So Rebecca had a bit of bleeding last night and notified her doctor, who
said she should not be bleeding at 28 weeks and should definitely be seen.
Rather than wait til the morning, after putting Sevi to bed and getting the
downstairs neighbor to come up and watch over her (which incidentally had
her too excited to fall asleep til 10:30) we headed to St. Lukes Roosevelt.
We were fairly expeditiously admitted, and Rebecca had a fetal monitor
attached, which, after several minutes seemed to show normal fetal heartbeat
and contractions of a sort measuring in about every 9 minutes–although
Rebecca wondered whether it wasn’t just his characteristic kicking and
rolling around that read as contractions. To inhibit contractions they
attached Rebecca to an IV drip and we waited. Eventually a resident came in
with an ultrasound machine, and the sonogram she conducted had her a little
befuddled–it seemed to her to be possibly placenta previa, a condition in
which the placenta has attached wholly or partially over the cervix, which
raises concerns about bleeding and preterm delivery. But being a resident,
and confiding in us that she hadn’t eaten all day, she wasn’t confident of
her finding. As luck would have it, the expert ultrasound doctor was on
hand, and he guided her through a more complete reading, which showed no
abnormalities, although no explanation for the bleeding either. He then
also guided her through the more invasive vaginal ultrasound to inspect the
cervix–again no apparent problems, though no answers. After he left, the
resident rolled in her tray to conduct her manual exam. She proceeded
carefully, and was probing around with her fingers when she froze. She
called very forcefully to another attending resident to come immediately.
She repeated twice with ever greater urgency. When asked what the problem
was she said “I HAVE CORD”. I can’t imagine three words that would have had
a more drastic effect on the ward. Everyone, I mean EVERYONE attending
dropped what they were doing. It was as if the walls had collapsed open
around us. The residents fingers were still frozen where they had been and
the attending doctor told her not to move an inch. They brought Rebecca’s
head down on level with her pelvis. The resident rattled through the stats
she had gathered while the senior resident asked her a barrage of questions.
They undraped Rebecca’s belly and the nurse came in in an instant with a
razor and began to shave. Another resident brought paper and pen over to
Rebecca’s head and informed her her signature was needed on a consent form.
For what? C-section. What the resident had discovered was a prolapsed cord
protruding through the cervix, basically a crimped cord which could at any
moment cut off blood supply to the fetus. A critical condition. The OR was
being readied, the anesthesiologists were waiting outside the doors to take
over. This all happened in the space of about a minute. The resident was
ordered by the doctor to ever so slowly remove her fingers. He watched the
heart-rate monitor, and it showed no slackening of the heartbeat. He urged
calm, and to contact Rebecca’s doctor, whom they managed to reach in her car
just as she was heading out of the city, and who thereupon turned around and
sped back to the hospital. He wanted everyone to remain calm until she
could come and have a look. They left us alone beyond the curtain, Rebecca
shivering and requiring more blankets as we conferred about the
ramifications of perhaps having to give unconventional birth to a 28-week
old preemie. When Rebecca’s doctor, Dr. Paka, arrived, she did her own
manual exam to confirm the prolapsed cord. She got down on her side and the
residents tried to maneuver the light around her head while she probed.
What she found, thankfully, was not a presenting cord, but rather a half
finger-long length of polyp outside the cervix that had been almost
certainly been the cause of the bleeding. All the dire scenarios that had
sprung up just as precipitously melted away. This was a relatively minor
problem, and one that may have little or no implications for the pregnancy.
She counselled that Rebecca take it easy–she HAD had contractions after
all, but these may have been due to dehydration and may have been largely
incidental. So, 4 hours later we got back home and relieved our sainted
downstairs neighbor of her Sevi duty. An eventful night. I hope Rebecca
carries this baby to term because, speaking only for myself, I believe I
could use at least 12 weeks to get the adrenaline stores back up to where
they used to be.