I walked out of the U/s happy about having a boy, and into a meeting with my midwife, Lee. We chatted about how well the baby was developing ~ he had been in the 80th centile for weight measurement, the fundus measurement was spot on, and all seemed pregnancy-as-usual. Lee then asked if I had had my Anti-D yet. Anti-D is a blood product routinely given to pregnant women who have a rhesus negative blood-type, especially during a first pregnancy, just in case their offspring is of a positive blood-type, which may provoke an immune response in the mother against subsequent babies (this is how I understand it, although I recently read there can be health consequences for that first baby, also, in the form of brain damage. Part of that article, by the Red Cross, introduced James Harrison 'The Man with the Golden Arm', who's blood has a particular immune quality used in Anti-D ~ it was used in the first batch in the 80's, and has been incorporated into every batch since. His blood has saved the lives of an estimated 2.2million children, who otherwise would have been unable to be treated for Rhesus Disease. Many thanks to James Harrison for the treatment I received).
I replied that my routine Anti-D was not due for some weeks...then I was told in an offhand way, 'Ah, but you've had a bleed...'
This was the first I had heard about my pregnancy being anything but normal (cue: huge kick in the guts).
I disappeared off to the treatment room, wondering about this bleed, and duly received the Anti-D shot. My now fairly encyclopaedic knowledge of Placental Abruptions reveals I was one of the rare few to have had the Abruption diagnosed ante-partum, as a concealed abruption, which does not bleed like a revealed Abruption, is extremely difficult to discover at that point in pregnancy. It is most commonly found during autopsy/post-partum investigations of the placenta, or when massive blood loss occurs suddenly during delivery. It is responsible for the deaths of 4% of mothers, and up to 20% of babies who have the misfortune to develop the condition. Another way to discover an Abruption is spontaneous pre-term labour (PTL) with very rapid contractions that blend into one another, with associated extreme abdo pain and tenderness between contractions. But more about those symptoms in a future post.
I mused about the causes of this bleed to Lee, and was told not to worry, it was only just visible on U/s, and most likely had no discernible cause. I personally attribute it to a slip and fall I had in the bath 2 weeks before its discovery, where I felt a tearing feeling in the abdomen. At the time I thought, "That's not good...no more Bath Yoga for me!" I was told that abruptions are rarely caused by anything but moderate to severe trauma (ie, car accident or domestic abuse), and are more commonly associated with lifestyle risk-factors like cocaine use and smoking. Not being predisposed to massive cocaine use during pregnancy(!), and having mitigated lifestyle factors by kicking the ciggies as soon as my pregnancy was discovered, this bathtub fall is the only factor that I feel may have played a part in the development of a placenta that, at the end of the pregnancy, was almost completely a swiss-cheese of haemorrhage.
Story on James Harrison 'The Man with the Golden Arm'
can be found here: http://www.dailymail.co.uk/news/article-1259627/Man-golden-arm-James-Harrison-saves-2million-babies-half-century-donating-rare-blood.html
Resources: Wikipedia entry on Placental Abruption: http://en.wikipedia.org/wiki/Placental_abruption
There is no specific entry for Concealed Placental Abruption (of the kind I experienced), but Subchorionic Hematoma does have an entry, here: http://en.wikipedia.org/wiki/Subchorionic_hematoma
My hopes for an optimal outcome and love and strength go to all women who are currently experiencing this condition. xx
