Well, I had a doctor's appointment today, annual GYN visit...I know, very exciting and definitely something I should "blog" about, but there's a reason for its mention, and for the title of the post. So I mentioned that we are hoping to start trying to become pregnant again in June, after I turn the dreaded 30!!!!!!!!!! So we began discussing what happened with my pregnancy with Charlie, everything's great and then bam, dilated to 4cm at 29 weeks. I asked her what my placenta showed, if there was any reason for the complications, etc. She said that I am to be considered someone with an incompetent cervix. Well, really! They couldn't call it something nicer? There's something really weird about that term...but besides that, she started talking about all of the precautions she plans to take, progesterone injections, bedrest, out of work early, frequent digital exams (yikes!)....I guess I kind of thought all of that would come up but also hoped that she would say, it's all fine, just a fluke, you'll have no problems carrying a full term baby. Well, it's the price you pay for the love of your child! It was just kind of a strange visit, as I was excited about telling her our plans, and excited that the next time I saw her would be to confirm a pregnancy...now I'm kind of afraid to do it again. I know we will, I really want one more baby, but I feel less adequate now! If anyone reading this has any experience with taking progesterone shots with this problem, please let me know. She said it's something they would start right away and obviously I'll do my research about it but wondered if anyone else had any experience with it. Now I'm off to my family doctor to try and get some meds to help my nasty cold go away...I never go to the doctor for medication...you know I'm feeling bad today! Hope everyone else is healthy and avoiding the nasty winter bugs...especially all my preemie friends!
2 comments:
Hey Sara,
I work with patients who take progesterone injections so if you need any info let me know. Our patients use the injections for helping the pregnancy develop if they have low numbers, but I can't say I ever heard of progesterone for an incompetent cervix. Did you ask about cerclage of the cervix? In all the years of OB-GYN nursing, I have only heard of patients getting cerclages to help with an incompetent cervix. Stich it up till its time, take out the stich at 36-37 weeks and by that time baby is well developed and ready to enter the world. I don't know how they determine if you need a cerclage or not but it might be something that you should look into as far as benefits, risks, etc.....
Anything I can help with let me know.
Love the blog page, that Charlie is just tooooooo cute :)
Jamie
This is a big topic on my micropreemie mom blog. It seems that the P-17 shots do help with PTL, but it's so unclear who has PTL and who has (the unfortunately named) incompetent cervix. Several moms have been told that, as long as they are not having cervical shortening by 24 weeks, their cervixes are competent and that they should not risk a cerclage due to the increased risk of infection and chorio, which can bring on PTL. Others were told that they had incompetent cervixes when they delivered at 24 weeks after little real labor. If you go to our blog, and then click on Arianna's blog, and then make your way to her mom's pregnancy blog, Jennifer (Arianna's mom) has a whole lot of research on this and other questions related to premature delivery. I am sure that she would be happy to correspond about this...
Of course, this is something that is very important to us, too. We never did determine why Sharon went into labor early. My reading on the subject suggests that she had polyhydroamnios, but I am not sure why. The girls had infections right around their birth, but also they had no skin, raising the risk substantially of infection. And Sharon's bans were higher than they should have been, but this could have been because her cervix was opening. So, chicken, egg, who knows? I know we'll do the P-17 shots, and that we'll also make sure to check for fibronectin regularly in the second trimester and beyond (there's a lot of data suggesting that a positive fibronectin test is a good indicator of delivery within two weeks), but whether we'll risk the cerclage...who knows. It's obviously more complicated with twin pregnancies, but the weight of two twins and two placentas at 23 weeks is probably nowhere near the weight of a full term baby plus placenta, so that cannot possibly explain it all.
Good luck with figuring out this one and let us know what you determine. Meanwhile, I hope the double ear infection and bronchitis are gone...Sharon seems to have bronchitis right now, but weirdly, Hallie and I, so far, are doing ok.
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