? about Placental Blood Clots/Placental Abruption

VivC · 02-06-2005, 01:23 AM

I just read the pathology report on my placenta. It shows minor placental abruption, which may or may not have caused problems (since it was minor). There was also a marginal blood clot (4x2x.5 cm) at the edge of the placenta. Is this why so many of us take baby aspirin? Should I worry about this next time?

It also states that the umbilical cord had a small amount of spiraling and slight congestion. Any idea what the heck this means?

And, since the placenta is responsible for progesterone levels, and low progesterone can cause PTL, could a marginal blood clot keep the placenta from putting out the right amount of progesterone?

Since Rivi was perfectly healthy except for being born infected due to PROM/PTL/IC, I don't think any of this would have had a long-term effect. But just in case, I'm wondering if anyone has any input for my next pregnancy.

Dr. Incompetent LIED in his report and said I'd been put on IV antibiotics after the PROM. Like the nurses' logs wouldn't prove he'd put me on oral? What an incompetent A** he is! And I'm very annoyed because Rivi's birth certificate states that his cause of death was RDS and extreme prematurity. I've known all along that the infection is the reason he died, and the NICU logs prove my case. He was septic throughout his entire body. And he had a Grade III cerebral hemorrage. So, had he lived, he would have had severe disabilities. Why did I read this?

Thanks!

TickledPink · 02-06-2005, 01:27 AM

I have no info for you, just wanted to tell you how sorry I am that this has happened to you.

SheriKCMO · 02-06-2005, 02:40 AM

Viv,
Are these the things the new doc said not to read? I'm sorry you had to see them, but I think I would have wanted to also. You and Rivi got a very bad doctor through this, and a series of very unfortunate events led to his passing... it's just really too bad that the details and truth can't be accurate in the files. Sometimes, when that's all we have left, we need it to be right. I can't stand when someone says I had a miscarriage, because the antonym of miscarriage is live birth, and that's what I had. Sometimes it's the little things that can really feel awful, and I hope that at some point these which are not possible to change can fade into distant memory and not hurt so much!

I think the placenta and cord details aren't bad at all, but let your doc know for the future if you are concerned about them. Usually it would take a lot more than those little things to cause problems, jmo.
Hugs,
Sheri

VivC · 02-06-2005, 04:07 AM

Yep, these are the things she told me not to read. But I kept staring at the envelope, and I had to know. It really wasn't that bad to read the NICU stuff. The notes were so positive for so many hours that it made me proud of Rivi for fighting so hard. And one of the nurses kept writing how remarkable he was for his gestation (and I remember her talking about his dimples). My little guy - a charmer AND a fighter! I got a little shaky when I read about the hemorrage and how many times they had to rescusitate, but I saw them to CPR on him twice. It's not like it was a surprise.

I am really annoyed about his birth certificate, but I've known that was wrong for a while. Prematurity isn't what killed him. In itself, that can't kill a child past viability age. That's what annoyed me so much. And the hospital has him listed as "Boy Crayton." He had a name, and they knew it. They just didn't get it into the records.

As far as my records go, now I'm even more worked up over the idiot doc. But reading the notes from the peri just reminded me of how much I can trust him. He was honest with us from the beginning that we were grasping at straws, but he was willing to try to give Rivi a chance. That's all I wanted. And since the new doc is a referral from his office, I'm feeling a lot of peace about my doc situation for next time (when/if I get there). Now if only we can figure out what's going on with my cervix (I need to go see primary doc I've never had to see to get a referral to the peri because the regular OB/GYN can't give me a referral. Insurance rules suck).

Overall, I'm glad I read it.

sun · 02-06-2005, 12:29 PM

viv - ((HUGS)) I can't answer your questions on the placenta stuff.

But I did want to give you one less thing to worry about. It is normal for a baby's records to be listed as boy/girl last name or boy/girl mom's first name/last name. Even tho my son was in the hospital for over 6 weeks his were under my name. I've also worked in a storage company for almost 4 years, any time we look for a baby's records we're given the mother's name.

I hate that you had to go through all this. I've thought about you and Rivi often since you left the Feb. due date thread.

Reebekah · 02-06-2005, 04:06 PM

Viv-

I know just how you feel. When I read my medical records, my head started spinning. I came up with a zillion different scenarios about what happened. I read them over and over and over. Then I did months worth of research. And I made MORE doctors appointments to ask them my questions. But guess what -- I still dont know exactly what happened. I still don't even know if it was IC or PTL or PPROM or what. Nobody knows, nor will anyone ever know. Now that you've read them, my advice to you would be to put them away or you'll drive yourself nuts like I did.

Mine also mentioned "retroplacental hematomas" -- or blood clots at the base of the placenta -- but I was told that can occur during delivery, as the placenta tears away from the uterine wall. I was told by 3 doctors not to worry about this. I was STILL worried, and insisted on being checked for blood clotting disorders, which came back ok so far (I'm still waiting for a few results).
My records also talked about "extremely fragmented placentas" which made me think that I actaully had an underlying placental problem. I was told that this "probably occured during birth".

As far as the language used in the records, it made me CRAZY as well. For example, I had a dye test done to see if I was leaking fluid. It came out when I urinated. I said to them "I just peed and dye is in the toilet and I'm not sure where it came from" -- but in the records it said "patient FELT LARGE GUSH VAGINALLY while using toilet which became filled with bright blue fluid". Are you freaking kidding me?! I flipped out when I read that. That's not what happened. See what happens when assumptions are made. From now on I guess I'll have to make people repeat after me when I tell them something is wrong :o) Ok, so the dye confirmed a leak. But because the hospital used the word GUSH, my regular OBs office then updated thier files to say that I had "SPROM OF BABY A'S SAC". That is NOT what happened at all. I didn't have "SPROM" - it wasn't spontaneous at all - it was a leak that I had all along. AND during delivery it was found that Baby B's sac had a tear in it -- which means that she was the one who was leaking, not baby A. But of course now all my medical records are wrong. Ugh!

Anyway, my point is -- YOU know what REALLY happened...regardless of what exactly the records say...so try not to let it bother you too much.

PJC · 02-06-2005, 10:58 PM

Viv,

Being the little investigator I am, I would have read them, too. In fact, I'm thinking of asking for copies of both Anna's and my records. They'll probably be worrying they're going to be sued (since DBF was threatening the day Anna died), but I just want them so I can understand everything.

Anyway, the doc told me at my pp appointment that the umbilical cord had no twist (spiral) in it. She said it may or may not have been the reason. I am definitely asking our new high risk doc this at our appointment in a couple weeks. From what I read on the net, less spiraling means less activity from the baby, and that it usually has an "adverse" outcome and is sometimes associated with PTL. That's all I can really say about that, I am going to ask, though. My head was still very much in a fog at my 2 week pp appointment, and I think I misunderstood some of what she said. DBF doesn't trust anyone in the medical profession, and after reading everyone's experiences, it makes me question my own experience, you know what I mean?

Patty (Sorry I probably wasn't much help here.)

VivC · 02-07-2005, 01:01 PM

Patty - let me know what you find out about the spiraling. I was thrown off because the pathology report said it "may or may not have affected the outcome of the pregnancy." So I thought spiraling was bad. Hmm...guess this is what happens when somebody with no medical training tries to play super sleuth!

And, if anyone get copies of theirs and/or their babies records, ask for abstracts. My record was 8" thick, Rivi's was 3" (for 14 hours and 43 minutes of life!) and it would have cost a fortune to have them copied. So I got abstracts. They're still pretty thick, and they contain doctors' notes, nurse's notes (each time they monitored me, etc.), notes about calls placed to my docs, notes about the cerclage, discharge info, even a note from the hospital chaplain who prayed with me while Rivi was dying. I was annoyed because the nurse I didn't like (the only one, everyone else was wonderful) wrote a note about how I was inconsolable, weepy and depressed. How else was I supposed to feel? And I wasn't inconsolable. The other nurses took time to talk to me and comfort me. And none of them made notes about it. I really don't like her.

PJC · 02-07-2005, 02:55 PM

Viv,

I will definately let you know what the doc says. Our appointment is on March 2, 2005. If you want to read some stuff on it before hand, I just googled it. It's technically called "hypocoiling" but I didn't find much with that. Go with abnormal spiraling of umbilical cord (or something to that effect) and see what comes up.

Oh my gosh, I didn't realize the records would be so thick! I thought they would fit into one of those manilla folders!! How much do they charge you for the abstracts or the whole thing? And who should I actually ask to get them? Thank you, I wouldn't have known to ask for the abstracts.

At my pp appt, I don't even remember the doc mentioning the spiraling of the cord. I thought she said something about the way the cord was inserted in the placenta, and that sometimes the pregnancy goes along fine, so they couldn't really say for sure if that was even the reason. I was under the impression from what she told me that maybe the cord was inserted at more of an angle or something, where it should have been attached straight on at a 90 degree angle. I thought maybe it was kinked a little bit. So, "super sleuth" (LOL) that I am, I did my online investigations. I was so happy because it looked like it was a fluke, and of course I had been worried about a future pregnancy.

When I went to return the breast pump a month after Anna was born, I had to go up to the ob's office to get the doc to sign for the milk bank saying I was healthy, blah, blah, blah. I asked the nurse what this thing w/ the cord was called. She got a doc to come in and talk to me and that's where she explained about the cord having no twist. More or less all she said was that we still don't know why she was born so early. Great, back to square one. I, of course almost lost it. She said the twist usually develops later in the pregnancy, and is usually associated w/some defect in the baby. This is not exactly what I've been reading on the internet from various sites. I've read that spiraling is usually defined by the 6th week (I think, anyway it was somewhere between the 6th and 9th week). It does occur in babies w/defects about 1/3 of the time. To me that means 2/3 of babies who have this are w/out defects! Also is associated with premature birth and sometimes still birth. My question is that if less spiraling means less activity from the baby, then why wasn't she active? Anyway, I did read that there is more spiraling as the pregnancy progresses, but that is from the activity of the baby, which is normal. I also read somewhere that there can sometimes be abnormal cord insertion along w/ the abnormal spiraling thing, probably somewhat what the doc was trying to explain to me. I'll tell you, there is a whole lot more about having a baby than I ever learned in HS biology!

I can't believe that nurse wrote that about you. A fine example of a person who enters a profession that has no business being there. I couldn't imagine the nurse that was with me when Anna died being mean to me. She really helped me and comforted me. Now DBF, on the other hand, she never let on to me how aggravated she was with him (he was not very cooperative on the phone). I went in to see her just before Christmas and brought some baked goodies for the NICU staff. She had been wondering about me since the day Anna died, but not wanting to call where it was so close to Christmas, knowing it would be hard. I was so thrilled I went in (I almost mailed it to them!) I was crying, but so happy she was thinking of me. Now that nurse and I chat through e-mail (it also turns out she lives just the next town over).

Overall, I think the care there was pretty good for Anna, despite the fact that she's not with us now. It's MY care before that I have a bit of issue with. I just wish I knew the complications I was at risk for w/pcos. Maybe it didn't even have anything to do w/it, but I still wish I knew, for I would have been more in tune to the symptoms I noticed but dismissed as normal, I guess. I know we can't do the shoulda, coulda, woulda, thing, though.

Patty

VivC · 02-07-2005, 06:29 PM

Call your hospital's medical records department. My file was thicker because I was in there twice, 5 days each time (rescue cerclage, then for PTL/Delivery). My hospital sends the files out to a copying company, who then sends the copies along with an invoice. Mine was about 200 pages, and I was invoiced $68.00. Rivi's was about 50 pages, and I was invoiced $17.00.

I still want my records from doctor incompetent, but I'm debating whether they're necessary. I don't really want to have to deal with him, and now he's charging a $25 handling fee for copies of records because his malpractice went up. Wonder if somebody sued him?

I definitely want to see the report from my 19-week US. I was laying there as she was checking my cervix, and she said, "Oh, isn't that cute - his foot is IN YOUR CERVIX!" I freaked out, but then when he moved and she went back, all was okay. Maybe she meant ON my cervix. Who knows. I just hope to God she didn't drop the ball, too. It's scary how many idiots somehow managed to obtain such important jobs!

The good news is that next time the Peri will do all of the US. Somebody who knows what to look for!

PJC · 02-08-2005, 07:14 PM

Thanks Viv, for the info on the medical records. I will look into that. It IS amazing that idiots get such important jobs. I'm really starting to understand why DBF is having so many trust issues w/medical personnel.

Patty