which put her in the 40th percentile. This isn't too different from Owen except for the fact that at our last scan two weeks ago she had been slightly bigger than him and she has only gained 5oz in that time compared to his 10oz. The plan is to scan weekly to evaluate the placenta, the cord flow and her growth. If at any time the diastolic flow becomes absent or reversed or her growth has dropped off, we would deliver the babies early. The peri said the best thing for this is simply bed rest. She said that me relaxing as much as possible and keeping my blood pressure down will make her resistance less and easier for her to pump blood. She actually recommended that I go to a pool daily and rest my upper body on a floatation device while letting my body dangle in the pool to take all pressure off and reduce resistance. But the OB told me not to leave the house, so I need to clarify which of these is more important.
At this point I think I am more concerned about Eden's cord than i am about preterm labor.
Keep praying for healthy and as close to possible full term babies!
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