Stuck in BedStuck in Bed

Author Topic: 22 weeks, cerclage, cervical changes with contractions.  (Read 15578 times)

Jessica87

  • Newbie
  • *
  • Posts: 5
    • View Profile
22 weeks, cerclage, cervical changes with contractions.
« on: December 24, 2011 at 10:08 PM »
Hi everyone, Im Jessica and I'm looking for some advice. I am 24yrs old and 22 weeks along with my 2nd pregnancy. I lost my first baby at 18 weeks due to suspected IC but I did have contractions the entire day so I know there was PTL involved too.

I got at cerclage this time around at 14 weeks and have had a stable cervical length since then until yesterday. First I'll mention I am ending a course of metronidazole for BV on Monday so I do have that. Anyways very early in the morning I went to L&D with extreme pelvic pain, my cervical length was ...odd. They said all the cervical length above my cerclage was opening and the cerclage was keeping my baby inside and I had 1.4cm of "functional cervix" they sent me home at 8am and I saw my perinatologist 4 hours later at 11am. He did another cervical check and said my cervix was dilating and contracting (above the cerclage again) during the ultrasound. He said they were contractions but I could not feel them. Also the contraction monitor at the hospital did NOT pick up any contrax but they were happening at my peri. I have not had the pelvic pain since then but I have had mild cramping last night, none today.

I was sent home on bedrest and not given any meds. I asked for 17p and my peri said that they are used in women with a history of PTL, which he doesnt think I have because he said an 18 week loss isnt PTL it was incomp cervix. Since I have cervical change plus contractions shouldnt I be treated with 17p as well since those are the criteria for preterm labor? Procardia? I CANNOT lose this baby because I have been to hell and back when I lost my baby boy in Feb, I will do any and everything to keep this baby (a girl) in. I'm looking for advice and to make sure my docs are doing the right thing sending me home without meds. Thank you!
« Last Edit: December 24, 2011 at 10:13 PM by Jessica87 »
Feb 2011- 18 week loss caused by Cervical Incompetence/UTI
Oct 2011- McDonald Cerclage placed at 14 weeks
Dec 2011- Bedrest. Cervical shortening/funneling
April 2012- Rainbow baby due!

AngelLily03

  • Full Member
  • ***
  • Posts: 100
    • View Profile
Re: 22 weeks, cerclage, cervical changes with contractions.
« Reply #1 on: December 27, 2011 at 03:26 PM »
Jessica,

Sorry your having such a tough time and I don't know how much help I can be.  I had my second at 36 w 4 d, starting contracting 20 weeks and in hospital with PTL at 24 and 35, and becuase of that I am at a higher risk for early delivery.  I've been contracting since 8 weeks and things went south at 25 when they got regular and I had a positive FFN (did they do one for you).  No one has even mentioned the 17p shots with me, I don't know if its because my cervix has actually been holding.  I've been on bedrest and nifedipine to control the contractions.  I have an amazing OB and I know if she felt I needed them I would have them.

As for the hospital monitor not picking them up, that is common.  When I was in a 25 it took over an hour of moving the monitor around to finally start to pick them up.  If you are worried seek out a second opinion.  Out of the 4 Dr's in my L&D, 2 tend to error of the side of mom's over reacting and you really have to fight with them to prove you are contracting, and the other 2 are treat the contractions ask questions later type.  I hate it when the first two are there, as one of them was about to send me home at 25 until the positive FFN came back.  They just seemed jaded and get burned out by the false alarms.  We've been to L&D 11 times since this all started and 8/11 it took additional medication to calm things down.

You know your body, you know if something isn't right, so fight and get them to listen.  I knew something was wrong well before they came back with the positive FFN.  I hope that helps, another thing to ask for are steroid shots for the baby to help her develop a little more.

Angela

  • Administrator
  • Hero Member
  • *****
  • Posts: 2023
  • It's all good. 39 weeks...no sweat
    • View Profile
    • KeepEmCookin
Re: 22 weeks, cerclage, cervical changes with contractions.
« Reply #2 on: January 01, 2012 at 11:45 PM »
Hi, Jessica.

I feel strongly that you should request the 17P shots. Many doctors make it a standard part of treatment following a second-trimester loss, even with a cerclage in place.

I posed your question on our Facebook site too, and here are the responses so far:

Brandi says:
 I was told to take the shots in lieu of a cerclage after delivering my triplet angels at 23 weeks 6 days after an emergency cerclage. This time around they felt it was preterm labor versus a weak cervix so we opted out of a cerclage and tried the shots and was successful!

Andrea says:
YES!! Absolutely! I would question any doctor that wouldn't consider that type of prevention and find a good perinatologist that will do whatever it takes.

You might want to print out this page called "Pregnancy After a Preemie" where all the doctors recommend 17P along with a cerclage: http://www.keepemcookin.com/pregnancy_after_a_preemie.aspx

I am so sorry for your loss, and I understand that you want to do everything you can for your daughter. When is your next appointment? I'd ask your peri to offer his argument against the shots, if he has one. You may also want to ask about progesterone gel instead of the shots, because that has also been shown to be effective in helping to keep the cervix stable. In fact, ask your doc if he prefers to prescribe the shots or the gel, because that is what you want. Tell him you need to know that you are doing everything you can to keep your daughter safe.

I'm pulling for you! We all are. Keep us posted!
Angela

Jessica87

  • Newbie
  • *
  • Posts: 5
    • View Profile
Re: 22 weeks, cerclage, cervical changes with contractions.
« Reply #3 on: January 02, 2012 at 02:32 PM »
Hello guys, I wanted to keep you guys posted on my situation. The good news is that I'm 23wks today and baby girl is kicking away safe inside :)

I went back to the ER on xmas day (real fun...) because my abdominal pain returned. They found a very bad UTI which didnt show up 2 days prior. We were shocked (I had zero of the traditional UTI symptoms)-- I was put on Macrobid 100mg 2x daily for 7 days and then 1x daily until delivery. This is my 2rd or 3rd UTI this pregnancy. No clue why I'm so prone to them in pregnancy but this basically confirmed to my OB that the UTI I had at 18wks along in my prior pregnancy caused my cervix to dilate and labor to begin. It's good to have an answer but sad that something as stupid as an asymptomatic UTI caused my loss.

I had a follow up appt with my peri after several days on bedrest and Macrobid and somehow my cervical length was 2.8cm!! My contrax had also stopped. My peri was noticeably relieved and so were we. I'm on bedrest indefinitely but at least until Weds (1/4) when I have my next cervical length check at my peri's office. Additionally, I spoke with my regular OB and she said due to my "history and anxiety level" they will give me the betamethasone steroid shots at 24 wks because I am an "early delivery risk".

Thanx for the advice and I will ask my regular OB about 17p again at my next appt on 1/9. It is really strange to me that no one EVER mentioned them to me even though I've said repeatedly to them that I want to take ALL the steps to prevent this baby being born early. I love my OBs but I wonder why 17p was never offered but steroids were... I would think 17p would be the first line of defense to PREVENT the need for steroids because steroids generally mean all else has failed and they think you're going to deliver early. Do you think insurance companies don't like to pay for it and doctors are hesitant to offer it for that reason? I remember earlier in the year, there was a huge issue with progesterone costs going WAY up. I dunno but I will ask my peri for his argument against the shots and I will push for them as I've pushed for steroids.
« Last Edit: January 02, 2012 at 03:45 PM by Jessica87 »
Feb 2011- 18 week loss caused by Cervical Incompetence/UTI
Oct 2011- McDonald Cerclage placed at 14 weeks
Dec 2011- Bedrest. Cervical shortening/funneling
April 2012- Rainbow baby due!