Incompetent Cervix - stitch/cerclage - threatened labour

[LaRockera]

It seems that I have missed some posts a few days back, I'm sorry, I'll answer them straight away.

Jimmy - I refused to shop anything until I was 27/28 weeks. I was just too paranoid, and even then, I did it one bit at a time. The only thing I ordered around 20/22 weeks was Xanthe's nursery, which was just too much of a bargain to be missed: cotbed, wardrobe and drawers with changer from £1000 to £550! And even then, I just had to give a 10% of the full amount to secure it on my baby plan. Of course, when the time came DH and I were all over the place because we had only a few weeks to buy, assemble, wash and prepare everything before we'd leave for Greece. Luckily, it coincided with Xmas/January sales, and I got a lot of things half price.

Christiana - We will definitely meet at some point. I'll leave Athens at some point in March/early April (provided it all goes well, paranoia never leaves you as you may already know), and return by the end of August/September. I'll tell you what. You'll have had your own baby by now, perhaps you can come to Xanthe's christening? We're doing a small and discreet one in a chapel or something for the sake of the parents, so I'll have the chance to meet you in person and chat a bit.

Bookfish - hmm, I think you're doing the right thing to wait. With a bloody clot in there, I agree with the rest of the ladies, better leave it alone. Easier said than done for sure, but be patient hon, and it will be over soon. I have frequent attacks of vulvodynia (vulva goes sore and raw for an hour or two) and I always take comfort in the fact that it's just down there, and by baby's not in trouble. I've always said I'd rather have tons of that than anything else.

Olga - hon, I'm so sorry you're going through this. I know how you feel. When I first joined the thread I used to see garrickbaby's and truthtobetold's and MA's tickers and wish time would fly by and I'd reach full term soon. Well, guess what? It happened! Fingers crossed, I'm full term in six days! Although I never stop worrying, even though IC is an obstacle I can confidently say I bypassed in this pregnancy. There are plenty of other things to drive me mad. By the way, I agree with Lizzy, I think your cervix is in a decent length, and even if you funnel, the stitch is there to hold it closed. The stitch does work. There are ladies without it that went full term on full bed rest, and you have an unbreakable, super-strong cord-like cerclage that is designed to hold the weight of a baby, with all his/her amniotic fluid, placenta and umbilical cord. Cerclages don't break that easily hon, and your cervical length is still very decent, given you're a few days away from viability. It may very well stay the same length for weeks, that's what mine did. Bed rest sucks, I'm sure, but it can be a life saver. Take comfort in that, and the fact that time will have flown by before you even blink, and you'll soon be third trimester, and then holding your baby.

 

[lizziedripping]

Hi Christiana. A placenta doesn't move around as such, but as it and the uterus grow and stretch it does change position. It probably still covers some of the front, but the majority of it is now up and towards the back. The placenta is huge relative to the baby, and takes up a large percentage of the uterine wall.

The tightenings you feel are classic BH, and I had them all the time. I was usually left with a racing heart and butterflies afterwards, like an adrenalin rush. I was never sure if this was hormone related, or anxiety. I hated them, but by 32wks they bothered me less because I had gotten past the danger zone. Sometimes just playing on Super Mario with my son triggered them! The slightest tension or excitement was enough to set them off, and then they'd last for a few hrs. X

Thinking of you for today JJ xxx

 

[book.fish2011]

LR: yeah, how nice if all of us lagging behind here could time travel and catch up with where you are now? Will I too one day have a ticker like yours? I desperately want to.

 

[chistiana]

La rockera-that would be great!!your bub will be all grown up and may even be crawling around by september and my bub will be older too so they can meet up too and talk about how their mothers drove them crazy with anxiety!seriously though, i ll be very very honnored to come to her christening!!btw i cant believe you are almost full term...wow the weeks go by fast!

Lizzie-thanks for the explanation hun it really got me puzzled yesterday! As for the BH i am sooooo daft!!!i had them with ds too (only he was a smaller baby and only stayed in right horn of uterus) and i never understood it was bh until i went into actual labor and noticed the similarity!!thanks again xx

 

[kateqpr]

Hi everyone,

Well, what a lot has happened!

Olga - you poor thing. I know just how stressful being in hospital can be, even if you know its the best place for you, just on a reassurance level. It sounds like your doctors are being extra cautious, which is great news for you. They are as determined as you to get you to term! So trust in that. You're in a great position, and actually your cervix sounds like its in a good state, compared to so many others, so please please try and relax.

I had a stint in hospital when i was almost 24 weeks, and was eventually given the steroids, which really helped me mentally to feel like i was doing everything i could for my LO (otherwise i just felt helpless). I remember those days in hospital as being really quite difficult. I was on a labour ward with women giving birth, and it just felt so scary and out of my control. Plus i got NO sleep, which just didn't help my mental state. But these days will pass, and i promise you you'll soon be a few more weeks along and feeling a lot more confident. Just try and keep busy, with lots of books, DVDs and visitors.

Bookfish - gosh you really are going through the mill. I hope your girl bits are starting to feel a bit better now (nice medical term!). Its always stressful having an infection, but luckily it sounds 'external' so really shouldn't effect your LO's. They're very well protected in there - it just means you have to deal with the discomfort which is no fun. Hope it's starting to ease for you.

LaRockera - hello!! Cooeeee!! So good to hear you're finally settled into your new love / baby nest for the next few months. PM me your address so i can at least send you a card! And the big STITCH REMOVAL is this Friday, yes? Such a relief when it comes out. I remember walking out of my removal thinking, finally, i am a NORMAL PREGNANT WOMEN!! Such an emotional relief to have no foreign object in me. Oh, and to have a long hot bath....and the possibility of sex (yeah right...felt so so big by that stage, but the prospect that i could have it if i wanted was nice.

JJ - you poor sweetheart. What a rough few days you're having. I have everything crossed for you and your appointment today. You are due some good news, and hopefully all your hard work keeping on bed rest will have shown some reassuring results. I know just how awful this must be for you, but you are one week on, and baby is still there and happy. Hopefully the doctors can confirm that you've just had non pregnancy related nausea to put your mind at rest. And i shall come and see you next week, when Poppy is at pre school and i can bring you something exciting for your birthday week (for your should drag out any celebrations for a week, just like the Queen).

No news from me. I am just feeling nauseas today (so sicky its horrible...and yet i can't stop eating. Must be morning sickness saying hello again) and so so tired. Can't wait to try and get an afternoon nap today. I've started having to get up and wee ever hour or so at night. I hate it, and just feel like a zombie. I was fully prepared for this AFTER the baby came, but not now! Also, i have my cold back. Again. After having it already for two weeks, i thought i would have developed some immunity. Plus i'm anemic so feeling just a bit pah! Other than that, all is tickedy boo. I even got a card and flowers yesterday which was totally unexpected.

Happy Wednesday everyone - and here's to some positive news all round ladies. Come on, you can do it!

XXX

 

[book.fish2011]

Kate, loved your new term, girl bits? Lol

Unfortunately my girl bits are still swollen and painful when I walk around. Only thing am hanging on is on the hope that infection will not get to the cerclage.

 

[JimmyJam]

Hi girls.

You'll forgive me if I don't reply to you all separately. Thank you for your kind words. I'm all smashed up.

It's not good news. My amniotic fluid has gone up to 35, I'm carrying an extra litre of water & showing like I'm 28 weeks. I wish.

If I go above 40 They will have to perform amniocentesis to drain the fluid which in a normal person has a 2% risk but because I have the stitch there's an additional risk of bacteria getting in through the entry hole which puts my risk up to 10%. And the procedure would have to be carried out repeatedly. They won't perform a c-section until 26 weeks b/c under that they don't think it's worth it.

I'm devastated & don't know how the fuck I'm going to get through this.

My cervix is holding at 18mm with progesterone supplementation & bed rest but it is having to take the additional pressure of my extra water, before the baby is big enough. Apparently my waters could give any time.

Everything Lizzie said about the cervix holding with rest is valid but, as I've suspected all along, it's the polyhydramnios which is the real threat. I've just got it - rarely - at a gestational age which is too early.

I'm waiting dor FFN results but they can't tell me anything about the excess water. That's just a case of playing the waiting game.

I don't know how to stay positive any more.

I know there's nothing anyone can say, I just have to try & get through this.

JimmyJam

 

[book.fish2011]

JJ, am so sorry, I completely understand how worried you must be. I was hoping for some positive news from you today; I myself am devastated.

I will be praying the fluid stays at 35. I just hope it does.

For cervix, can you be on hospital bed rest with elevated legs position? I know a girl through blogs, at 21 weeks her cervix funneled, she was put on hospital bed rest and she is now in her 29th week. Doctors have now sent her home to rest at home. I don't know if your case is much different from hers, so pls excuse me if am not making sense.

Pls share with us your worries. We'll talk to you. That's the least we can do.

 

[liven1980]

Hello everybody,
I am sorry to not post often, but my arms hurt after 9 weeks i bed loosing muscles. So writing comfortably on Ipad is not easy. But I can tell you that I am thinking about you all the time.
Thank you all for being here and being supportive and positive!
I have had a good week, meaning that it went faster than last week. Hopefully I will reach 29 week on friday. I am also going to the hospital to check all the usual stuff-groth, swab and so on. I am not so interested in measuring the cervix as the doc use a lot of time on this and I feel that BH increases afterwards. Ihave rea that many of you stop measuring after 28 w, but i dont think my doc agrees...Do you have some suggestions to what i can say to make her agree with me?

To everyone:to prevent UTI I drink water with fresh lemon. The acid kills the bacteria. Many people dring orange juice, but it often has a lot of sugar added, and that is not good for the culture in vagina. I have not had uti yet, so i think it helps. And of course a lot of water and often toilet. I actually stand at the end of the toilet-visit, so that the bladder empties completely.

jj: I dont know what to say. You so do not deserve this. I can just say that i will pray for you and that it sounds like youre docs have a plan for what to do. This will give you and your baby a chance. The interventions can help you, thats why they are performing them. It must be so hard to be you now, noone can understand it. I am sending you my love.

 

[kateqpr]

Jimmy J my love. What an awful day you are having. I imagine you just want to lock yourself away and hide from it all. Of course things can all still work out, but i know its the not knowing, and no one able to give you guarantees, that is the worst part. I know you must feel terribly alone right now - but i'm sure Matt is being your rock, so lean on him and your family as much as you can.

If you're showing like you're 28 weeks, does that mean that you have the fluid equivilant of 28 weeks pregnant? I'm guessing your body is capable of holding a lot more than that, as you would normally progress into your third trimester. Hopefully that means that your body is more than capable of getting through the next month or so happily intact, and that the stitch is actually going to help your body cope with that weight.

I know an amniocentisis is not ideal, but that is still a 90% success rate, which is good, plus will hopefully buy you more time for your baby to grow. A good few friends of mine have had them and all been fine, so try and trust that the procedure, although scary, will really help you. Plus 26 weeks gestation, although early, can still have a good survival rate. There was a girl on this thread (Amy) who had her baby at 26 weeks just before Christmas. Her little girl is still going strong in the hospital, and showing good signs of making a full recovery, so don't think that your baby coming early is the end of the world. With steroids, and your doctor's aware of your situation, there is every chance your baby will be okay.

This is a total headfuck for you, i know (pardon my language) but it is. I feel for you and wish so much we could all wake up and it be a month down the line and things all okay. But that can still happen.

I am in Chiswick tomorrow most of the day. If you do want to chat, then just let me know. Otherwise, try and keep positive and distracted. I am sending you a lot of love, and wish there was something else i could say or do to help.

I have found a couple of positive Polyhydramnios stories on this forum - let me know if you want me to forward them to you x

 

[chistiana]

Hey jimmy. I m so so sorry things arent improving. There is not much i can say other than what all the other ladies have said. And that the story kate posted might not necessarily make you super happy but it could give you some hope. Maybe it wont go over 40? But even if it does there are still very good chances the amnio will do its trick. Is there something you can do to keep it from increasing? Sorry if i sound completely ignorant but i m just trying to think a positive way out.anyway please keep writing to us all, the weeks will go by and 26 is not so far away, with the steroids your baby will have a very good chance even at 26 weeks if need be. Hugs xx

 

[HelenGee]

Hi JJ, what a shocker of a day for you, you sound so downbeat after repeated knocks. Please bear in mind that whilst Doctors are amazing at medical intervention, they can also seem like harbingers of doom when a bump appears in the road. I think it's an innate reaction for Doctors to see and prepare you for the worst case scenario first, almost as a preservation tactic.

So to the reality, a stitch can hold up under the weight of a twin pregnancy (Lizzie and her "chunks"). That is a fact. You are a few weeks post-shirodkhar, therefore if the stitch were to fail it would have happened by now. A shirodkhar is the strongest type of vaginal stitch you can have. I'm also assuming that you had antibiotics after the stitch, which most likely means that infection is unlikely to be an issue for you at the moment too.

So, the stitch is doing it's job, after you were given stats of a 70% success rate. My doc was extremely pessimistic about my stitch working, quoting stats of 70% chance of carrying to full-term. At that point full term was a dream that happened to someone else, not me, so I tried not to dwell on it. However this was difficult, as my early posts on page 8-ish show, I felt that there was no hope. My doc struggled to give guidance when she wasn't dealing in absolutes, she refused to give me what might potentially be false hope.

So the polyhydramnios is proving to be an issue due to the weight, is there a reason they can see that's causing it, or is it just "one of those things" for you? Intervention, as you said, carries a 10% risk of complications, that's 90% chance of not causing complications. They would not offer or carry out this procedure if the risk outweighed the benefits. If the stitch can work for you, at a lower success rate, as it appears to be, then amniocentesis can also work. I know of 2 ladies who've had amnios done and they were harmless.

This is a nightmare for you, it's knocking your confidence, your body and your ability to stay positive in the face of these constant knocks. Please lean on us, your hubby and your family. Let them know how you feel, don't feel guilty about feeling scared, but do keep those stats at the back of your mind. The hopelessness that these complications bring are utterly isolating, you are entitled to shut yourself away a little if it helps you to cope, but you are not alone, please remember that xxxxx

 

[JimmyJam]

Make it brief.

Girls thanks - all of you. I'm rock bottom.

From what limited info I can find online polyhydramnios is uncommon anyway & rare at this gestational age. The earlier it presents & the greater the levels of fluid, the greater the likelihood of chromosomal & congenital abnormalities. I know nothing anout this area & I'm scared shitless.

I'm dealing with the stitch, which carries its own risks, really high excess amniotic fluid & the prospect of fetal abnormalities. And I can't find anyone with this condition at my stage to share with.

I feel lonely & desperate, like my miracle dream after all these years of pain is slipping away.

You're all being so amazing, thank you, I'd reply in person to each of you but I'm struggling to hold it together.

It's all a big shock today. I need to get some sleep & dig deep to find my strength again.

If any of you know of any threads I can look at plse post.

Thanks.

JimmyJam xx

 

[lizziedripping]

Hi Jimmy

I am so sorry you didn't get better news today, or that at least things had remained stable for you. As Kate already said, all may still be well in the end, but at this point it is impossible to know that, you have been told the odds are firmly stacked against you, and for that reason alone, the situation must feel unbearable. I am so sorry for you and dh that you are being put through this agonising wait

Ok, now for my thoughts on this situation. I've done some readin around polyhydramnios (but admittedly there's limited information about it), and Whilst its true that the condition puts you as officially high risk, in reality it isn't bleak hun. If a baby appears sonographically sound, then it usually is and it is not necessarily fetal issues which are causing the excess fluid. In these and most cases, the cause is unknown and can be managed by monitoring, and in more severe cases amnio reduction (which you referred to). The impression I get is that this is a relatively rare occurrence, but not unheard of, and once identified not catastrophic.

I understand you have the added worry of IC. Whilst this does cause more concern among your docs, I can promise that it is still absolutely possible to carry this excess weight on a weak cervix that has a stitch.

An incompetent cervix opens less due to weight of the foetus, and more because of stretching, and it is this that is thought to increase pressure on the cervix and force it to open. Although you are ahead in weeks due to the fluid, a woman's uterus can tolerate potentially 24/26Ibs of baby/amniotic fluid/placentas as I proved with the twins, without triggering PROM, labour or tearing through a stitch. Even a woman carrying one, hefty baby can manage 16Ibs in total before the uterine stretching triggers labour.

At 22wks, the average baby is 1Ib, the placenta 2Ibs and water 2Ibs. Yours is more , but you are still only sustaining the weight and pressure of a woman with still several more weeks to go before her body can no longer manage. You have much more 'give' in your body yet hun, despite how alarmist the doctors may seem.

If the onset of labour were due to something as simple as excess stretching and weight, then every woman carrying twins or large babies would deliver them by 28wks. The risks for those women are greater, but very few are in fact delivered before the average twin gestation of 34wks. The causes of labour are not fully understood, but it is a complex process which requires several factors to be in place. I can vouch for the fact that uterine girth, weight and stretching are definitely not one of them. My uterus was so over -distended, that it would not have gone into labour by itself because it was paper thin by 38wks, completely atonal and knackered - it still held, as did the stitch.

These are not just words JJ. You are too intelligent, and in too much despair for me to be offering false platitudes hun ( something I hope I never do on here). I have sat in a room with a Consultant, who has looked me square in the eye and told me he thought he had done us wrong by effectively saving a 'dead baby' in our beloved Evie! He meant well, but along with every other expert in the hospital, feared that she wouldn't make it, and if she did would have a catalogue of health issues which would make her life intolerable. They were wrong!!!

If I had given in to the feelings, advice and prognosis by every single professional on the night of her birth, we would have let her go there and then. These people are experts, they do know the statistics (and they are pirely that) but their primary role is to give you the absolute worst case scenarios - and they never fail to deliver.

When I discovered I was expecting twins, I was met with abject doom and gloom. It was felt that My cervix would never be able to manage a twin pregnancy, and like you I was told outright that an IC couldn't support a uterus that would be consistently several weeks ahead of gestation. To give you some perspective, my uterus measured 54wks gestation at 28wks.

Twins are hugely difficult to get to term, fraught with complications, and usually deliver early as a result. That's before you throw IC into the mix. Your condition is a problem, but not much more of a problem than carrying twins. In your predicament, you would have been fed the same bleak prospect if you had been pregnant with twins, as you have because of the excess fluid. The difference is that twins are not strictly considered a 'complication' of pregnancy - a subtle yet massive psychological difference of perception for you and your Doctors.

Just as with the polyhydramnios twins are thought to increase the risk of PROM, PTL and stitch failure (some docs won't even contemplate a stitch with twins because they are born prem for so many other reasons that it is thought pointless! - they are wrong!). These are theoretical risks only tho hun, and in reality are still very small.

Hard as it is, try to imagine yourself with a stitch, but a few weeks ahead in gestation - from a cervical pressure perspective. This is your position, no worse, no better. Your cervix is reinforced and holding - and the stitch can take several months worth more pressure if necessary. It hasn't changed significantly ina week, but your fluid has risen and the strain increased. If it continues in this way then it proves it can remain more or less the same despite the ebb and flow of amniotic fluid.

I am not an expert, nor are there guarantees in any pregnancy, particularly one with complications. However, I strongly feel that this isn't over for you JJ. You have been given worst case scenario, which is necessary and typical of medics who are duty bound to offer you every possible negative outcome. In reality, the unpredictability of pregnancy and your condition ironically also gives you immense scope, because no one can say for definite that this will not work out ok, and that you won't take home your full termer in a few months time. Measure for measure, I have seen many more healthy babies born of far more complex pregnancies with dire prosepcts than not - my beautiful daughter being one of them.

They have fgiven you this arbitrary figure of 10% infection risk because of the stitch!? Is this based on sound medical research? Or is it simply theoretical? I can't imagine there are many women in your position to have confirmed this figure. It is interesting that many doctors still point blank refuse to place elective stitches because they fear their potential for causing infection, when in reality they don't and the risk is minuscule.

I am not an expert, and there may be many more unknowns that further cloud this issue for you JJ, BUT I do know that polyhydramnios is not a lost cause, and can be fixed. I also know that a stitch can more than hold its own against the weight you are carrying now and 10 wks from now. I understand that the waters could 'go at any minute', but I'm not sure how much of an actual risk this is? Is the pressure of 35cms of water now with a smaller baby any greater than th pressure at 32wks with a larger baby and normal fluid levels? The membrane is actually quite tough, and again PROM is a far more complex issue than just increased pressure.

I am sorry that I and the others cannot offer more than words hun, but I do hope amidst all the panic and fear, that you can take some comfort in them and perhaps see that at least some of it makes sense, and that the picture isn't necessarily so bleak

PS - sorry JJ, after posting just wanted to edit and add that I feel my post is grossly inadequate, and might seem overly confident on your behalf, when I have no right to be! I suppose I deal with fear by going immediately into 'info mode', reassuring myself with facts, figures and clinical research - its my way, but is not for everyone and probably seems insensitive to your cause. Please understand, I am not and feel desperately sorry for you, totally helpless, and trying to help in the best way I know how. I know very little about your condition, but still stand by what I say, though I don't want to appear flippant or unduly 'brave'. Hope that makes sense xxx

 

[olga2424]

Hey Lizzie,

Thanks for your reassurance. Making this a quick one as I'm knackered.

Have still felt a bit nauseous & gripey today, just not 100%. My abdomen area (I know it's not my stomach because that's moved!) just feels tender & hurts when I lie on my side - though the tightenings have subsided. Hopefully I'll get some reassurance tmrw - & I think they'll start FFN testing from this week too ...

You are a darling for your dedication to reassuring all of us, thank you. It means a lot.

Olga love I am sorry. I am a week behind you & am having a really rough time too. I had started funnelling last week & my doctor muttered that closer to 24 weeks I too might have to be put on hospital bed rest. I'm 40 next week & have a sneaking suspicion I could end up spending my bday in bed. I too find it really tough being horizontal the whole time, I'm suffering from v bad back & hip ache. I hope you're ok, it's crappy but probably the best place ...

Christiana - poor you on your 30th - you are so right anout making the next bday the important one. I am loving your optimism & positive vibes.

Thanks for your thoughts LaRock, hope you're doing ok.

V nervous about more bad news tomorrow. Will come back then.

Night all & Happy St Valentine.

JimmyJam xxx

Jimmyjam hun,am all choked up as am typing this post. I so wish I could say or do something other than having you in my prayers and routing(sp) for you to keep fighting. Please hung in there and don't give up yet! (I know easier said than done) we are all here for you and we will see you through this tough journey hun.

Kateqpr "I know an amniocentisis is not ideal, but that is still a 90% success rate, which is good, plus will hopefully buy you more time for your baby to grow. A good few friends of mine have had them and all been fine, so try and trust that the procedure, although scary, will really help you. Plus 26 weeks gestation, although early, can still have a good survival rate. There was a girl on this thread (Amy) who had her baby at 26 weeks just before Christmas. Her little girl is still going strong in the hospital, and showing good signs of making a full recovery, so don't think that your baby coming early is the end of the world. With steroids, and your doctor's aware of your situation, there is every chance your baby will be okay." That was well said hun and also thanks for the encouraging words.

Christiana hun, I also had a low lying placenta @ my 14w scan but it has since moved as the pregnancy progressed.

Book.fish, am so sorry for all the problems your having with your lady bits but have you tried the oral tablet for your thrush? as it seemed to have done wonders for me when the cream was useless. I know they say they don't recommend in pregnancy/early pregnancy but my doc prescribed it for me as a one off in the second tri (check with them!) its called fluconazole.

Okay, day 2 for me in hospital and I have been experiencing some weird sensation, pulling/pressure, mild lower back ache and its starting to make me paranoid.
Ive also had my 1st dose of steroids and a drug called nifedipine to calm my uterus down which am pleased about plus the consultant will be scanning me again in the morning (hope its good news and the funneling is not as bad as I think).
Am having trouble sleeping due to being admitted on labor ward with loads of screaming ladies and babies who have just been born. Its really tough going and I feel so tearful and emotional (HORMONES!!).

Lizzie, how are you hun? helengee, and live1980, hope you all well..

Ps; 2 more sleeps to v day yikes!!!

 

[olga2424]

Hey Lizzie,

Thanks for your reassurance. Making this a quick one as I'm knackered.

Have still felt a bit nauseous & gripey today, just not 100%. My abdomen area (I know it's not my stomach because that's moved!) just feels tender & hurts when I lie on my side - though the tightenings have subsided. Hopefully I'll get some reassurance tmrw - & I think they'll start FFN testing from this week too ...

You are a darling for your dedication to reassuring all of us, thank you. It means a lot.

Olga love I am sorry. I am a week behind you & am having a really rough time too. I had started funnelling last week & my doctor muttered that closer to 24 weeks I too might have to be put on hospital bed rest. I'm 40 next week & have a sneaking suspicion I could end up spending my bday in bed. I too find it really tough being horizontal the whole time, I'm suffering from v bad back & hip ache. I hope you're ok, it's crappy but probably the best place ...

Christiana - poor you on your 30th - you are so right anout making the next bday the important one. I am loving your optimism & positive vibes.

Thanks for your thoughts LaRock, hope you're doing ok.

V nervous about more bad news tomorrow. Will come back then.

Night all & Happy St Valentine.

JimmyJam xxx

Hi Jimmy

I am so sorry you didn't get better news today, or that at least things had remained stable for you. As Kate already said, all may still be well in the end, but at this point it is impossible to know that, you have been told the odds are firmly stacked against you, and for that reason alone, the situation must feel unbearable. I am so sorry for you and dh that you are being put through this agonising wait

Ok, now for my thoughts on this situation. I've done some readin around polyhydramnios (but admittedly there's limited information about it), and Whilst its true that the condition puts you as officially high risk, in reality it isn't bleak hun. If a baby appears sonographically sound, then it usually is and it is not necessarily fetal issues which are causing the excess fluid. In these and most cases, the cause is unknown and can be managed by monitoring, and in more severe cases amnio reduction (which you referred to). The impression I get is that this is a relatively rare occurrence, but not unheard of, and once identified not catastrophic.

I understand you have the added worry of IC. Whilst this does cause more concern among your docs, I can promise that it is still absolutely possible to carry this excess weight on a weak cervix that has a stitch.

An incompetent cervix opens less due to weight of the foetus, and more because of stretching, and it is this that is thought to increase pressure on the cervix and force it to open. Although you are ahead in weeks due to the fluid, a woman's uterus can tolerate potentially 24/26Ibs of baby/amniotic fluid/placentas as I proved with the twins, without triggering PROM, labour or tearing through a stitch. Even a woman carrying one, hefty baby can manage 16Ibs in total before the uterine stretching triggers labour.

At 22wks, the average baby is 1Ib, the placenta 2Ibs and water 2Ibs. Yours is more , but you are still only sustaining the weight and pressure of a woman with still several more weeks to go before her body can no longer manage. You have much more 'give' in your body yet hun, despite how alarmist the doctors may seem.

If the onset of labour were due to something as simple as excess stretching and weight, then every woman carrying twins or large babies would deliver them by 28wks. The risks for those women are greater, but very few are in fact delivered before the average twin gestation of 34wks. The causes of labour are not fully understood, but it is a complex process which requires several factors to be in place. I can vouch for the fact that uterine girth, weight and stretching are definitely not one of them. My uterus was so over -distended, that it would not have gone into labour by itself because it was paper thin by 38wks, completely atonal and knackered - it still held, as did the stitch.

These are not just words JJ. You are too intelligent, and in too much despair for me to be offering false platitudes hun ( something I hope I never do on here). I have sat in a room with a Consultant, who has looked me square in the eye and told me he thought he had done us wrong by effectively saving a 'dead baby' in our beloved Evie! He meant well, but along with every other expert in the hospital, feared that she wouldn't make it, and if she did would have a catalogue of health issues which would make her life intolerable. They were wrong!!!

If I had given in to the feelings, advice and prognosis by every single professional on the night of her birth, we would have let her go there and then. These people are experts, they do know the statistics (and they are pirely that) but their primary role is to give you the absolute worst case scenarios - and they never fail to deliver.

When I discovered I was expecting twins, I was met with abject doom and gloom. It was felt that My cervix would never be able to manage a twin pregnancy, and like you I was told outright that an IC couldn't support a uterus that would be consistently several weeks ahead of gestation. To give you some perspective, my uterus measured 54wks gestation at 28wks.

Twins are hugely difficult to get to term, fraught with complications, and usually deliver early as a result. That's before you throw IC into the mix. Your condition is a problem, but not much more of a problem than carrying twins. In your predicament, you would have been fed the same bleak prospect if you had been pregnant with twins, as you have because of the excess fluid. The difference is that twins are not strictly considered a 'complication' of pregnancy - a subtle yet massive psychological difference of perception for you and your Doctors.

Just as with the polyhydramnios twins are thought to increase the risk of PROM, PTL and stitch failure (some docs won't even contemplate a stitch with twins because they are born prem for so many other reasons that it is thought pointless! - they are wrong!). These are theoretical risks only tho hun, and in reality are still very small.

Hard as it is, try to imagine yourself with a stitch, but a few weeks ahead in gestation - from a cervical pressure perspective. This is your position, no worse, no better. Your cervix is reinforced and holding - and the stitch can take several months worth more pressure if necessary. It hasn't changed significantly ina week, but your fluid has risen and the strain increased. If it continues in this way then it proves it can remain more or less the same despite the ebb and flow of amniotic fluid.

I am not an expert, nor are there guarantees in any pregnancy, particularly one with complications. However, I strongly feel that this isn't over for you JJ. You have been given worst case scenario, which is necessary and typical of medics who are duty bound to offer you every possible negative outcome. In reality, the unpredictability of pregnancy and your condition ironically also gives you immense scope, because no one can say for definite that this will not work out ok, and that you won't take home your full termer in a few months time. Measure for measure, I have seen many more healthy babies born of far more complex pregnancies with dire prosepcts than not - my beautiful daughter being one of them.

They have fgiven you this arbitrary figure of 10% infection risk because of the stitch!? Is this based on sound medical research? Or is it simply theoretical? I can't imagine there are many women in your position to have confirmed this figure. It is interesting that many doctors still point blank refuse to place elective stitches because they fear their potential for causing infection, when in reality they don't and the risk is minuscule.

I am not an expert, and there may be many more unknowns that further cloud this issue for you JJ, BUT I do know that polyhydramnios is not a lost cause, and can be fixed. I also know that a stitch can more than hold its own against the weight you are carrying now and 10 wks from now. I understand that the waters could 'go at any minute', but I'm not sure how much of an actual risk this is? Is the pressure of 35cms of water now with a smaller baby any greater than th pressure at 32wks with a larger baby and normal fluid levels? The membrane is actually quite tough, and again PROM is a far more complex issue than just increased pressure.

I am sorry that I and the others cannot offer more than words hun, but I do hope amidst all the panic and fear, that you can take some comfort in them and perhaps see that at least some of it makes sense, and that the picture isn't necessarily so bleak

PS - sorry JJ, after posting just wanted to edit and add that I feel my post is grossly inadequate, and might seem overly confident on your behalf, when I have no right to be! I suppose I deal with fear by going immediately into 'info mode', reassuring myself with facts, figures and clinical research - its my way, but is not for everyone and probably seems insensitive to your cause. Please understand, I am not and feel desperately sorry for you and totally helpless, and trying to help in the best way I know how. I know very little about your condition, and don't want to appear flippant as a result. Hope that makes sense xxx

Wow! Lizzie, well said hun.....SPEECHLESS!!

 

[book.fish2011]

JJ, how are you today? I have been thinking about you a lot.

How are the other girls?

Olga & Christiana & Kate & LR, how are things progressing with you?

Well I don't have very good news from my end today. The nurse telephoned me in the morning to tell me I have yet another UTI and must do a course of abtibiotics. This will be the third course since past 4 weeks. How can it even be possible that am susceptible to this continuous string of infection. Not to mention, my girls bits are still sore and painful and yeast infection continues. It seems like am walking around with two bulbs attached down there. ( multiple abscess)

I google for multiple infections and I bump across million stories with 2 trim losses. It's all quite depressing.

Can you all lovely ladies tell me if you've seen anyone on this thread with cerclage and infections like me, and who went on to have a successful pregnancy?

Dear Lizzie, with all your xperience here, can you think of someone who has really been through this and managed to birth the babies successfully?

 

[olga2424]

JJ, how are you today? I have been thinking about you a lot.

How are the other girls?

Olga & Christiana & Kate & LR, how are things progressing with you?

Well I don't have very good news from my end today. The nurse telephoned me in the morning to tell me I have yet another UTI and must do a course of abtibiotics. This will be the third course since past 4 weeks. How can it even be possible that am susceptible to this continuous string of infection. Not to mention, my girls bits are still sore and painful and yeast infection continues. It seems like am walking around with two bulbs attached down there. ( multiple abscess)

I google for multiple infections and I bump across million stories with 2 trim losses. It's all quite depressing.

Can you all lovely ladies tell me if you've seen anyone on this thread with cerclage and infections like me, and who went on to have a successful pregnancy?

Dear Lizzie, with all your xperience here, can you think of someone who has really been through this and managed to birth the babies successfully?

Hi bbok.fish, so sorry about the infections hun....Please do take the antibiotics asap especially now that you have a stitch in. I don't want to scare monger you but my experience with infections was not very good in my last pregnancy.....my consultant has been very active in treating me with antibiotics prophetically from 8w, 12w 16w 22w and now @ 24w.
And plse do try and keep away frm Dr. goggle. at least your lucky they've caught the infections in time before they do any damage hun....good luck and keep us updated.

 

[book.fish2011]

Hi Olga, am sorry about your last pregnancy. Am sorry I didnt have a chance to go through your posts. Of you don't mind can you tell me if you has infections then, and if they caused the problem? Only if you don't mind.

How are you doing otherwise today? What are the doctors saying? Can you feel your bubba's kicks?

My h went to the hospital to collect my new antibiotic pills, he also had a word with my high risk OB about my worries on infection affecting babies. OB told him that pills won't affect the babies but need to take them to avoid kidney stones. She assured him nothing will happen to cerclage or babies. I just hope she's right. There's nothing more I can do, apart from taking antibiotics and drinking water , correct?

 

[lizziedripping]

Hi BF - no one is totally sure about infection and ptl, and it is kind of a 'chicken and egg' scenario. Does infection trigger labour and open the cervix, or does an already dilated cervix allow infection into the uterus and then trigger labour. It is now thought however, that infection is generally only a risk after the cervix has opened. In my case, I had already dilated to 3cms with my daughter, an emergency stitch was placed but by then labour had set in only because my cervix had lain open for several hours.

In the twin pregnancy I had a confirmed BV infection at 21wks which had probably gone undetected for several weeks. It caused no problems at all, as is the case for most pregnant ladies - lots of women have the bacteria but are none the wiser because they aren't screened like us.

The reason you keep getting infection is because your immune system is lower in pregnancy, and the pressure of the babies on your bladder and urether allow bugs to breed more readily. Leaving a UTI untreated is dangerous in pregnancy mainly because it can spread rapidly and cause a kidney infection, which can in rare cases trigger labour. Lots and lots of women have UTis in pregnancy and the majority recover and go to term hun. There is no reason why the stitch should increase the risks or make the effects of a UTI any worse.

The vagina contains millions of bacteriahun, it is by no means a sterile environment. So long as you have some closed cervix, it would be unusual for the bacteria to make it any further than your mucus plug or stitch. It is only if and when that barrier is lost is there a risk. The soreness and bulging you are feeling are typical of thrush, an infection which is again, common in pregnancy and rarely (if at all) affects the baby.

Women here with IC who have previously lost their babies due to infection have usually had their IC go undetected until their cervix has already opened and infection got in. Sadly they are unaware of this until they experience the mild cramping and back ache of very early labour - often triggered by the infection and/or dilation.

This is a terrifying time for you sweet, and there are no words which will ultimately reassure, but please try not worry about these infections. It is extremely unlikely that they will trigger ptl in you as long as your cervix and stitch are intact. As I recall Kate had lots of UTIs and bleeding from 20 to 30wks but nothing ever came of them stitch-wise. I'm sure she'll be along to share her story with you soon hun.

Hope that helps xxx