I hope you don't mind me asking - ? about later loss.

Deeds2 · 06-28-2005, 07:23 PM

I had a loss myself, at 3 months, so nothing like what so many of you have gone through. I want to ask on behalf of a friend.

She tried for her daughter for years and eventually had IVF with ICSI and was succesful on the second try. Her daughter was born at 33 weeks and spent 5 weeks in NICU.

She is now pg again, through IVF, but this time with twins. Her history is that she had a colposcopy a few years ago, then this early delivery. I am so concerned for her with this pregnancy. Her daughter weighed only 3.5lbs. I have this fear that if this is as far as she got with a singleton, how far will she get with twins, will she be very premature or worse?
How can I offer support without scaring her? I suggested to her that she asked to have her cervix measured from early on, but she then said, yes, probably from 32 weeks.

I don't want to interfere, but UK doctors are not reknowned for being ahead of the game. I also don;t want to sit back and have her experience a tragedy.

I'm sorry if this is not an appropriate post and if so a moderator can delete it.

LaurAnnHere · 06-28-2005, 07:50 PM

Did she get a cerclage for this pregnancy?? She certainly should if she hasn't. Even extra cervical checks may not lead to enough time to save a baby. They certainly help. A rescue cerclage is not nearly as effective as a preventative cerclage. I'm on some pain meds right now and not able to type or think very clearly, so I don't want to try to go into detail right now. Make sure she finds a doctor who will give her a preventative cerclage. If you have any questions IM me and I'll respond better when I'm feeling a little stronger.

SheriKCMO · 06-28-2005, 08:12 PM

Your friend needs a cerclage and possibly bedrest. Seriously, it is not scaring someone to save their children. Some women can avoid tragedy with bedrest alone, so if she cannot get care, she can try to take care of herself. Kwannabee/KIm had a 30 week singleton and then twins at 21 weeks who were obviously not ready to be born. She had to demand proper care in her subsequent pregnancy, and she is now close to term with that new baby. A preventative cerclage has saved many children around here. It is better to be safe than sorry, even if it is simply cervical ultrasounds starting by 16 weeks with twins. NOT 32. She will definitely have those babies long before that. I'm sorry to sound alarmist, but there are way too many cases like hers around here.

You are a very good friend!

kwannabee · 06-28-2005, 08:42 PM

I lost my twin girls because i didnt have a cerclage

and almost lost my first son for the same reason...he was born at 30 weeks and i almost lost him anyway...this time my goal in life was to show my doctors who was boss...and no way was i going to go through that horror again...a preventative cerclage and bedrest for me is what has made my current pregnancy 2000% different...the pain of my recent loss is at war with the joy of my current pregnancy...i feel like a split personality at times, but i would do it in a heartbeat all over again.

A preventative cerclage cannot be done after 16 weeks....anytime after that it's a rescue and the risks of rupturing the amniotic sacs is higher cuz the baby is heavier and closer to the cervix. Add the extra weight of twins, double fluid and placenta and water retention and the extra tole it takes on your body...if theres any risk at all waiting til 32 weeks is useless in my opinion. Things start changing around 14 weeks maybe even 12 and once gravity sets in...well a weak cervix is in big trouble...two babies are heavier then one, obviously...and thats double the pressure on a finicky cervix!!! This time I almost felt like i made a full term preg when i hit 30 weeks...it was such a relief!! I dont think i've had a decent full breath between 12 and 30 weeks...too scared to believe i would be okay and even more scared if i moved the wrong way i'd push my baby through the stitch...i would not have made it sanity wise if i didnt have that little shoelace in there!!

I wish your friend well...doctors for some reason have this aversion to cerclage but if there is any risk at all due to history then i cant figure it out...they say they want 'evidence'...well how many babies do you have to lose before you have 'adaquate evidence...thats so stupid to me!! i had to insist...fight...but whats more important is i had to keep my emotions under control while i talked to them too...cuz every word that came out of my mouth was one step closer to falling apart...thinking if i'd only done this before my girls would still be here...i'll just never know though

whew...sorry for my rant...its so darn hot i'm feeling a little ***chy!!

Pm anytime...

Reebekah · 06-28-2005, 09:34 PM

A twin preg. is so much different. For starters, you measure 6-8 weeks bigger than a singleton pregnancy. I lost my twin girls at 20 weeks, and I was measuring almost 27 weeks. If I had actually been as far along as I was measuring, my babies might have had a chance to live.
At 16 weeks, I KNOW things were starting to go wrong....my doc didnt listen...he said it was b/c of twins...and I lost them a month later. If he would have checked my cervix at that 16 week appt and noticed my cervix changing, maybe something could have been done. But better yet, my cervix should have been measured from WEEK 12 on....that way something could have been done as soon as shortening was seen....before it was too late. With your friends history of preterm birth, she should DEFINATELY get a cerclage.......at the very least, her cervix should be checked every week starting at 12 weeks....but I really think a preventative cerclage would be best in her case. If I had a premie, there is no way I'd attempt a twin pregnancy without help. Heck, I lost twins and I wont even attempt a singleton pregnancy without help.

LaurAnnHere · 06-29-2005, 02:10 AM

I'm so glad some other ladies were able to answer your question better than me. I wanted to jump in and say someting, but my brain seems completely fried at the moment. I just wanted to make sure she got the cerclage info!

Deeds2 · 06-29-2005, 08:25 AM

Thank you all for your responses. I really appreciate it. I will see her tomorrow and ask her what help she is getting. She is 12 weeks now. Here in the UK there is so much less in the way of preventative care than I read about on these boards. I spoke to her about bedrest when she found out it was twins, we work together and I suggested she shoudl stop work early to ensure that her pregnancy is healthy and she could be off her feet totally. She just seems so calm about it all. I almost feel like I'm the crazy one asking her to get checked. When she said 32 weeks I realised she was making no comparison between her pregnancies at all. I will try and have a chat with her tomorrow and talk about the difference in weight of the two pregnancies. I am so worried for her, but she doesn't seem to have a care in the world.

I really appreciate all your advice and I am truly sorry that you have had to go through the terrible losses you have.

kwannabee · 06-29-2005, 10:01 AM

Lauranne i thought you'd been kind of quiet lately...hope youre feeling better soon!!!

Quote:

She just seems so calm about it all. I almost feel like I'm the crazy one asking her to get checked.

Deeds...its ironically in your friends best interest in a way to 'not' be over come with anxiety cuz THAT doesnt help her pregnancy either...there are actual hormonal changes that could trigger problems just from the stress alone...and yet you dont want her to get slammed out of no where either by not being prepared...

good luck with your chat...

VivC · 06-29-2005, 07:06 PM

((Hugs)). I'm hoping that she listens. Nothing's worse than the "I should haves." I'm also hoping we're all worrying for no reason, but it's better to be safe than sorry. I had a rescue cerclage at 22 weeks, and made it to viability. My son still died. I wish I could force your friend to listen to us all. She needs to get a cerclage VERY soon...if her doc won't do it, she'll have to scramble to find a high-risk specialist.

Reebekah · 06-29-2005, 08:56 PM

Sometimes the patients need to be the proactive ones. I had to do my own research, figure out what I wanted to do for my current preg., and then find a doc who agreed. If I would have known then what I know now....
I didnt really think that twins was a HUGE high risk pregnancy before....but now that I lost them, I know. And Im a member of a few groups specifically for twin loss.....you have no idea how many are lost to preterm birth....more than you could imagine.

Deeds2 · 06-30-2005, 04:06 PM

Thank you again. I spoke to her today, I asked how she was doing etc and she is very upbeat, but she is starting to consider the possibility of very early delivery, so I took the opportunity to talk about getting her cervix checked. I eplained to her that external chekcing wasn't enough, that the funnelling happens from the inside out (I hope I got that right) and that she needs to demand that they check her. She seems to be talking in terms of demanding the proper care, so I hope she is going to.

Thank you all. I hope your advice makes her push for what she needs.

VivC · 06-30-2005, 06:42 PM

Yay, Deeds! You're right, funneling starts on the inside, which is why it's missed so often. It doesn't "look" from the outside like anything's wrong.

Viv

Deeds2 · 10-05-2005, 05:41 PM

I hope you don't mind me adding to this thread. I just spoke to my friend. She had her boys today at 26w 2days. They weighed 2lb 2oz and 2lb 1oz and are both breathing on their own. She was never given a cerclage and they planned to look at her cervix next week. Please keep them in your thoughts that they thrive and do well.

I apologise if this post upsets anyone unduly.

VivC · 10-05-2005, 06:16 PM

Deeds - I'm so annoyed. Looking at her cervix AFTER the fact may not show anything wrong! Tell her that, regardless of what they say, if she gets pregnant again, she should get a cerclage.

I'm glad the boys are doing okay, and my fingers are crossed. They have a long road ahead of them, but miracles can happen (like making it far enough for them to even have a chance).

Viv

SheriKCMO · 10-05-2005, 08:26 PM

Thank you for the update. I am happy to see survivors, but as you know they should have been given a better chance. I swear that the girls in this forum would make better physicians than some that we hear about!!

Best wishes for the little guys.