Hi ladies, hope you are well.
He said that there was Group B strep evident in the membranes and placenta, though he has no way of knowing whether the memrane rupture introduced the strep or the strep broke the membranes but he thinks my cervix opened enough to allow the membranes to become exposed to the bacteria which weakened and broke them. That's pretty much the conclusion I had come to as well, as in retrospect I had a few signs of silent dilation, though I didn't recognise them at the time and I tested positive for GBS on admission.
That's the same thing that they told me, baby and placenta infected by group b strep but they don't know if it caused early labour or was a result of it. Their conclusion for me was no known cause. Do you mind me asking what signs you had of silent dilation? When I went into hospital, they examined me and they said my cervix was closed, but within about 30 mins when I was examined again it was fully dilated? I still worry if maybe it was a cervix issue.
xx
Hi Mhazzab,
The signs were very very slight, but about a week prior to the rupture I had a snotty clump of discharge, after no discharge the whole pregnancy (all my mucus production seemed to be happening in my nose, lol, same as with DD) and I remember thinking "that looks a bit plug-like" but then there was no more and it went out of my head. From about then on (in hindsight) I had a watery clear discharge, which kept making me run to the loo to check for blood as it had that dribbly feeling to it (sorry TMI), it had no smell and wasn't the milky discharge you normally get with pregnancy but it's been so long since I was last pregnant i just thought it must be pregnancy discharge. I've since read it can be a sign of silent dilation and one of the Obstetricians said something similar. The whole time from about 10 weeks I had lots of what I thought were Braxton Hicks and I was generally damn uncomfortable for most of the time, but the distension was probably caused by the twin pregnancy.
How were you checked though? By internal Ultrasound, or just manually? The thing is, it starts to dilate from the inside out, so it could start funnelling for quite a while, allowing the membranes to bulge into the cervix quite a bit but not be picked up from a visual or manual exam, unless it's by U/S. A manual exam may have triggered the sudden dilation for you as well. I don't know how dilated I became because I wouldn't allow any more manual exams after the first sterile speculum on admisssion, to try to keep infection out, but i obviously dilated enough to push them out.
Did you have obvious contractions before your waters broke? i.e was it early labour proper, or pPROM?
Did they say whether they would monitor for cervix issues in any subsequent pregnancy? If you are worried I would push for that, as too many times IC isn't diagnosed till you've had two or more losses, that's just not on, as far as I'm concerned. Did they say they would do anything for you in a future pregnancy?
My Ob did say that strep is naturally present in many women at some point (which I knew) and that in itself is no cause for alarm, only if it's in the urine, then it signals a massive overgrowth. He said normally there is no way for it to get into the upper tract (uterus) unless the cervix has opened to let it in, but I know if it's in the urine it can trigger contractions as well.
Can I ask how long your waters were broken for before you went into labour? This may help you ascertain whether the strep would have had time to ascend after the rupture, or whether it was more likely the cause of it. I had 6 days from rupture to labour, so for me there really is no way of knowing which came first but if yours was quite fast then I'd be asking the question how it got in there and definately pushing for cervical checks in future. he said that after a rupture it's not a case of if infection will happen, but when.
I'm sorry you got no answers, i didn't either really as there is no way of knowing for sure but I was glad I didn't have to fight for the cervix checks, as that was my main concern as well. Can you get back in touch with them to ask some more questions? Hope you get somewhere, otherwise, if you get pregnant, just make some noise until they listen to you!
Sorry this turned into an essay!
ETA: I've also read that the body can be tricked by the weight of twins + amniotic fluid etc to think it's time to go into labour, so it may just be a twin thing too, sad as that is. xx