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Friday, August 07, 2009

Baby V - birth

And I thought it was another routine couple of days' stay at the hospital to stop the bleeding and I could go home / back to work after that. 24hrs later but 73 days early, Baby V was born.

It was a stressful couple days preparing the big audit by our HQ, and I've worked hard staying late most of the week before. Right after the 2 day presentation and meeting, all were satisfied and we went for dinner.

I drove home after dinner and rested. But I noticed some blood clots and immediately got E to send to me my gynae's hospital (un-named due to possible repercussions). On the way there, I felt cramps and thought this MUST be false contractions, I am WAY TOO EARLY to be starting labour.

But when we were there, I was indeed in labour. 4 cm dilated to be specific. I was given Dexsar to help the baby's lungs develop faster to adapt to the breathing in air world. The hitch was the medication needed 2 doses administered 12 hours apart, and a total of 24 hours for it to work fully. We may not have that much time. I was put on sabutamol to relax the womb and hopefully buy some time.

The pedae arrived and was on standby, and the prognosis according to him was worrying. Lots of things could go wrong with a birth this early. 29weeks + 2 days. Not to mention the astronomical costs of Neonatal ICU (NICU) at a private hospital, estimated at $1k per day, for 2-3 months...

We frantically pulled on strings to move me to KK where I hope to get into a C class ward, but KK told the doctors that they were full and I will not be excepted if I were to transfer there. We tried NUH and SGH where both are going to be more expensive than KK, but have a system for reduced charges once fees hit a certain ceiling.

It was passed 12mn, and I woke up my parents. Demanding over their protests to wait till a more godly hour like when the sun is up that they pull on some very distant strings, waking several families in the mean time. And the final verdict was to have me change back into my street clothes and transfer to KK in a private ambulance (making no mentions of the hospital I came from) and just show up at KK A&E. The delivery was thought to be imminent and my gynae and padae were worried enough to hop into the ambulance with me and deliver the baby in the ambulance if necessary. I can't tell you how gratified I was with their unselfish thoughtfulness and professionalism, and the comfort in thought that they were there.

There was some grilling at KK admission, and was told that if not for the dire circumstances that I was in and being unfit to be moved, I would have been moved for there were not enough ventilators. But thank goodness the long distant strings were pulled and favors were granted. No time were lost even during the questioning, and I was quickly changed and examined.

6 cm dilated.

I was given another dose of dexsar at 230am. The doctors dithered with their administration of sabultomol in increasing dosage of 15ml per half hour due to the side effects (both short term and long term) on the heart. But I pleaded with them to up it to the max that my heart could withstand ASAP, before the window closes and the tipping point reach, where too little too late was given before the labour proper starts and the baby would have lost all fighting chance (time) for her lungs to be ready.

They agreed with me, but not before counselling us on the pros and cons, and amongst them... we have 2 other children. The very stark message being, they were responsible for both mother and child, but they judged it to be more important to have 1 mom + 2 kids than 3 kids with no mom. Yes... but still. They upped the sabultamol.

The next 20 hours were filled with waiting, where waiting was good. I was prescribed anti-biotics, blood drawn for various tests, monitored closely to ensure that my heart rate was no higher than 130 per min.

We waited and counted down the 24 hours required for dexsar to work. We didnt dare to hope for much, but celebrated every 30min. At first just to reach 6am (3.5hrs) than to 8:30am (6hrs where a quarter of the dexsar would have worked) than to 2:30pm (for the 2nd dose of dexsar to be administered at KK). We didnt believe that we managed to hold till then, I suspect not even the doctors.

At some point, my heart rate went racing above 138 and blood pressure dangerously low at 94/54. They lowered the sulbutomol, and soon the contractions gotten so much worst that I thought I was going to deliver, they gave me the gas mask and I breathed in freely. We held on and they increased the dosage of sulbutomol partially as my vital stats stabilised.

The target was 2:30 am 1/8/09 but by 10pm, I was post-dilated and the baby's head was low in the birth channel. I felt weak and told E that I could not go on.

He was dissappointed. And I was dissappointed that he was. I mean, the objective was both lives, wasn't it? At this time the doctors came in and he asked again about the side effects of the salbutomol and told them that I was feeling weak. My faith in him thus restored. And the doctors decided that there was no point waiting further. It was 20 hours after the 1st dose of dexsar in KK was administered, the baby's lungs had more than a fighting chance.

The 2 teams of doctors came in to the labour room, and the neonatal team was told to "be ready for resuscitation". I prayed as they pricked the water bag and I started pushing.

Baby V was born 1350gm, 41 cm long and 26 cm head circumference. Stats that were better than we had dared hoped for at such an early gestational period, and historical data from her elder petite siblings.

A CRY! A small cry from the baby! She's breathing! She does not need resuscitation!

That took everyone by surprised. She was quickly cleaned up and wrapped in cling wrap to preserve her body temperature. When she was ready to be pushed into the NICU, the neonatal doc gave E a slap on the back and congratulated him, telling him what a good girl we have there.

Baby V after birth

It was a minor miracle.

We thank all who had helped and prayed for us.

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she's lovely. congrats!
Beautiful miracle, congrats.
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