Incompetent Cervix - stitch/cerclage - threatened labour

Lizzie - sending you hugs and lots of love. No words can console the loss of a baby, it is impossible to get your head around. I had a very similar situation at 8 weeks, but I had just started to bleed when I went for a scan. I felt very guilty as I panicked when I found out I was pregnant, worried how we would cope with a toddler and a baby, and also financially. I then felt so guilty when I miscarried for thinking of those things. I think it's a case of grieving for the dreams and plans that I started to put into action. However, you don't know for definite, there may still be a chance of finding the heartbeat next week. It's not unheard of xxxxx thinking of you xxxxxx
 
Lizzie- So sorry to hear about your pregnancy, but keep you head up, sometimes mircles happens.
You are so right about worrying about things that are not important, I found out I was pregnant last week and started to panic this is my 6th pregnancy and I only have 1 child but last night I started to bleed red and went to the emergency room, I figured I was having a miscarriage and all I could think about was that I was worried and complaining about being pregnant and but I felt so bad that it was ending now but it turned out that I had a subcronic hemorrage and the baby is ok, I told myself I will not feel anymore worry about this pregnancy, whatever happens is what suppose to happen. We will get through and You will do the same. It's definitely hard, believe me.... most people cant understand how I get through after my losses especially the ones i've had at 24weeks but we are all blessed and will never be given too much that we can not handle.

Good Luck and stay positive.
 
lizzie, so sorry to hear your sad news, you're such a great help to so many women on this thread. i only posted once on here but got a lot of support and comfort from reading the posts.

I came back to post my story to try and give something back to pregnant ladies with an incompetent cervix.

i was a high risk pregnancy after a loop diathermy on my cervix only 7 months before i fell pregnant. i had a scan at 19 weeks and my cervix was 3.5cm and tightly closed. At a scan 2weeks later it had shortened to 1.9cm, still no funnelling. I was put on progesterone pessaries and scanned again at 23 weeks, it had shortened again to 1.6cm it was still closed, i wasn't given a stitch or put on bed rest. i took the pessaries until nearly 33 weeks and my waters broke 2 weeks later at 35 weeks. i had a healthy baby boy weighing 4lb 11 who needed 5 days in special care, we were home by 36 weeks. He's now 7 weeks old and doing really well. good luck to all you amazing women out there,I'll always remember how worrying this pregnancy was and hope i can offer a bit of hope to someone xx
 
Hi ladies - sad news for me I'm afraid :( I am pregnant, but had not made an official announcement on Baby and Bump yet until my family knew.

However, we went for a viability scan last night at 7wks 3days and there was no fetal pole - only a yolk sac. The sonographer would not commit to saying it was definitely a failed pregnancy, but I know enough to know it is because there really should be a fetal pole/heartbeat by now. I had begun to feel queasy and fatigued, but that began to fade so I was suspicious, and that was the reason for having a scan.

I will be scanned by my Consultant on July 1st, and she will confirm the news for me, but I suspect I may start to bleed before then. It's funny, but I was panicking about how we were going to manage the pregnancy with the twins to take care of, and I had so many doubts, but now I just feel sad and none of those worries seem important.

I know I will feel better soon, it will just take some time. I am blessed to have 4 healthy kids, and will try to focus on that to get me through. One thing is for certain, I have special respect for ladies who have recurrent miscarriages now - I felt sorry before, but now I'm not sure how they cope :( This is so much tougher than I had imagined it would be.

Thanks for listening my lovelies, and let's now get some healthy babies delivered this year to cheer us all up ;) xxx

Oh Lizzie, I am in tears and have such heartache for you. :hugs: Honestly there's nothing but time that lessons the pain of a loss. People used to throw scripture my way because I'm a Christian and it never helped. What DID though for me was Knowing that though my child had passed, He wasn't actually dead but very much ALIVE. I wasn't walking away from Him but toward Him when I would be home again and have an eternity to love our little Jackson.

It takes so much time to process and it never really goes away. You are more sensitive to your surroundings and life after something like this happens as you have expressed.

I don't know your stance on God and faith so I won't push that on you, but in my OWN healing. I had questions. I NEEDED to know if I would see my son again, not just that, but if He would know me. I've read many books but the one that is more concrete biblically is called "Heaven" by Randy Alcorn. I'll tell you that it blessed my heart and helped me to move forward in KNOWING I wasn't just walking away from my baby. He wasn't just gone. I highly recommend the book when and if your ready in the future. In the meantime, I think it's hardest when you lose a child and it feels like the world moves on and you find yourself with no answers. If you check out my link to my blog "broken heart mended fences" you'll find a few links to grief concerning miscarriages. It's what helped me through and some of the ways these women release their sadness has been SO tremendous and beautiful.

In the meantime, no matter HOW you choose to grieve. We are here for you and love you SO MUCH!:hugs: We cry WITH you and will be here for you when you need to talk.

I pray in the meantime for joy in the midst of sorrow. And like God did for me in my own darkest hours...that He would pick you up when you cannot stand and give you strength and wisdom for the grieving journey in Jesus name I pray...AMEN!

Please forgive me if my prayer affends you. I am unsure of your stance on faith but it's the only thing I feel I can do so far away when all I want to do is hug you and be a shoulder to lean on.

Love you my dear friend! :hug:
 
Hi Lizzie, just wanted to reach out to you. Your scan reminds me of the experience I had with my second miscarriage last year and as heartbreaking as it is, do not give up hope. Although, you will never forget this pregnancy, seek comfort in your family at this time. God bless you all xx
 
Lizzie- Im so sorry :( Make sure to take time for yourself and give yourself permission and time to grieve.




I had my appt today- cervix was measuring 3.4cm....Im pretty happy and excited about that! Doc is switching me to a progesterone gel instead of a tab because it has proven to be more effective, and he already sees baby bouncing its head off my cervix.
 
Thanks ladies - I knew I could share my story here, and receive understanding and support, you are all real treasures and your words of comfort mean so much :)

MA - You could NEVER offend me hun. You express your love and support with a strong faith and religious belief at its core, what is wrong with that?

Though I am not religious as such, I am a firm believer in things happening for a reason, and knowing that offers me solace at this time. I have had experiences in my life which have demonstrated that I am being guided and supported thru all life's trials - to be reminded of that by someone like yourself, whose motivation is heartfelt and well intentioned is very moving to me, so thankyou.

I know that I will be fine - I just need some time. It isn't helping that there is still some uncertainty about the outcome. While ever I am still 'pregnant', and not actually miscarrying it is tempting to hang on to some hope. I still feel queasy and tired, tho not as much as I have been in previous pregnancies, and so it is hard to accept that this is over entirely. I need some kind of closure now, but unfortunately have to wait for that - that is tough. One thing is for certain, I am so grateful that you all took the time to reply, that in itself has helped me tremendously, and I won't forget that!

Now, to everyone working so hard to get their precious LOs to term, well done! It is brilliant to read about your success Chockie, and Dash your cervix is looking amazing. I really feel that we are getting ourselves behind these babies on this thread, and getting some fab outcomes - that really cheers me up. Keep baking girls :) xxx
 
Hi Lizzie, Hi everyone

Lizzie, I am saddened at the news of your loss. I can also sympathize as I also had a loss at 7 weeks before getting pregnant with Gabriel 2 months later. You are such a great support to everyone here and I think I am not alone in saying that we are all here to support you at such a difficult time. Much love to you and your family.

I have just returned from the hospital where I received steroid shots for baby's lungs. All went well and my cervix is still holding at 15mm. I did however find out that I have gestational diabetes. I was so sure I didn't have it so I was a bit shocked to find out that news. I don't know what it all means yet because i will see the endocrinologist next week and he/she will give me more info. I suppose it means cutting out sugar altogether. I guess I'll be visiting the GD thread from now on... They also did an FFN test that came back negative which is reassuring. They said it means I won't go into labour in the next week. I always though it was 2 weeks but they said 1. Anyone have experience with this?

Hope you are all well and still baking your little bundles of joy!
 
Hi Ren - thanks for your kind words ;)

As for GD, try not to stress too much about it. I had it diagnosed with the twins, but on doing fasting blood tests, it was found that I didn't. If I had, it would have been controlled by dietary adjustments alone - smaller, regular meals with more veg to carb ratio etc, and avoiding anything overtly packed with refined sugars.

I hope I'm being reassuring hun, and not dismissive - not at all my intention. After all you have been thru to get to this point, GD will probably seem like a walk in the park sweet :) I am thrilled you are still cooking that little girl btw - I had a feeling you would..............I think now there is every chance your cervix will get you to term or thereabouts - fingers crossed xxx

Btw Ren - when you had your loss at 7wks, did you bleed before or after you saw an u/s confirming the loss? I haven't had definitive confirmation yet, and have no bleeding and still have nausea. I am wondering how long it will be before I actually miscarry? x
 
Hi Lizzie, Hi everyone

Lizzie, I am saddened at the news of your loss. I can also sympathize as I also had a loss at 7 weeks before getting pregnant with Gabriel 2 months later. You are such a great support to everyone here and I think I am not alone in saying that we are all here to support you at such a difficult time. Much love to you and your family.

I have just returned from the hospital where I received steroid shots for baby's lungs. All went well and my cervix is still holding at 15mm. I did however find out that I have gestational diabetes. I was so sure I didn't have it so I was a bit shocked to find out that news. I don't know what it all means yet because i will see the endocrinologist next week and he/she will give me more info. I suppose it means cutting out sugar altogether. I guess I'll be visiting the GD thread from now on... They also did an FFN test that came back negative which is reassuring. They said it means I won't go into labour in the next week. I always though it was 2 weeks but they said 1. Anyone have experience with this?

Hope you are all well and still baking your little bundles of joy!

I have type II diabetes and wear an insulin pump so I know a bit about GD. Try not to stress too much about it. You'll be watching what kind of foods you'll be eating. For instance white processed foods like pasta, white rice, white breads, cookies, cakes and candies. They'll raise your blood sugar. Switch your white processed to whole grains. Brown rice, multi grain breads, Either a protein pasta or whole grain pasta, pizza with whole wheat crust. You can even make cookies with whole wheat flour instead of white flour and I'm SURE in France you MUST have chocolate chips that are grain sweetened maybe at a whole foods store or health food store?!

It's just a matter of replacing bad ingredients with good in what you like. Agave nectar is low on the glycemic index. You should also be able to find it in a health food store and it basically tastes like honey.

Berries are low in glycemic index which means berries are less likely to cause highs.


MY BIGGEST tip is if your eating carbs....pair a protein with it. Something like Hummus, Peanut butter, beef jerky, cheese poultry, fish and/or beef.

If you pair brown rice with beans it is considered 1 full protein. So there's another source of protein. :thumbup::winkwink:

It's not at all hard and as my gram used to say, "everything in moderation". If you want a piece of cake, cut a tiny piece. Don't over-indulge on the processed sugars, but don't make yourself nuts over having a small amount either.

Lizzie, while I know your waiting for the inevitable, I'm still praying for a miracle. I know there have been plenty of stories about fetal pole issues on here. I know the circumstance is a bit different here, but I'd still like to hope until/unless they confirm. These always push me over the edge because the waiting part is SO hard on mothers. It's breaking my heart to even think it's going to happen but I suppose coming face to face with the possibilities is being realistic. Ugh how I wish I could live in a land where everything turns out happily ever after like in the fairy tales.
 
Hi Ren - thanks for your kind words ;)

As for GD, try not to stress too much about it. I had it diagnosed with the twins, but on doing fasting blood tests, it was found that I didn't. If I had, it would have been controlled by dietary adjustments alone - smaller, regular meals with more veg to carb ratio etc, and avoiding anything overtly packed with refined sugars.

I hope I'm being reassuring hun, and not dismissive - not at all my intention. After all you have been thru to get to this point, GD will probably seem like a walk in the park sweet :) I am thrilled you are still cooking that little girl btw - I had a feeling you would..............I think now there is every chance your cervix will get you to term or thereabouts - fingers crossed xxx

Btw Ren - when you had your loss at 7wks, did you bleed before or after you saw an u/s confirming the loss? I haven't had definitive confirmation yet, and have no bleeding and still have nausea. I am wondering how long it will be before I actually miscarry? x


Hi Lizzie,

Thanks for the GD info. I was really surprised to hear I had GD because I had done the fasting blood tests and passed them easily. i'll know more when I see the specialist next week. I'm not too stressed about it but like i said, just one more thing to think about!

As for my miscarriage, I started spotting before and then went to get checked.They didn't see anything and said the sac had already passed. With GAbriel, they didn't see a fetal pole when I was about 6 weeks 3 days. I insisted they do an internal and then there it was! With this pregnancy my dates were off by a week because the egg wasn't fertilized until 6 days after intercorse! We knew this because it was kind of an accident:blush: So everything was delayed for a week or so. There was only a sac when there should have been more etc. The waiting is unerving but positive outcomes are possible. Not trying to give you false hope but you just never know!

So, yes it looks like bubs will be baking for at least another week or two! I'm feeling much more optimistic now!

love to all!
 
Hi Lizzie, Hi everyone

Lizzie, I am saddened at the news of your loss. I can also sympathize as I also had a loss at 7 weeks before getting pregnant with Gabriel 2 months later. You are such a great support to everyone here and I think I am not alone in saying that we are all here to support you at such a difficult time. Much love to you and your family.

I have just returned from the hospital where I received steroid shots for baby's lungs. All went well and my cervix is still holding at 15mm. I did however find out that I have gestational diabetes. I was so sure I didn't have it so I was a bit shocked to find out that news. I don't know what it all means yet because i will see the endocrinologist next week and he/she will give me more info. I suppose it means cutting out sugar altogether. I guess I'll be visiting the GD thread from now on... They also did an FFN test that came back negative which is reassuring. They said it means I won't go into labour in the next week. I always though it was 2 weeks but they said 1. Anyone have experience with this?

Hope you are all well and still baking your little bundles of joy!

I have type II diabetes and wear an insulin pump so I know a bit about GD. Try not to stress too much about it. You'll be watching what kind of foods you'll be eating. For instance white processed foods like pasta, white rice, white breads, cookies, cakes and candies. They'll raise your blood sugar. Switch your white processed to whole grains. Brown rice, multi grain breads, Either a protein pasta or whole grain pasta, pizza with whole wheat crust. You can even make cookies with whole wheat flour instead of white flour and I'm SURE in France you MUST have chocolate chips that are grain sweetened maybe at a whole foods store or health food store?!

It's just a matter of replacing bad ingredients with good in what you like. Agave nectar is low on the glycemic index. You should also be able to find it in a health food store and it basically tastes like honey.

Berries are low in glycemic index which means berries are less likely to cause highs.


MY BIGGEST tip is if your eating carbs....pair a protein with it. Something like Hummus, Peanut butter, beef jerky, cheese poultry, fish and/or beef.

If you pair brown rice with beans it is considered 1 full protein. So there's another source of protein. :thumbup::winkwink:

It's not at all hard and as my gram used to say, "everything in moderation". If you want a piece of cake, cut a tiny piece. Don't over-indulge on the processed sugars, but don't make yourself nuts over having a small amount either.

Lizzie, while I know your waiting for the inevitable, I'm still praying for a miracle. I know there have been plenty of stories about fetal pole issues on here. I know the circumstance is a bit different here, but I'd still like to hope until/unless they confirm. These always push me over the edge because the waiting part is SO hard on mothers. It's breaking my heart to even think it's going to happen but I suppose coming face to face with the possibilities is being realistic. Ugh how I wish I could live in a land where everything turns out happily ever after like in the fairy tales.

Thanks MA! I won't see the specialist until next week so i'll take your eating advice and try to follow it this week. It will be good for me anyway. I'd like to keep my weight under control until the end of this pregnancy. I've put on about 30lbs already and would really like to stop there. Looks like I'll be throwing out the tub of chocolate ice-cream in the freezer...oh how I will miss you!! Thanks again hun!
 
Hi Lizzie, Hi everyone

Lizzie, I am saddened at the news of your loss. I can also sympathize as I also had a loss at 7 weeks before getting pregnant with Gabriel 2 months later. You are such a great support to everyone here and I think I am not alone in saying that we are all here to support you at such a difficult time. Much love to you and your family.

I have just returned from the hospital where I received steroid shots for baby's lungs. All went well and my cervix is still holding at 15mm. I did however find out that I have gestational diabetes. I was so sure I didn't have it so I was a bit shocked to find out that news. I don't know what it all means yet because i will see the endocrinologist next week and he/she will give me more info. I suppose it means cutting out sugar altogether. I guess I'll be visiting the GD thread from now on... They also did an FFN test that came back negative which is reassuring. They said it means I won't go into labour in the next week. I always though it was 2 weeks but they said 1. Anyone have experience with this?

Hope you are all well and still baking your little bundles of joy!

I have type II diabetes and wear an insulin pump so I know a bit about GD. Try not to stress too much about it. You'll be watching what kind of foods you'll be eating. For instance white processed foods like pasta, white rice, white breads, cookies, cakes and candies. They'll raise your blood sugar. Switch your white processed to whole grains. Brown rice, multi grain breads, Either a protein pasta or whole grain pasta, pizza with whole wheat crust. You can even make cookies with whole wheat flour instead of white flour and I'm SURE in France you MUST have chocolate chips that are grain sweetened maybe at a whole foods store or health food store?!

It's just a matter of replacing bad ingredients with good in what you like. Agave nectar is low on the glycemic index. You should also be able to find it in a health food store and it basically tastes like honey.

Berries are low in glycemic index which means berries are less likely to cause highs.


MY BIGGEST tip is if your eating carbs....pair a protein with it. Something like Hummus, Peanut butter, beef jerky, cheese poultry, fish and/or beef.

If you pair brown rice with beans it is considered 1 full protein. So there's another source of protein. :thumbup::winkwink:

It's not at all hard and as my gram used to say, "everything in moderation". If you want a piece of cake, cut a tiny piece. Don't over-indulge on the processed sugars, but don't make yourself nuts over having a small amount either.

Lizzie, while I know your waiting for the inevitable, I'm still praying for a miracle. I know there have been plenty of stories about fetal pole issues on here. I know the circumstance is a bit different here, but I'd still like to hope until/unless they confirm. These always push me over the edge because the waiting part is SO hard on mothers. It's breaking my heart to even think it's going to happen but I suppose coming face to face with the possibilities is being realistic. Ugh how I wish I could live in a land where everything turns out happily ever after like in the fairy tales.

Thanks MA! I won't see the specialist until next week so i'll take your eating advice and try to follow it this week. It will be good for me anyway. I'd like to keep my weight under control until the end of this pregnancy. I've put on about 30lbs already and would really like to stop there. Looks like I'll be throwing out the tub of chocolate ice-cream in the freezer...oh how I will miss you!! Thanks again hun!

We have sugar free ice cream here. Not sure if you can get it where you are but there is sugar free chocolate ice cream. Wish I could send you my favorite Stonyfield brand. As I said, it's just kinda taking what you like and reworking it with a new ingredient. I usually make my own ice cream in the summer and use natural sucanat which is like brown sugar but in it's more natural form. I even can jams and jelly using agave nectar and it STILL tastes good.

It took me awhile to learn I could still have the things I liked, just needed to work in something different. For instance, instead of adding oil in your chocolate cake mixes, add in black beans for chocolate mixes and white beans for white mixes and you have a healthier cake. I think it's cup for cup to replace them if I believe. I'd have to look at that one.

Good luck. It shouldn't be that hard for you. As lizzie said, you've been through MUCH tougher a situation!:winkwink::hugs::flower:


AFM, thought I'd do a small update. I'm on flagyl for BV and the other day they called to tell me I have an odd bacteria in my urine sample so now I'm on macrobid too. :wacko: All this bad bacteria! Goodness. ah well, at least we caught it early. :thumbup: Today's 17P injection caused blood to spurt out of my butt. :haha: Never had that happen before. I think the rock solid pilling in my muscle is causing things to shift. Doug felt terrible, but it's a part of the process. 25wks on Sunday! :happydance: NEVER would have imagined I'd get this far. 11 more weeks of the injection...not sure if they'll take the stitch out at 36wks or 37 for me. It's SO awesome to see a bright side and maybe even think I'll make it to term. Holy Cats! Does that ever make me excited!

Have a good weekend ladies! :hug:
 
Hi,

Ren- all sounds great with you (except the GD which I am SURE you can handle, you have overcome so much more). Bonne chance cherie xxx

MA - sorry you have another infection, but they sound really on the ball with this monitoring and i've got everything crossed you'll have a peaceful ride from now on. The cervix envy friend sounds like a bit too much to handle at the minute, sometimes you just have to choose your battles for the sake of tranquility and sanity. 25 weeks is marvellous, well done hun xxx

Chockie - congrats on the birth of your baby, that's wonderful news and gives more hope to those in the earlier stages. I know how glad I was to hear of successful outcomes when I was in the stressful 20's.

Lizzie- how are you doing today? Hope you're not being hard on yourself, but you're allowing yourself to grieve. I don't think there is a single lady in the world who doesn't have a feeling of panic at a positive pregnancy test, but the fact that ic complicates the pregnancy somewhat means that your worry was absolutely justified. In fact, it shows just how much you care and want the baby as you have obviously pictured yourself weeks down the line, managing the pregnancy and your beautiful children. Please don't feel guilty for worrying about these practicalities.
The torment of being in limbo is hard and makes this situation even more
difficult to bear. Please remember that we're all here for you - you've supported me when I was in my worst, darkest place and I'll never forget that kindness. :hugs:

Sherri? Any news? Xxxxx can't wait!!! :hugs:
 
Lizzie im so sorry to hear that you are going through such a tough time. Thinking of you x

Im now 30 weeks and 3 days pg with my elective stitch - i have managed to clear the anaerobes so no infections for the last 2 weeks thankfully!!!!

How is everyone? x
 
hi this is my first time on here.. i really need some advise..please..;(

i lost my son when i was 24 weeks pregnant-july 2010, one minute i was fine, then i got pains, i instantly knew they were contractions, about half an hour later i was at the hospital, they examined me to then tell me i was 10cm dialated, as my waters were bulging, then my waters broke and i had my son 2 hours after..!! he died due to a true knot :cry: miss him lots.
i have recently found out i am around 10 weeks pregnant we are so happy,:thumbup: but ssssooooo scared, my consultant has suggested we have a stitch, but im scared on my rates of having this baby.. has anyone else been through this, pls... im loosing my mind with worry...
 
hi this is my first time on here.. i really need some advise..please..;(

i lost my son when i was 24 weeks pregnant-july 2010, one minute i was fine, then i got pains, i instantly knew they were contractions, about half an hour later i was at the hospital, they examined me to then tell me i was 10cm dialated, as my waters were bulging, then my waters broke and i had my son 2 hours after..!! he died due to a true knot :cry: miss him lots.
i have recently found out i am around 10 weeks pregnant we are so happy,:thumbup: but ssssooooo scared, my consultant has suggested we have a stitch, but im scared on my rates of having this baby.. has anyone else been through this, pls... im loosing my mind with worry...


I don't know what a "true knot" is hun, but I can tell you I lost my son Jackson at 22wks. I lost my mucus plug from what I'm now thinking was an Incompetent Cervix, And I had TERRIBLE bacterial Vaginosis which moved to the cervical area and caused inflammation to the amniotic sac and thus I too had a bulging sac which led to delivery and 25 minutes, my son was dead.

Because of the women in here and by the grace of God, I surpassed that 22wk milestone and almost past viability week where tomorrow will be 25wks. I learned in here I had IC and got the stitch at 22wks (though NOT without a fight for monitoring as I wanted the darn thing at 14wks)

I also have been taking 17P injections to keep PTL at bay. Both have seemed to help a great deal and while I'm STILL dealing with bacterial infections this pregnancy, I am being closely monitored and seem to be on my way to what I HOPE will be full term. I NEVER thought I'd get this far.

That stitch is an EXCELLENT miracle! I think you will be just fine now that you have someone willing to take this precaution. Many of us have had to FIGHT for it!:winkwink:
 
hi this is my first time on here.. i really need some advise..please..;(

i lost my son when i was 24 weeks pregnant-july 2010, one minute i was fine, then i got pains, i instantly knew they were contractions, about half an hour later i was at the hospital, they examined me to then tell me i was 10cm dialated, as my waters were bulging, then my waters broke and i had my son 2 hours after..!! he died due to a true knot :cry: miss him lots.
i have recently found out i am around 10 weeks pregnant we are so happy,:thumbup: but ssssooooo scared, my consultant has suggested we have a stitch, but im scared on my rates of having this baby.. has anyone else been through this, pls... im loosing my mind with worry...

Hi there hun, and I'm so sorry for your loss :nope:

Please, please don't be afraid of the stitch, and accept your Doctors offer of placing one as soon as possible. With it you have an excellent chance of getting to term.

IC is a cruel pregnancy complication, but fortunately it can easily be fixed, but often the problem is getting Docs to agree to a stitch at all. If yours are pro cervical stitch then go for it. Good luck xxx
 

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