Pregnant after endometrial ablation

[racquelm]

I am 38 and 7w3d pregnant after ablation, something I did not even realize that was possible. Needless to say I have been on an emotional coaster for the last few days. I am scared to say the least. I am not sure I can terminate a living child regardless of my risks but I have other children to think about.

I found out I was pregnant by accident. After having gallbladder type pain (no longer have gb) my doctor referred me for testing. While waiting for my CT prep I feel this pop and whoosh between my legs. I hurry to the bathroom to see blood everywhere and called my doctor after I passed a large clot. She at first tried to dismiss it as my period and I explained I do not get heavy bleeding and have not for 3 years since the procedure. I asked her is it possible I am pregnant and miscarrying? So she ordered a blood test and it came back positive. The CT tech took me down to US for a quick check to see if I could still have the CT (if a MC was in process). The US tech found a heartbeat and I was rescheduled for a more detailed US the following day.

I had the US on Friday which confirmed I was 7w1d and I was pregnant with twins. They could only get heartbeat on one and it appeared that the remaining baby was starting to absorb the twin already. Anyway the doctor thinks that could have been cause for the bleeding.

Well last night after doing very light house work (I was washing a few dishes) I started bleeding again and passing blood clots plus lower back cramping so I went to the ER. The doctor there was about as helpful as a twig and said I could be having a threatened miscarriage. No attempt to check on the baby via US just did some blood and sent me home. Even though I was still passing large blood clots every time I went to the bathroom because I was not "soaking through pads" at the rate of 1 per 30 min- 1 hr I was not considered high priority to them. Even though I have thrombocytopenia and a high risk pregnancy- oh well go home.

Here are my recent HCG quant levels
1-29-09  26,969.00
1-31-09  32,433.00

I would have expected them to go down with the bleeding and cramping but not sure how quickly that happens if someone is actually experiencing a MC. The ER doctor said I am supposed to repeat the blood work in 48 hours to see if the levels have changed.

I am still bleeding this morning but it is only when I go to the bathroom. The urine is pretty bloody and I am still passing clots. I am not sure why this appears to be happening only when I go to the bathroom. I mean I do bleed a little in a pad but nothing like when I got to the bathroom. Any thoughts would be appreciated.

[adgal]

I am so very sorry.  I don't even know what to say except that my thoughts are with you, and I am sending you a big hug.  I know that doesn't take away the pain, but please know if you need someone to vent on, I am here. I understand the heartbreak of miscarriage, and I too would not wish it on anyone.  My thoughts, prayers and best wishes are with you.  

Amanda

[racquelm]

Well I wanted to update everyone. I had another sono yesterday and Twin B did the vanishing twin thing. However we have worse news. Twin A no longer has a heartbeat. The tech looked for a long time trying to pick one up but nothing. These last weeks have been pure hell. An emotional roller coaster I would not wish on anyone. I have spent the last 2 days crying. My appointment was moved up to Monday in case they have to plan for surgery. My levels are still high even though it is estimated my baby died 5-7 days ago. I had my levels checked today and they were 15,727. I had one previous miscarriage that did not abort on it's own and I imagine this one will be the same. I am going to see if this new doctor will do a hysterectomy instead of just a D&C.I think it would mentally break me if I had to endure this again.

[racquelm]

I sent you a private message since your email address is not showing up here. I would love to hear from some women who went on to successfully deliver. I have been a complete basket case these last few weeks. I wish there was more information on the web regarding birth after ablation. I found a few postings from women who were pregnant (even on here) but most stopped posting after 32 weeks.

[tkirby]

Yes, I saw the doctor who done the novasure ablation.  I have an appointment with a high risk doctor on 2/24/09.  I do not know if this will make you feel better, but I have located 2 other women who have had a good out come with their pregnancy.  I am still trying to get information from them and if you would like I will forward the emails to you if you will send me your email address.  My email is ***@****.  

[racquelm]

Not sure if you saw my question. Did you see the doctor who did the ablation regarding the pregnancy or someone else?

[tkirby]

Thanks for the welcome to the group!

Teresia

[adgal]

I am glad you are seeing a different DR., although I am sorry it's so far away.  I don't claim to know much about pregnancy after ablation, but I do know it can be really difficult, and in some cases dangerous.  I don't say this to frighten you, but to sort of reinforce what you already said..it is so important to be monitored closely.  I have heard success stories on here from women who have gone through this and gone on to have healthy babies.  It is so great to hear you have found someone who seems to take this seriously, and is going to give you the attention you need.  My last OB was always very rushed and not great about giving me info.  My new one is fantastic...really takes her time and explains everything!!!!!  

Please keep us updated as to how you are doing...I am following your posts and am so interested in this...you telling your story here will help many other women as your right, there is not much info out there on this.  

I wish you the absolute best, and look forward to reading how you and baby are doing!!!

Amanda

[racquelm]

No, nobody has mentioned this but like I said the only OB I have seen so far was a nutcase. I think the High Risk OB I found in Albq (who was referred) will be able to answer all my fears/questions. I did not find anything on the web yet about fetal amniotic band syndrome being a risk in mothers who had ablations.

I am not sure how each different ablation is looked at when it comes to getting pregnant. I did not have Novasure, mine was done using Thermachoice Balloon therapy. Does that play a part in determining how viable a pregnancy is? I have no idea.

The nutty doctor (and the referred doctors nurse did confirm this- even a stopped clock is right twice a day lol) said if I had this procedure done 6 months prior to getting pregnant termination would be highly recommended. However 3 years after the procedure it is possible for new tissue/healthy tissue to start regenerate making the pregnancy possible and viable.

If you saw a regular OB especially the one who did the procedure then that was probably a HUGE mistake. You need to find a High Risk OB who has actually seen or at least heard of pregnancy after ablation.

I think the important thing is to be monitored very closely. Regular sonograms from what I understand are extremely important.

[tkirby]

Racquelm,

Has the doctor talked any to you about fetal  amnotic band syndrome because of  the novasure ablation procedure?  I am worried to death about this pregnancy and so confused about what needs to be done.  I cannot find enough information on this and my doctor thinks miscarriage or D&C is the best for me   I know that bleeding and possible uterine rupture is possible.  

[racquelm]

Okay here is my appointment update. This was the most crazy experience I think I have ever had!!

Not a good first appointment at all!! I think I was literally in a baby factory! My appointment was 9:30 and I was not taken to the back for "processing" until 11:30. I actually got there at 8:45 to make sure I had plenty of time to file out my paperwork only to be told to take a seat and I would be called and hour later to get my stack of forms. During my time there from the time I actually started counting 45 pregnant women came and went from the office before I went back. This is a ONE doctor practice!! I should have went running screaming at that time but no I stayed hoping for some answers. I get taking to the staging area where 4 other women are waiting for sonos. The tech was doing one every 5 minutes!! My US was a total of 2 minutes and she told me the hospital was wrong there was monoamniotic twin but there was another empty sack and a pool of blood in my uterus. I told her the report was in my chart. They saw two fetal poles in the same sac and she huffed well I don't see them. I huffed back and said well that US the tech took her time and spent more than 2 minutes on the exam. Then I get taken back to the staging area where another tech comes and gets me for urine and BP. Then I am taken back again to the staging area then finally into a room where the doctor sees me for 3 minutes. He does not exam me and says this baby has a 60% chance of going to term for a vaginal delivery. I was like WTF have you been smokin Doc (didn't say that of course..lol). Didn't tell me the cause or even attempt a guess of the "pool of blood" just said the would repeat the Turbo US in 2 weeks to keep an eye on it. Oh he did say my levels were promising.

Needless to say I found a specialist in Albq which is 3 hours away. His nurse spent 30 minutes on the phone with me explaining the procedure and reason for proper delivery. I felt so much better after talking to her and she said had her doctor not been in surgery he would have gotten on the phone to talk to me even though I am not yet a patient. I cannot get in for 2 weeks to see him but if the bleeding starts back up I am supposed to call. I might have to try to find a furnished apartment in Albq during the last 8 weeks just so I am not so far away and in labor but I will know more when we find out how the placenta has attached. She said it is possible that it could have attached to some healthy cells and not to the muscle wall.

[racquelm]

tkirby,

The doctor I saw Friday was a quack and a baby mill. He saw no reason for a normal delivery but like I said he was a quack.

I spoke with another High Risk OB office and got to spend 30 minutes with a nurse on the phone. The doctor I will be seeing has delivered women who have had ablation and as long as the doctor and the patient know of potential problems such as bleeding one can have a safe delivery.

Before you do anything I would suggest getting another opinion. From my understanding there is about a 60% chance of carrying to term. With child birth there are always risks. Heck I hemorrhaged with my first son and did not even know. I passed a grapefruit sized clot which I thought was probably normal! I continued bleeding for 2 months before having a D&C that revealed remaining placental tissue.

I will not lie, I am scared to death. I have two children who need me and the extra risks to have this child is frightening to say the least.

[adgal]

HI Racquelm,  Those numbers are beta/hcg levels (the pregnancy hormone).  In a healthy pregnancy, they double every 72 hours until they hit a certain level, then begin to level out.  Your's are very high, so the fact that they are no longer doubling is not a problem at all. It is good they are still rising.  I hope all goes well at the OB tomorrow, and please keep us updated.  I am keeping you in my thoughts.  

[tkirby]

I would like for you to review your pregnancy with me.  I am 39 years old and had a novasure 3 yrs and I am 5 - 6 weeks pregnant.  My doctor is not wanting to continue with pregnancy because of the risk.

[racquelm]

Here is my latest level result from yesterday  43,212.00. I have no clue what all these numbers mean except it is good that they are going up. I see the high risk OB tomorrow so hopefully we will have some answers to all of our questions.

[racquelm]

Thanks Amanda, I just appreciate you being here to talk to me.

[adgal]

I wish I had the answers for you.  The waiting is the worst, and my heart goes out to you.  Yes, sometimes the heartbeat is not detected until 7 weeks.  I hope that is the case here, and that Twin B develops that heartbeat.  It is a positive sign that your HCG level continues to rise.  The bleeding can be caused by other things besides a m/c of one of the twins.  So many women bleed during first trimester, and often the reason is never discovered.  But they do go on to have healthy pregnancies and babies.  I so wish I could be more helpful to you, I do understand how agonizing this wait is, and I am keeping you in my thoughts.  Please keep us updated on how you are doing.

Amanda

[racquelm]

Looks like the US Tech was a little off on the date. In the report it says Twin A is 6wks4d and Twin B 6wks3d. It confirms that Twin B showed no heartbeat but I thought that a heartbeat often cannot be seen until 7 weeks so is there still a chance that this baby could be viable? The report also states that the sac shows monoamniotic twins but the sac had unusual morphology.

My levels keep going up. Today the level was 38,670 and I go Wed for repeat blood work.

What I don't understand is if the bleeding is caused by one twin dying how is that possible since they are in the same sac? I could understand bleeding if I was miscarrying one which was independent of the other.

In a way I hope that Twin B will still develop a HB. Since the size was only one day off from twin A then either it had just died or maybe the HB could yet be detected??

[adgal]

What a stressful time for you, I am so sorry you are going through this.  A couple of thoughts....you could be passing the twin with no heartbeat, and the other could be doing fine.  I find it odd with your history (ablation especially) that they did not do an ultrasound at the ER.  

I would be calling your Dr. first thing tomorrow.  I know that pregnancy after ablation can be very dangerous at the best of times and needs to be closely monitored.  You need to be seen.  If you have in fact miscarried both, your HCG's do not necessarily start to drop immediately.  In my case, they slowed down, leveled out, then started to drop.  That was at about 8 weeks.  

If the bleeding and clots get heavier, I would head back to the ER.  I got myself in trouble by not responding to heavy bleeding quickly enough, so don't ignore it.  Also, does your Dr. have an on-call # you can call?

I know this probably wasn't overly helpful, but it's the best I can do.  I wish you well, and hope all turns out well.