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Author Topic: 28 weeks - 2nd Pregnancy  (Read 1039 times)

Margueritevdw

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28 weeks - 2nd Pregnancy
« on: March 24, 2018 at 07:32 PM »
Hi there,
I was placed on bed rest with my 1st pregnancy in 2015 at 31weeks when we discovered my cervix was only 0.5cm. I had been feeling loads of pressure and many many non painful contractions, but being a first time mom didn't want to be alarmist! My mom also thought I should just 'walk it off' which is her advise for most things in life 😘

We got the shots to mature babies lungs and I was given tocolytics to calm my uterus.  I went for scans and check ups every 2nd day for 4weeks, but in the end I had a Csection at 38weeks due to low weight gain and low amniotic fluid. However - he was a healthy 3.1kg boy with high apgar and no issues.

Fast forward to 2018, and I'm now pregnant with no 2. We had a stressful start to the pregnancy as I was given a high risk of chromosomal abnormality, for which we did a non-invasive test, which was inconclusive. We where then recommended an amniocentesis which went very smoothly and finally at 21weeks we got positive news back. I was able to relax a bit after that!

Dr had me on progesterone and ecotrine due to my history, but my cervix was looking good at 4.5cm. However - 2days ago at 28.3 weeks the regular non painful contractions re-occured and my cervix shortened to 3cm in 1.5weeks. This is still OK, but I'm on nefidipine this weekend and rest and back to the Dr on Monday to check that any contractions and shortening has halted. They also have me a cortisone shot for in case.

I'm thankful that the Dr picked this up before it shortened too much, but also nervous because I was really really just hoping to avoid this!

OBmom

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Re: 28 weeks - 2nd Pregnancy
« Reply #1 on: March 26, 2018 at 02:06 PM »
Welcome to the club momma!
Where are you?

I also had a 2015 short cervix pregnancy and am now working on baby no 2 :)
Glad to hear your doctor was on top of things, aspirine to help the baby's growth and progesterone for the cervix.
Though we all hope to avoid recurrence, the normal thing is what happened to you: when it comes back, it's usually at an earlier time than with your first (mine were diagnosed at 28 and now 23 weeks). Still, 3 cm for 28 weeks is over the "normal" limit so yay!

Besides, if your cervix shortens any more you still have the option of placing a pessary - last time I had one placed at 28 weeks with a cervix of only 8mm and only delivered at 34w :) (You guys must think I get some sort of commission on pessary sales, but I honestly don't  ;D)

When's your next appointment / scan?

Angela

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Re: 28 weeks - 2nd Pregnancy
« Reply #2 on: April 06, 2018 at 03:40 PM »
Hi, Margueritevdw.

How have your last few OB appoints gone?

Margueritevdw

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Re: 28 weeks - 2nd Pregnancy
« Reply #3 on: April 09, 2018 at 12:17 PM »

So my previous reply is not showing up here! SORRY!  I went for a follow up appointment and cervix stopped shortening! JAY.   

I'm now 31weeks and 3cm, so all good in that department.  I'm still taking nefidipine daily along with ecotrin & progesterone.

However, baby is not picking up enough weight (only picked up 100g in 2 weeks... ) and is heading for 10th percentile line, so i'm on weekly check ups going forward and Dr will deliver if he dips below the 10th percentile.  Had another round of cortisone to help the lungs.  Not much more I can do but eat well and rest now and pray that bubs packs on a bit of fat :)   

OBmom

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Re: 28 weeks - 2nd Pregnancy
« Reply #4 on: April 09, 2018 at 06:44 PM »
Hi Marguerite,

Hope all is well with you.
As I've mentioned in previous posts, fetal growth is kind of my line of work. I help run the clinic for Fetal Growth Restriction (FGR) at my MFM center. Just a couple of things you should take into consideration:
1) Growth scans are generally only repeated every 2 weeks, that's the smallest interval in which we can see a difference
2) It's best if you can arrange for the same person to scan you every time - that reduces differences between measurements
3) Most experts in this field agree there's no need to deliver just because you've reached the 10th centile, especially before term!! We keep monitoring the baby using Doppler ultrasound - measuring the resistance in fetal and maternal blood vessels. We don't usually deliver unless there are signs of fetal distress.

Let me know if you need extra info on management of FGR. It's always best to meet your doctors already understanding what they're going to talk to you about.
Best of luck to you!

Margueritevdw

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Re: 28 weeks - 2nd Pregnancy
« Reply #5 on: April 10, 2018 at 07:53 AM »
What a stroke of luck to have you around @OBMom!

I went for an NST yesterday and Lil'bro was doing really well. I have private health care in South Africa (Johannesburg) so I'm seeing the same ObGyn thoughout (and for my previous pregnancy). His words were: no reason to act now, we will be doing weekly check ups (ultrasound, with cord blood flow monitoring and NST's) and if he dips we may have to take him out earlier. 

My 1st son had a growth wobble at 32weeks but picked up again after that, but he was in the 90th percentile for weight before that and ended up quite average at birth (3.1kg @38wks). I remember my previous boy being 1.8kg at 31weeks when I was put on bed rest and the Dr saying he would like him to reach 2kgs at least.  We got there and then some!  This one is only 1.3kgs now.

I'm hoping he continues to be strong despite his size, I'm sure Dr won't take him out for no good reason. Good to get insights on international best practice too! Especially the weekly vs bi-weekly growth scans.  Keep well!

Margueritevdw

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Re: 28 weeks - 2nd Pregnancy
« Reply #6 on: April 10, 2018 at 05:14 PM »
Sorry! @OBMom Just realised that saying you being on these forums is a stroke of luck is actually quite insensitive! Wouldn't wish bed rest and all this stress on anyone. No offense intended!

OBmom

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Re: 28 weeks - 2nd Pregnancy
« Reply #7 on: April 10, 2018 at 06:10 PM »
It's fine, really :)
Me being here IS actually a stroke of luck.. for me! It's incredibly stressful dealing with this alone.
Talking to everyone here keeps me sane and focused :)

Margueritevdw

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Re: 28 weeks - 2nd Pregnancy
« Reply #8 on: April 16, 2018 at 06:21 PM »
Last week Thursday we had a 4D scan that is offered for free by the baby clinic at our hospital. It's obviously awesome to see your baby in such detail (it feels a bit like peeking at a present), but baby was very quiet and had his hands in front of his face and no amount of walking and rolling could get him to budge.

The nurse who did the 4D also commented on the low fluid levels and then of course the worry started setting in. By Friday morning I was convinced that he wasn't moving as he normally does so I called my Dr who said I should come for an NST to be sure. Luckily halfway through the NST he woke up from his 2day chill out and really let me feel his presence. I was so relieved!! The Dr had been in emergency surgery, but called later the afternoon to confirm that the NST results indicated no cause for concern. Phew!

I went for my weekly check up today and he had picked up a bit of weight, fluid levels are slightly up, cord blood flow was fine and we had another normal NST. He is still on the 10th percentile for growth. So happy. We get another week! Cervix still closed and 3cm.

Good luck to all the other moms there!

OBmom

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Re: 28 weeks - 2nd Pregnancy
« Reply #9 on: April 17, 2018 at 09:39 AM »
Hi Marguerite.

I was happy to hear you're latest results are stable. Love the "we get another week" mentality. I think sometimes people on the outside just can't grasp how important that is to us. We're ACTIVELY waiting :)

Another thought that popped into my head after rereading your story - are you still on nifedipine? Long-term use of hypertension drugs can lower the blood flow to the placenta - and that might be contributing to your lower-end AF levels and growth impairment.  If the contractions have eased up a bit, I would ask your doctor if you can stop for a while and check how things go. I don't know, whatever we can do to try and make things balance, right?

How many weeks now? Fingers crossed for you!

Margueritevdw

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Re: 28 weeks - 2nd Pregnancy
« Reply #10 on: April 22, 2018 at 08:40 AM »
I've got head cold urgh.... But I have my 33week check up tomorrow! I will deffos ask my Dr about continuing the nifedipine. Baby was very active this week. Which has been so reassuring!

Keep well all!

Margueritevdw

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Re: 28 weeks - 2nd Pregnancy
« Reply #11 on: April 25, 2018 at 09:44 AM »
Hi. I had my check up and baby is still not picking up enough. Also seems like the abdominal / head ratio is moving in the wrong direction and I have very little amniotic fluid left. My Dr sent me to another Dr for a second opinion and they agreed to wait until next week to re-evaluate, but they both think its likely that we will deliver early. Next week baby will be 34weeks. Efw @ 33weeks was 1.6kg.

I'm off the nefidipine now as my cervix is stable.

Angela

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Re: 28 weeks - 2nd Pregnancy
« Reply #12 on: April 25, 2018 at 09:32 PM »
Congrats on a stable cervix! Did they talk to you about anything you can do to increase the amniotic fluid, such as drinking a certain amount of water? Or how often you should lay on your side to increase blood flow, which will help with growth? I can't provide medical advice, but those might be some questions to ask.

It's so stressful, but I hope you can still stay optimistic. You first posted five weeks ago and here you are ... still cookin'.

Margueritevdw

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Re: 28 weeks - 2nd Pregnancy
« Reply #13 on: April 26, 2018 at 05:32 PM »
Thank you Angela! Yes, I am thankful for every week that we are getting. This forum is a great help!

I've been eating watermelon, drinking loads of water and I'm working in a protein shake / smoothie over and above my normal meals. Hopefully is does good.

Thanx for all the support!

Margueritevdw

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Re: 28 weeks - 2nd Pregnancy
« Reply #14 on: May 15, 2018 at 01:43 PM »
Hi All!

Had another check up yesterday. Baby is still growing slowly. Now at 36 weeks and weighing 2.3kgs. Hardly any amniotic fluid present. Dr thinks we have done really well keeping stable for so many weeks and they will deliver him at 38 weeks the end of next week the 25th of May. I am so relieved and grateful that we came this far. Thanx all for the support!