If you don't want to read about things that can go wrong with s/r, please don't continue reading this. I am posting because I had no idea that what happened to me could be a possibility and I might have made a different decision had I known.
I always seem to fall on the wrong end of the 1 in XXXXX statistics though.
After three weeks of spotting and cramping, I woke up in the middle of the night last Wednesday to a huge gush of fluid. I called the OB on-call, and he said that there was nothing he could do - call back if something else happens but otherwise go into the office in the morning. Needless to say, I didn't sleep at all and sat there watching the clock until it was time to get dressed and head down to the office. I was there when they opened and the same OB that I had talked to earlier saw me, did an u/s - determined that the baby was OK. But then he did a vaginal u/s to check my cervix and said that it was such a mess that he couldn't tell what was going on and I needed to see the peri. There is a peri at my local hospital from MFM at Yale, where I had my reduction, two days a week. By some miracle, this happened to be one of those days, and the dr. who was there was the same one I had seen at Yale for my level 2 u/s the week before. She saw me right away, said that one of the reduced fetuses was in my cervix and was going to be delivered. She sent me up to labor and delivery. It didn't sound like she had much hope that my baby would make it. I was in L&D on full bedrest for two days under the theory that the more gentle the contractions, the more likely it would be that I could expel the reduced fetus without losing the baby. I woke up at 4AM on Saturday and knew that something was going to happen because I just felt different - I had a dull crampiness all the time instead of the intermittent stuff I had up to that point. At about 6:30, I went to the bathroom and heard/felt something plop into the basin they had me using so that they could inspect what was going on. I pulled the cord to call the nurse (I didn't want to look because I knew that if it was the fetus I didn't want to see it), she came in and looked and said it was just a really big clot. She said to go ahead and wipe and she would help me back to bed. I went to wipe and felt something else. She looked and said that it was the fetus. I had a 3 to 1 reduction because the identical twins were monoamniotic, so they shared a placenta. Since the placenta wasn't coming out, they had to cut the cord on the reduced fetus. So she got me back to bed, and then found a random OB that was available to cut the cord because the OB from my practice who was there was in the middle of a delivery. I saw someone carry out the plastic bag with something red in it and I am constantly having flashbacks of that moment. I asked the nurse to check the baby's heart rate with the doppler and she did - that reassured me a bit just to hear that sound. It took about a half hour for the OB to come in, and he first did an u/s to check on the baby, who was absolutely fine - membranes intact, good fluid level, and good heart rate. He then did a vaginal exam and wanted to trim the cord up to the bottom of my cervix to help reduce the chance of infection and other problems. Let me tell you, I have a new appreciation for stirrups after having a couple of vag. exams in a hospital bed with my as* propped up on an upside-down bedpan. He also confirmed that my cervix was closed. He put me on IV antibiotics as a prophylactic and said we could just wait and see but the biggest risk would be if I got an infection from having had my cervix open. My nurse came in afterwards and sat with me and asked if I wanted to see the fetus, which I knew I did not want to do. I told her that if they baby came out I would have to deal with it, but I had already been dealing with the other 2 for long enough.
At that point, it seemed like things were going to be OK.
But then around noon, I had a huge gush of bright red clotty blood and contractions started again and from that point on I was bleeding bright red at about the level of a heavy period. The OB came and said he thought that the bleeding was similar to what people have after a normal delivery. I barely moved all day Saturday and just kept talking to the baby and telling him that it's a cold cruel world out here and he should stay in there where it's nice and warm until the weather is warm outside. (I am 20 weeks today - due 6/16).
On Sunday when the OB came through on rounds, he said that he thought that I should be able to go home the next day after seeing the peri for an u/s, so he wanted me to take a shower and I could be up and about in the room. In retrospect, that was the wrong thing to do.
I went down for the u/s first thing on Monday. The peri said that my cervix had returned to the way it was when she saw it at my level 2, but she looked for the source of the bleeding and could see that it was coming from a partial placental abruption of the baby's placenta. It appears that all of the contractions I had been having caused his placenta to begin to separate from the uterine wall. So her opinion was that I should go home on full bedrest and hope for the best. She's not a very optimistic person - she said the goal right now was to get him to 24 weeks.
I don't have family in the area, so I wasn't comfortable with the prospect of going home yesterday. I spent the day making arrangements and then came home today. I definitely have less cramping today and I think I have a little less bleeding. I am hopeful that this issue will resolve itself, but I am scared sh*tless about losing my baby or having him born very prematurely. I set the goal at 34 weeks, which would bring us up to about May 1. When I left the labor & delivery unit, I told the nurses that I hoped not to see them again until the weather was warm. Now we just wait and see. I'll go back for another u/s next Monday.
I hope I don't freak out people too much with this story, but I really had no idea that something like this was a possibility. The good thing is that I didn't miscarry the whole pregnancy - which I understood to be the biggest risk of s/r besides infection. However, we're still at risk and can't be added to the positive outcome list yet.
In retrospect, I think it would have been better to either do the CVS at 10 1/2 weeks so that the reduction could be done at 12, or else not do the CVS and just proceed with the reduction. The dr. who did the reduction wanted to delay the CVS because of the position of one of the placentas, so I didn't have it until 12 weeks, which delayed the reduction to 14 weeks. I have to think that the fact that the fetuses were bigger at the time of the s/r had something to do with this. It definitely had not "dissolved"/reabsorbed.