Baby Declan Johnson

When you think of having your first child together the images that come to mind are of joy and happiness, sonograms and gender reveals, baby showers and setting up a nursery. You think of watching the baby kick and listening to his or her heartbeat. All of these things over 9 months help you and your family prepare for a new and exciting chapter coming in your life. For Dustin and Savanna Johnson it has hardly been exciting- From the moment they found out they were pregnant, fear and threatened miscarriage has been the shadow that has loomed over them. Savanna first suffered from a significantly large subchorionic hemorrhage. Savanna was bleeding significantly for over a week and would continue to bleed throughout most of her pregnancy so far. Savanna was put on bed rest and pelvic rest along with weekly sonogram visits to check on the status of the hemorrhage and baby. Then during a routine blood test done around 16 weeks Savanna tested positive for a high Alpha Fetoprotein (indicator for neural tube defects) and they were referred to a high risk specialist from Shreveport. The high risk doctor confirmed that Savanna has complete Placenta Previa and a strong possibility of Placenta Accreta. Dr. Barrilleaux then referred her and baby Declan to a team of doctors in Houston who specialize in Placenta Accreta. Dr. Barrilleaux also confirmed that the placenta itself is in very poor health. Lacuna (lesions) litter the placenta and a placental lake has formed putting the baby’s health at even more risk.

Complete Placenta Previa is when the placenta forms and grows directly over the cervix. This causes issues as the placenta grows and gets larger, the weight of the placenta and baby can lead to preterm labor. This risk is compounded by Placenta Accreta which is where the placenta grows directly into the wall of the uterus. This means that any contraction of the uterus could tear the placenta. On average the placenta passes 6 liters of blood every minute. This endangers the mortality of Savanna and baby Declan- if labor were to start or bleeding of any kind were to happen without being close to a hospital that is equipped to handle Accreta it could be a fatal event.

After visiting Texas Children’s Hospital in Houston on February 17th, all of the Johnson's fears and concerns were confirmed: Unhealthy placenta, complete placenta previa, and placenta accreta with possible invasion of Savanna’s bladder. It was also discovered that there is too much fluid inside the uterus(Polyhydramnios) causing increased pressure on her already thin and damaged uterine wall. The doctoral team in Houston said these conditions and risk factors require Savanna to stay in Houston within 10-15 minutes of the hospital in the event that any one of these conditions worsened, preterm labor were to start, or spotting/bleeding of any kind were to occur. The Johnsons agreed to stay after their next appointment on March 17th in which Savanna will be just 27 weeks. This means they are required to live in Houston for 6 weeks prior to surgery and then possibly some time after Declan is born for his stay in the NICU. As of now they are looking at a stay of 3 months.

This C-Section is much more invasive and has more risks and complications than a traditional Cesarean. The best case delivery is 33/34 weeks. At that time Savanna will be admitted into the hospital two days prior to the scheduled C-Section to receive steroid shots’ to help Declan for life outside of the uterus. On the 3rd day a spinal will be given and Savanna will need a Cystoscopy done prior to starting in order to view inside her bladder and see what damage has occurred so the team knows how to best approach. Next, the urologist will place urethral stents in as well as a central line/aortic balloon into Savanna’s main artery in her groin area to decrease blood flowing to the area where the doctors will be working and hopefully help to decrease the risk of blood loss. Savanna will receive a vertical peri-umbilical incision(starts above the belly button down to her pelvis) in order to give the doctors more visibility and work space. There are so many unknowns at this time as to how things will go once the surgery is started. Savanna could end up intubated and under sedation in ICU if a blood transfusion is required or if there is a possibility of needing to go back in a reoperate once she is closed. If all goes well Savanna is looking at 5 days in the hospital after delivery. With the possibility of up to 14 days and bladder repair surgery attempted at that point- but they are hopeful that will not be the case and no extra damage will be done during removal of Declan and the placenta.

They have applied to stay at the Ronald McDonald House, however due to the risk and liability of Savanna’s condition the RMH requires that somebody stay with Savanna at all times and that it be the same person for the safety of the other children and families staying in their facility. This will put Dustin having to take time off of work and relocate to Houston as well. Savanna nor Dustin will be able to work for approximately three months while paying 25 dollars a day to stay at the Ronald McDonald house and maintain life and bills here at home in Louisiana. Savanna will also be leaving her 3 older children here so they can finish school- a hard season for sure. Any support would be greatly welcomed and appreciated.