The journey so far...from Prem to Boy

This blog is for my personal observations of my little boy's developmental path and adventure in learning about the world.  Started for my own records, but published here so I can save and manage the info,  hopefully this blog of a Mum's thoughts-made-visible can entertain or possibly enlighten those interested in child development from a layman's perspective.

BIRTH AND BEGINNINGS

Blake was born just over 5 weeks early, gestational age 34+5w, by induction, due to sudden and marked Intra-Uterine Growth Restriction (he went from upper range centiles in the first trimester to 2nd centile by weight at birth, with an average gain of only 45g per week in the final fortnight), caused, most likely, by a severe concealed Placental Abruption (subchorionic haematoma) that made swiss-cheese of my placenta.

From 19w GA whence it was discovered during the routine gender-determining and developmental ultrasound scan, the PA had waxed and waned, healed and abrupted, never bleeding externally but dissecting the placenta and completely infiltrating it until only 20-30% functioned normally, the rest a mass of gritty, piecemeal, dysfunctional tissue.  He had thrived despite the harsh conditions, small, but otherwise healthy.  After some bed rest and a changing medical game-plan based on the tried-and-true scientific 'wait-and-see' approach, my uterus became irritable ('irritable uterus syndrome') from the constant bleeding, sending me into early contractions at 27.2w.  I was hospitalised due to Threatened Pre-term Labour (fibronectin test negative), given Nifedepine and monitoring, and labour was mercifully arrested.  I had a severe talk with my body and begged and cajoled it into holding on, keeping the boy inside.  This event galvanised my care team into action; my care was transferred to a hospital with a NICU (Mercy Hospital, Heidelberg, Melb.), I had fortnightly growth U/s scans and doppler scans of the abruption to assess the chances of it packing up or keeping going for a little longer, and twice weekly CTG's (fetal monitoring) to assess bub's health.  Also on the list were steroid injections to mature bub's lungs in case of a pre-term birth, and 'Anti-D' shots to help prevent bub's blood from interfering with my immune system, if perchance the placental blood was crossing the chorion into my system.

Then began the waiting game...it felt like russian roulette ~ wanting my baby to hang in there and grow, and not leaving the birth too late till there was no live birth at all...   If it wasn't for the fortunate discovery of an old scholl friend becoming my obstetrician through a chance meeting at the Mercy's maternity clinic, I doubt the outcome would have been anywhere near as optimal as it was.  I was extremely lucky to have a doctor who listened to and cared about my concerns, and responded to my worries.  I was told to expect a 35wk premmie (preemie), then 34, 33, or 32wks or earlier.  I started looking into premmie care; touring the Special Care Nursery and NICU, and all along I had bought clothes in ever decreasing sizes.  This allowed me to at least feel some control and input into an anxiety-provoking and unstable situation.  I eventually stopped at 000000000 sized clothes...and he grew into those clothes ten days after birth.

Blake was born at 11:30pm on the day of the induction, which began at 9am with Artificial Rupture of Membranes and Oxytocin IV (no prostoglandin gel, as it can hyperstimulate the uterus).  I won't go into the labour and birth too much here, but it wasn't that pleasant, with 7 attempts to hook a monitor to bub's head to allow me to move around, uninterrupted monitoring due to the placenta's crap and fragile condition, and uninterrupted vomitting due to my crap and fragile condition.  He emerged, blessedly, with a textbook 'A-Waaa, A-Waa' cry, breathing well, with apgar scores of 9 and 9.

True to the final growth scan, he was 1759g at birth, 44.5cm long with a head circumference of 28cm~ roughly the size of a 30-31wk baby.  He was on CPAP for 11hrs for respiratory support, in an isolette for a fortnight, and in Special Care for a month.

Therefore his age is corrected (reduced) by 5w+2d until 24mo to reflect his prematurity.  I used to think his developmental path lay somewhere in between true and corrected age, but in reality, like all bubs, he is behind his peers in some things, and rockets ahead in others.

I have kept charts and notes since becoming accustomed to this in the SC Nursery, and it will take me sometime to catch up and post my observations here, as he is now almost 21mo (19.5mo corrected age ~ hereafter referred to as CA).

So here begins the task ~ of scribing my notes on past things of note and current updates of Blake's progress through learning.