Pregnancy Story Part 3: Fetal Surgery + Cervical Cerclage
If you haven’t read parts one and two, head over to those blogs for the full story!
Hospital & Surgeries
After one night in triage, and my poor husband having to sleep on a gurney - labor and delivery (L&D) was full and not ready for our late and unexpected arrival) - I was hooked up to an IV and prepped for the first slot the next morning for surgery. And as is the theme with the pregnancy, it was TWO surgeries, not just one.
Needless to say, I was scared, and I was worried for my twins and myself during this surgery. But I was happy to have it done, as it would likely treat the TTTS and lead us to a path of growth and recovery. It was definitely a morning filled with prayer and deep breaths.
Fetoscopic Laser Surgery Experience
Fetoscopic Laser Surgery is a treatment for Twin to Twin Transfusion Syndrome (TTTS) which we were diagnosed with and you can read more about in my diagnosis blog. For those interested, maybe moms and dads who have this surgery on their horizon, I’ll go over my experience at Johns Hopkins in Baltimore. But know that every medical team and every woman’s body and pregnancy is different. Though, I wish that I had some type of account to read before going into my surgery to help me feel more prepared. You can read more details about the surgery here.
Fetal Laser Ablation Procedure
For the procedure, I had to be fully coherent because I needed to be able to control my body and follow direction if needed. This is a VERY precise laser surgery performed in the uterus through a small incision (about a half inch). I could not talk or take any deep breaths as that would be the equivalent to an earthquake for the procedure - so…you know….no pressure.
I was given a local anesthetic for the incision area and then one deeper down. I’ll start by saying that a few days after the surgery the doctor said the team could’ve administered more anesthetic so I probably felt more pain than I was supposed to. The worst of it, and probably the weirdest and one of the more painful things I had ever felt, was the entry of the laser/camera tool. It was a sharper pain (probably not nearly as bad as it would’ve been with no anesthetic) and a bunch of weird skin level and internal organ pressure for the lack of a better description. I may or may not have kicked out my leg and disconnected their ultrasound screen showing them what was happening inside the uterus while they were in my uterus. Talk about a stressful situation for the entire room. They quickly got that back up and working. I felt so bad but they assured me it was okay, but also to not move again.
The team gave me meds in my IV to cut the edge off my anxiety and a bit more of the pain, but I did feel skin level pulling and some pain - nothing more than a tattoo would feel like. Though, with it being surgery, it was a lot more scary than getting a tattoo and I probably over dramatized it in my head. I think the procedure was complete in 30-40 minutes.
Cervical Cerclage Surgery Experience
My second surgery was a cervical cerclage, which is a stitch that holds the cervix closed. In my case, this was done to stop my cervix from shortening further, to keep it closed, and give it more support. These have to be removed before giving birth. In the end, I ended up having to get two because I was still contracting during surgery and it was hard for the doctor to place the cerclage where she wanted it the first time. Two is not unheard of, just not very common.
This procedure is far more common than the laser. And I was thankfully given a spinal tap, which was the worst part pain wise and it wasn’t even that bad. It felt like getting a normal shot on the initial poke, then started going numb. I quickly lost feeling of temperature and pain from the waist down, as well as being able to move my limbs. It’s similar to if you’ve had a limb go numb and you can still feel pressure and pushing but nothing else as far as temperature or pain. Definitely weird - but not scary or uncomfortable.
And for those who haven’t gotten a cerclage - here’s a quick rundown. Your legs are up and spread, and my table was angled with my bottom half upward with my lady parts and more all on display to about 5 people….lovely. But something I got over very quickly as the team made me feel very comfortable and I was exctatic to be numbed for the whole process.
I can only speak to what I felt and not the actual procedure itself. I felt zero pain and only a lot of pressure, though nothing very uncomfortable. I think this one lasted for about 30-40 minutes as well.
Recovery
Once we were done, I was transferred to a rolling bed and wheeled off to the L&D recovery space for a couple hours where I was kept on a magnesium and saline drip to keep me hydrated and lessen/stop contractions and keep my uterus calm. Then I was moved to a room in L&D for the night. My sweet husband was there through it all and completely forgot to eat until dinner time. When I made him go to the cafe and buy some real food for himself and a big chicken breast sandwich for me as I was cleared to eat solid food after a day of only clear liquids.
Magnesium is a heavy muscle relaxant which requires you to stay in bed. I was also on a couple other medicines to help with contractions as well. This lasted the rest of the day after surgery and through the night until 6 AM, when I was taken off of it. I remained in the hospital for 1.5 more days for monitoring and care for my contractions and ultrasounds of the babies (who were doing well post-op).
Thankfully, my contractions subsided to about 1 per hour and then less than that the final day and we were discharged! Afterwards, I was put on limited movement / bed rest for 2 weeks. Then work from home for 2 weeks after that. Then easing back into the office after that. I’m writing this at the end of my two weeks of bed rest.
How it’s Going
I haven’t had much pain, and am on two different medicines alternating every 3 hours for contractions along with a progesterone to assist with my cervix lengthening. While it’s a bit cumbersome to wake up every 3 hours overnight, I’m more than happy to do it to keep my babies baking for as long as we can. And I mean - I’ll have to be waking up on the same schedule once I have newborns, so I’ll take the prep!
Moving forward, after two weeks of ultrasounds at Johns Hopkins, the babes are leveling out as they should be. Baby B is slowly acquiring more fluid, and baby A’s fluid is slowly decreasing. The doctor’s say it takes about two weeks for things to get back to how they should be. As of now, both babies are in-range as far as size, though B is still smaller than A and might just stay that way. Which as long as they come out healthy, I am completely okay with!
I am 20 weeks pregnant today - WOO Half baked! - and I’m just starting to feel baby A (the larger one) move a bit here and there. I have an anterior placenta so that tends to muffle the feeling from what I understand. We’ve “graduated” from Johns Hopkins, and have been cleared to see the high-risk team locally moving forward at a weekly pace for the rest of the pregnancy as long as all keeps progressing in the positive direction.
God is definitely great and has blessed us (parents and babies and the medical team) through this whole experience. I am positive that this would not have been possible without Him.
If you are scheduled to get a laser or have already, I’d be happy to chat with you, pray for you, or be a support! Just send me an email or DM on Instagram.