March/April Spring Rainbows

[nanajoy]

Kazy- I told my dr I'd come in every day for bloodwork if they thought it'd help (they don't...). But that's really cool your doctor did that. My recently past dr was amazing, with me through 6 of my 8 pregnancies. But he had moved to a surgical position in the same hospital. My current dr has my previous dr's nurse, so she gets me.

Klabro- Sorry they're not going with what seems like the obvious option. I know dr's are the ones who should have the answers, but it can be hard to know why the do things. I am on progesterone supplements. Have done the suppositories, but am on pills now. I do heparin shots twice daily, so I think they're trying to save my already tender midsection.

 

[klabro]

Well to answer the questions here is the gist of what I was told by my high risk doctor:

In cases with a preterm delivery like my last there is a 40% chance of it recurring again (if left untreated). That 40% figure is a little lessened for me because I had my daughter at almost full term (37 weeks) and maybe lessened a little bit because of the twins last time (but its still not normal to efface at 20 weeks pregnant with twins) So her example was lets say your risk is a 30% (just guessing here) chance it will happen again....Giving progesterone weekly will cut that risk in half which makes you more in line with a "normal" pregnancy. She said they will monitor my cervix weekly and give me a stitch at the first sign of any changes. She also said that throwing a cerclage in right now isn't proven to be any more effective than putting one in when changes are spotted.

So that is basically where I'm at now. She said that much of the "preventative" cerclages that you see being put in is more in line with the "old school" way of thinking. Not really sure what exactly that means because it just seems like preventative cerclages are what you see happening in almost all of these cases.

 

[Kazy]

Klabro- I can only imagine all that's going through your mind. It's good they are monitoring you weekly and will be able to catch it quickly.

 

[SweetV]

Well to answer the questions here is the gist of what I was told by my high risk doctor:

In cases with a preterm delivery like my last there is a 40% chance of it recurring again (if left untreated). That 40% figure is a little lessened for me because I had my daughter at almost full term (37 weeks) and maybe lessened a little bit because of the twins last time (but its still not normal to efface at 20 weeks pregnant with twins) So her example was lets say your risk is a 30% (just guessing here) chance it will happen again....Giving progesterone weekly will cut that risk in half which makes you more in line with a "normal" pregnancy. She said they will monitor my cervix weekly and give me a stitch at the first sign of any changes. She also said that throwing a cerclage in right now isn't proven to be any more effective than putting one in when changes are spotted.

So that is basically where I'm at now. She said that much of the "preventative" cerclages that you see being put in is more in line with the "old school" way of thinking. Not really sure what exactly that means because it just seems like preventative cerclages are what you see happening in almost all of these cases.

I have been almost in your shoes with my last pregnancy having gone into spontaneous labour at 25 weeks the pregnancy previous. I took progesterone until 14 weeks with my subsequent pregnancy and was then monitored weekly for cervical changes with antibiotics, aspirin and vitamin C supplements. With cerclage there is a greater chance of infection and as my SIL can attest, having lost her first pregnancy and having a cerclage placed for her next 3, she still delivered all cerclage pregnancies early and had to have the stitch removed in an emergency fashion. also know many people that have had the cerclage placed and their water still broke early so I would have to agree with your doctor in this case. I delivered my last pregnancy at 36 weeks and will follow the same plan for this pregnancy with weekly monitoring starting next week. The cause for my 25 week delivery was unknown, I dilated and my water broke but they don't know why.

 

[klabro]

Thank you for your experience SweetV. It is encouraging to hear. I just get so discouraged because it seems like everywhere I look it is all about preventative cerclage and it being successful. Which is odd really because in many pregnancy conditions when you look them up it seems to be all of the negative sides. I think its just taking a while for the news to set in because after I lost the twins cerclage was mentioned to me by both the MFM and my OB. So I just kind of had it in my head that was the treatment we were going to use. I do trust the high risk doctor, its just really hard for me to wrap my head around a different treatment plan when I've been building up to to this one for over a year now. I'm trying to be positive and know that it is very possible for me to carry to term without cerclage as I have done it with my daughter.

 

[dreamingmom]

Had my scan yesterday, the news was not good. There is no growth and no HB. Doctor wants to schedule a D and C. I have not had any blood work so after some insistence he agreed to have my HCG levels tested and I have one more ultra scan scheduled for next Friday. I don't expect any different results but I need to be 100% sure especially since my body is not registering anything is wrong. I haven't had any really strong symptoms but I am still tired, my breasts are still sore and my sense of smell is still very strong. I checked my cervix, it is still high and closed and my BBT is still in pregnancy range. At least, last time everything stopped the day I mc on my own, this time I have to make the decision so although the doc says he is 100% sure the pregnancy is not viable I don't want to take any chances that there is a mistake. DH is being very supportive but does not seem upset. He was not at the appointment with me so I am figuring he is still in denial until he hears it for himself. I wish the rest of you the best in your pregnancies. I will let you know how this plays out but I am pretty much counting myself out. I can only hope that with me out of the game the probability for the rest of you having healthy pregnancies is higher. DH and I will keep trying once it is safe to do so and I plan to continue with acupuncture in hopes to conceive again quickly. I will be 34 in a few weeks, so I pray that we will not suffer through more years of infertility after this pregnancy and I will eventually see beyond the first trimester and a healthy baby.

 

[klabro]

Dreamingmom, I am so sorry to hear this news and I do not blame you for requesting further testing to make sure. Please do keep us updated of any changes.

 

[Kazy]

I'm so sorry dreaming mom. Keep. us posted.

 

[SweetV]

klabro - They mentioned after my 25 week loss a cerclage as well as progesterone shots and I know how hard it is to feel like you are not doing every single possible thing that you can do.

dreaming - I'm so sorry. I've had 2 mmc and it's such a hard decision to make.

 

[mrs unicorn]

Dreaming - I am so sorry hun. You must do what you think is best, I understand needing to be 100% sure (I waited a week for my ERPC) Do keep us updated, I know we'll all be thinking of you. X

 

[klabro]

SweetV-I'm starting to feel a little more on board with this approach. I talked to another MFM within the same clinic (they will all be providing my care) and I feel like I was a little more open to hearing what they said at that point. Basically the reason that I am not being offered a preventative cerclage is because the mechanism for why your cervix would efface is different in a twin pregnancy. So that coupled with the fact that I carried my daughter to 37 weeks makes them think that the risk of putting in the cerclage as a "preventative" measure outweighs doing the progesterone and waiting. They will give me a cerclage the same day or next morning if my cervix shortens to under a 3 during the first 24 weeks. We have a level 3 NICU at my hospital so they will try to resuscitate a baby at 23 weeks and above. My twins missed that cutoff by 2 weeks.

Do you mind me asking about your 25 week loss? Did your cervix efface and dilate first or did you go into pre term labor that caused you to efface and dilate? Its hard to know in my case because I wouldn't necessarily have felt contractions at that point and I was feeling slightly crampy. Thanks again or sharing your experiences with me.

 

[SweetV]

klabro - they don't know exactly what happened as I waited a while to go to the hospital. My water broke at 2am but I didn't realize exactly what had happened until the next morning. I then went right to the hospital where they confirmed that I was in labour. I had no cramping or indication of why it happened and my cervix at that point was closed (they said it could have closed again after the fact, there was no way to find out). I carried him for another week and he passed during labour (again with no cramping or contractions I stood up one morning and was half way through delivery but my cervix closed again and he was stuck). The hospital I was in has the best NICU in the country and I was prepared for a long stay but it was not to be. As they weren't sure a cerclage would help me in my next pregnancy we tried the "wait and see" approach. My cervix stayed long until 32 weeks when they stop measuring. The weekly ultrasounds were a great bonding experience and having the best team of doctors was amazing. I hope you get the same experience this time I'm glad you are feeling a little better about their recommendations.
Also I love to talk about him (I just hope my experience doesn't scare anybody. I know most people feel safer in the second trimester. Rest assured I was told that what happened to me has a less than 1% chance of happening)

 

[klabro]

Thank you for sharing that SweetV. I know how rare a second trimester loss is so I always worry about freaking other people out when I tell that story. How many weeks were you when you delivered your first? My MFM this time said that there is a possibility that I am just prone to have a shorter cervix later in pregnancy in general due to the fact that I delivered my DD at 37 weeks. Not 30 weeks, but also not 41 weeks as she put it. I really did not ever feel right during my last pregnancy. I mean the pregnancy itself was different due to twins, but it was normal enough for what it was supposed to be. I just had a very strong sense that something was wrong. I am very anxious and wanting to know as much as I can this time, but I don't have that sense of just knowing that something is wrong. That makes me feel better.

 

[SweetV]

My first was born 2 days after his due date totally uncomplicated pregnancy. I also had a bad feeling during my second trimester loss but chalked some of it up to the two miscarriages I had in between. I had bleeding early in the second trimester and they couldn't tell me why. I had my anatomy scan where they said everything was fine and then at 23 weeks I had a bad feeling and reduced movements went to the ER but they sent me home with a pat on the head. 5 days later my water broke. I had another 2 miscarriages and so with my last pregnancy felt totally removed and couldn't come to terms with bringing home a baby. The weekly ultrasounds were great and at 36 weeks my placenta failed but because I was already going to a MFM and was there every week they caught it quickly and I was induced that day. I really feel that if it wasn't for everything that had happened this little one wouldn't be here.
When do you start your weekly cervical checks?

 

[klabro]

I start weekly checks and progesterone shots at 16 weeks. The MFM did mention that I'd get my first anatomy scan earlier than the standard 20 weeks and they'd do more follow up ones throughout. The extra monitoring will be nice. I was getting tons of monitoring last time due to the twins and so far I'm kind of on the same schedule as I was with them. I feel like this current wait from 13-16 weeks is the hardest of all of my "waits" so far because now I am anticipating the cervical checks and the shot itself.

 

[mrs unicorn]

Gosh you ladies have been through it. I cannot imagine how hard it must be to have a loss in the second tri. Don't worry about freaking us out on here though - discuss all you want. Klabro, it does sound like your doc thinks there's a good chance you won't have the same problem again. Fx they are right. I know it must be difficult once you have got to grips with the idea of a certain procedure taking place, only to be told it's not happening. Really hoping it's a good sign though. The monitoring will hopefully put your mind at ease at little , I'm wishing those weeks away for you. X

 

[Kazy]

Totally agree with Mrs. Unicorn too!

My nausea eased up tonight which is great. I feel like I'm mentally on edge because I've felt like the walking dead for about 6 weeks now. I'm exhausted and all food sounds disgusting but I don't even care because right this very second I don't feel like vomiting. I feel.so bad for my family. I've been a major grump.

How are you all feeling?

 

[mrs unicorn]

Glad the vomiting has stopped Kazy. How many weeks are you now? And what's all this rubbish about feeling better as you approach 12 weeks - im guessing it's a very slow process!

I thought I was 'turning the corner' as I managed to eat some veg at weekend but I am absolutely exhausted. I've been sleeping 10-11 hours each night and still have to drag myself out of bed. Plus I take a nap during the day if I can. I actually took yesterday off because I felt so rubbish. It's making me pretty grump too kazy!

On a good note we bought a Doppler last week and I flippin love it!! It took me ages to find bubs the first time but now I can find them really quickly. My heart melts / sings /skips a beat every time I find baby

 

[Kazy]

I'm 12wk3d. So I should.be out of the woods soon. I was on progesterone which can I crease symptoms. But I was on that with my last pregnancy and it didn't I crease my symptoms. So who knows. This morning I'm still pretty tired but nausea seems manageable. I hope you feel better and get more energy soon here too mrs unicorn.

 

[klabro]

Sorry you've felt so bad for so long Kazy. I felt about the same for the first 12 weeks. Now I have good and bad days. Yesterday was bad, I didn't feel good all day. My pelvis was achy and I kept feeling weird pressure. However, today I feel great. Its nice to have good days mixed in with the bad now, so I'll take it. I think my uterus has been putting pressure on my bladder because on Friday I called my doctor because I was feeling like I had a slight UTI. They called back and wanted me to come down right away to get my urine tested. Came back all clear and felt much better the next day.

MrsUnicorn-glad to hear you love the doppler! I take mine out every few days and listen in and it definitely is nice to be able to do that. I do find that it makes me not look forward to my regular OB appointments as much, because they only do what I can already do at home