I was just wondering something. If you deliver preterm, is an IC something they would have seen on an ultrasound beforehand? Or is it something that is diagnosed through a pelvic exam? I lost my baby at 24w2d and don't have a reason why it happened. I guess I'm trying to at least figure out the reasons why it wasn't. Also, if I had an infection or something, did they automatically test me when the baby was born, or is it something that can go completely undetected? They never said that I had one, but they didn't say that I didn't either. I assume if I did and they knew, I would have been told. Thank you.
IC is tricky. Sometimes (in rare cases) it's caught through U/S in those cases in which the cervix shortens before opening. Mine just opened without ever shortening, so the U/S a few weeks before was completely normal.
The annoying thing is that they can't diagnose IC until it happens. So, with my next pregnancy, I'll get a cerclage early, and we'll keep an eye on everything. I hate that my little Rivi had to be the test case, though. As I'm sure you hate that your little one had to pay the price.
PTL and IC are a little different. IC is when your cervix opens, often with no warning or contractions. PTL is actual labor - contractions along with the opening cervix. With me, I had no contractions until after my cervix had opened, so it's definitely IC.
I would make an appointment with your doctor to discuss exactly what s/he figures happened, and how to address it in your next pregnancy. I'm switching to a high-risk OB next time I'm pregnant (my doc seemed in over his head at times), but if you think your doc's on the ball, just educate yourself so you can stay on top of him/her.
As far as infection, I'd ask the doc to do cultures/etc to rule out any infection. My doc will do these at my 6-week check-up automatically.
__________________ Dominici was born May 2006!
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My doctor sees the two, ptl and IC as a continuum. Some cases are purely one or the other, but many are somewhere in between. He sees me as right in the middle. I was probably contracting but not feeling anything. This might have followed a slight shortening of the cervix on its own and then added to the problem. I don't know, but I do know that I won't do a pregnancy again without a cerclage and close monitoring (u/s and manual checks). I need to feel that my baby is safe.
I think more moms, especially those of us with hormonal imbalances, should be watched more closely.
I wish there was more I could say about it, but I just don't know.
__________________ Metformin 1500mg, Yasmin, managing IR/pcos with lower carbs
First pregnancy ended at 23 weeks due to incompetent cervix.
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Second loss March 9, 2004 at five weeks
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Hi PJC, I'm very sorry for the loss of your baby. Where in Mass are you? I'm in Western Mass.
Have you had your first postpartum visit yet? That's when they answered all the questions for me that you are asking.
If your cervix was already open by the time you got to the hospital, than there is no real way to know which came first, the cervix opening, or labor. They can rule out IC, if your cervix was completely closed but you were having contractions when you arrived. But if that is not the case than its almost impossible to tell which came first.
They know I had IC because I had a silent dilation of the cervix ... very very small, that they caught on what should have been my routine 18 week ultrasound. They sent me home on bedrest, intending to check again the next week and possibly put in a rescue cerclage then. (oh how I wish they had just done it that day) and three days later I went into labor.
I did have an infection, which they found when they did an amniocentesis and also in pathology when they examined the placenta. Most likely your placenta was sent to pathology after you gave birth if you gave birth in the hospital. They should be able to tell from that if you had an infection or not. However, they may not have mentioned it to you, especially if you didn't have your post partum visit yet.
Aviva
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I forgot to mention that my doctor has seen patients whose previous doctors declared that they had IC and not PTL, so put in a cerclage and waved goodbye. No monitoring of the mother's cervix or for contractions. Well, they blew out the stitch and had another loss as a result. Being stubborn about which one you have is pointless. Better to be safe than sorry, for sure, in both problems. I wish you the best of luck next time around. Keep in touch... every success story is helpful to the other cysters, and I think you'll be telling one soon.
__________________ Metformin 1500mg, Yasmin, managing IR/pcos with lower carbs
First pregnancy ended at 23 weeks due to incompetent cervix.
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Second loss March 9, 2004 at five weeks
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I am actually 14 weeks postpartum tomorrow, so I've already done my pp checkup. No one ever mentioned IC as a possibility, it was just something I was trying to rule out in my own mind, I guess. When I went for my pp checkup at 2 weeks, I was expecting them to tell me to come back in another 4 weeks to see how I was doing physically. I asked and they told me I was all set. They didn't even give any sort of a pelvic exam, which I thought was unusual. I called my primary doctor to ask about this, and she said that was normal with an uncomplicated vaginal delivery (which it was). I still have never heard of this, but oh well!
Anyhow, at my 2 week pp visit, we discussed what happened with the baby. The doctor checked on the pathology report of the placenta. The only thing that came back was that the cord had no twist in it. She explained that this wasn't unusual and probably had nothing to do with her coming so early. Apparently the twist develops later in the pregnancy anyway, and no twist in the cord is usually associated with some kind of birth defect or abnormality. Anna was perfectly formed and perfect as far as I know, she just arrived too early and was not developed enough to survive.
I had a routine ultrasound just 5 days before she was born. I had been experiencing all through my my pregnancy this constant need to pee. I know this can happen throughout the whole 9 months, but I was feeling constant pressure on my bladder. The 45 minute ride to the hospital for doctor appointments were unbearable (never mind if we got stuck in traffic in Boston!). I wasn't sure how I would do this for another 3 or 4 months and as the baby grew would it get worse? I hardly left the house because of it, and when I did, I tried to make sure to have bathroom access. I also felt lots of aches and pains in the abdomen, but the "book" said that was normal, so I attributed them to being pregnant, out of shape, and too chunky to start with. I was also very tired all the time. In general, I felt very uncomfortable during the pregnancy. I felt like how people describe what their last month of pregnancy is like, not realizing that it WAS my last month of pregnancy. On the day I had my u/s, I went up to the ob's office and asked the nurse if she would do a urine test to rule out a UTI just in case. It came back normal, and she told me the peeing all the time thing was normal, too.
When I did go for my pp visit, the ob doctor referred me to an endocrinologist, as I did not have one yet (I was diagnosed w/PCOS May 2002 but have exhibited symptoms since puberty started). She said I could get the name of a high risk ob from her (the endo) for my next pregnancy and to make a preconception appointment with them, so I'll be monitored more closely. ( I didn't know I was pregnant before officially until I was about 16 weeks along --it was kind of unplanned, but very much wanted!) I forgot to ask her at my appointment a couple of weeks ago, but I have another in 5 weeks or so and since we're going to wait on trying again a little bit, I can find out then. I was going to the ob resident clinic, I guess maybe because I was on freecare at the hospital, so I never saw the same doctor twice!
I am just worried that if it was IC and they didn't know for sure about it, will they do something next time? I was dilated to 5cm when the midwife finally got around to believing that my water actually broke. I guess it may not be IC, as I was apparently having contractions since late the night before, although it just felt like aching hips, but I'm just worried that nothing will be done if it turns out that it was IC, because we'll never know for sure, you know what I mean? I think I'm repeating myself--sorry! I guess I can probably ask the new high risk person some of this stuff when I get the appointment, I'm just going crazy now. I just hate when something happens and nobody knows why from a medical perspective. Oh the stress!
I think they should monitor pregnant women with PCOS or other hormonal problems a lot more closely, too. It seems like we have more problem pregnancies than problem free ones! I guess it's all about the bottom line as usual! I also think we could all become doctors with what we have to learn about our bodies! I'm finding out that we often know more than the doctors, because we communicate with each other about what goes on with all the "crapola" (sorry) with PCOS!
Aviva, I live South of Boston, West Bridgewater to be exact.
I want to thank you all for your help and encouragement!
Patty (PJC) I'm such an idiot, I thought we had to use our "code names" (hehe!)
Patty, I think the high risk OB is a really good idea. A prenatal appointment will probably help answer a lot of those questions. Given your history I think I'd go with what Sheri is saying and insist you be monitored both for IC and PTL. (whether or not you want to have a preventative cerclage or not is something to talk about with your doc) I've heard good things about the high risk Docs at Brigham and Women's if either of their campuses are close to you.
Sending you some strength...its hard enough to get over a loss, it seems really unfair that you also partially have to be your own doc.
Aviva
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I am actually going to Brigham's for all of my care (primary doctor as well as ob and endo). While I was surprised by the way the ob clinic was run, I don't blame them for anything that happened with Anna. Most women have no problems and need only minimal monitoring. Unfortunately, we usually have to learn the hard way who needs closer monitoring. It's just nobody's fault.
My Dad has his doctors there and they basically saved his life after a local hospital almost killed him, so that's why I went there. People come here to be treated from all over the world, so why not if I'm only 45 -1 hour away? It is encouraging that you've heard good things about the high risk ob's there.
I also wanted to go there for the pregnancy in case I had any complications. I never dreamed there would be, though. I think if Anna had been delivered at the closest hospital to me, I never would have had the 4 precious days she was with us. I don't think she would have even lasted a day. I can't say enough good things about the doctors and nurses who took care of her. They were just so wonderful, and they did everything humanly possible to help her. They also put me on the floor with the high risk patients, so I wasn't listening to the new babies of others crying. Those nurses on that floor were so nice to me, too.
I will definitely have to make a list of questions for the new ob when I get the appointment. I usually get so nervous that I forget to ask!
Thank you all for strength and encouragement. It means alot to know that others care and understand, even when I get a little long winded on the subject. After going through this, I feel like I can do anything! Take care...
Patty,
One of the moms around here who has just carried to term after a loss of twins went with bedrest as the main intervention. She had early bleeding, so her plan for bedrest starting in the second trimester actually started much earlier. I think it was a sub-placenta bleed. Her success strongly suggests that a fair number of us could go without a cerclage, though we just never know. I personally did not have a single doubt about it. And I'm too wiggly to do so much bedrest! lol It is very important to find doctors whose thoughts on the issue click with your own feelings. There are plenty of good choices that you can look around, especially after you do some thinking about this and are ready to try again.
I am very glad you got some time with your baby. The few minutes that we had changed my life forever, and I treasure them. I'm also glad that your experience and care at the hospital was as good as could be expected.
__________________ Metformin 1500mg, Yasmin, managing IR/pcos with lower carbs
First pregnancy ended at 23 weeks due to incompetent cervix.
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Second loss March 9, 2004 at five weeks
Third pregnancy, Cerclage at 13w
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Sheri,
It's always encouraging to hear a success story. The bedrest thing seems like a tough thing to do but very well worth our baby's life. If you get a cerclage, are you still restricted to bedrest? (not that that would be a deciding factor, I'll do anything I have to!) I will definitely discuss these things with the high risk ob when I get that appointment.
With everything that happened, all the pain and sadness, I'll never regret having my little girl, even though we only got to have her for 4 days. I truly believe that her short little life served some important purpose on this Earth, even if it is completely beyond us. I know for one, it has made us rethink our priorities.
I truly hope and wish for you and your family that your little "honey" becomes your little "Valentine!"
With my son i had a normal ob visit where my cervix measured 4.5cm and two weeks later i went in thinking i was constipated and was 7cm dialated! With my girls i was 3.8cm and a week later i was having a routine u/s and on the screen they could see my amniotic bag bulging out of my cervix and i didnt feel a twinge, a cramp nothing until the actual pushing out of the babies...and my doctors STILL wouldnt come right out and say i had IC Because of the bulging of the sac i caught an infection of the chorio lining and this time when i get pregnat again (thinking positive here ladies) i will insist...INSIST...on a cerclage. That wonderful mom Sheri you mentioned very kindly sent me a wonderful book in the mail about bedrest and let me tell you my feets up for 6 months...no matter what they say!
PTL and IC i think are one and the same...like you said just on a different stage of the continuem...but i think sometimes doctors are so caught up in statistics and formulas and 'research papers' they dont always listen to the patient! The fact that my bags never ruptured (during both early labors my sacs had to be manually ruptured by the doc), i was monitored for contractions and didnt have ANY...the fact i had no pain or anything... i dont know why they wont classify me as IC and NOT 'possible' ptl...but i dont care...if a cerclage will help even a little to keep those babies baking a little longer sign me up!
Sheri how ya doing anyway...
__________________ Kim 40 PCOS/IR/IC/PIH/PTL
DS6yrs-preemie-30w)Twins-Met,Prometrium, Puregon Injectibles DS3YRS
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TTC#4 w/Injectibles-IVF conversion/CERCLAGE/6.2mo bedrest/emerg c-sec at 38wks
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I am so sorry for your loss! Although I am new to the boards, I felt compelled to reply.
My situation was a bit different although my daughter survived and to this day I am not sure how or why...
I was 24w4d pregnant with my first DD and I felt in my heart that something was wrong....just a gut feeling. I went straight to my OB's instead of work and got there just as the office was opening. They took me back and we were joking that I was being a paranoid pregnant mom. Well he did the internal exam and looked at me with a stern face and said you are going to the hospital right now. You are 2/3 cm dialated with a bulging bag. I almost fainted right then. I was taken to a level 3 hospital and was told to be ready for delivery. Much to my surprise My DD held on until 32w4d and had no complications. I was DX with an incompetent cervix.
I went on to get pregnant again and just had my second DD in May of this year. They put in a preventative cerclage, it was removed at 36 weeks and amazingly my 2nd DD was born at 40w3d. I was on partial bedrest with some mobility but was not able to work or stand for long periods.
I think doctors tend to lable an incompetent cervix if there is no know cause for pre-cervical dialation.
Again my heart goes out to you! IMHO, I think you should talk with a Perinatologist if you plan to ttc again. They can be very helpful and insightful about IC.
Take care!
Allison
Mommy to Sara 10/20/02 32 week preemie and Charlotte 5/13/04
__________________ It's funny how the world changes sometimes, how the streets you walked your entire life seem darker, colder. How the silence isn't so quiet anymore. How eyes you've barely even noticed now look at nothing but you. How the walk home every night is no longer routine, but a victory. And then you begin to wonder...maybe it's not the world that's changed. Maybe it's just you.
...Roswell 1999 Liz Parker
Patty,
I just looked in on this thread after a few days, and you are so sweet. I appreciate the support I've been getting through this huge challenge. Pregnancy is never the same innocent venture after we know that it sometimes doesn't end with a living child to bring home. The women here are jewels, all of you. When you are ready to try again which you should not rush at all if you can help it during this awful grief, we will be here to see you through it. Hopefully I'll have my little Valentine and be a busy mom, exhausted but finally happy. I hope that having my baby to love and hold will help my aching heart and remind me that it honors my little girl to keep my life moving forward.
((Hugs))
Sheri
__________________ Metformin 1500mg, Yasmin, managing IR/pcos with lower carbs
First pregnancy ended at 23 weeks due to incompetent cervix.
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Second loss March 9, 2004 at five weeks
Third pregnancy, Cerclage at 13w
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Welcome to the board. I think maybe you meant to address your note to Patty and not to me, though that's ok, I'm sure we all knew what you meant.
I got kind of confused there for a second though, because I was like "but we don't know if we will TTC again or not? We need to get through this pregnancy first!" But then I realized the names were just mixed up I'm so glad to hear your daughter made it, its amazing that she hung on for so long.
Patty:
Not everyone with a cerclage goes on bedrest and some do more strict bedrest than others. For me, I really needed to feel I was doing everything that could be done, and I knew I was capable of doing bedrest and didn't have to worry about working. I've done modified bedrest but stay down for most of the day every day. It gets tedious but it keeps me from getting as scared. Even I will admit though that I probably am more strict than is necessary. It just depends what you feel comfortable with. Don't worry about being long winded here, say what you need to say. We've all been there.
Aviva
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Allison, It's miraculous that your 1st daughter was able to hang in there until it was safer to be born. It is also wonderful that you were able to carry your 2nd daughter so long. I am so inspired as well as encouraged by this! There is no question in my mind about seeing a high risk ob for a future pregnancy. Like I said before, I don't neccessarily blame them for what happened, but I do think I should be looked after more closely from now on, and it would be my fault if I didn't see to it the second time around.
Sheri, The support I have found here has meant the world to me. My family and friends have also been wonderfully supportive, but most of them don't bring up the subject very often and when they do, it's mostly just a "how are you doing" kind of thing. I know they mean well, and they probably think that I will get upset if they mention anything. The fact is, sometimes I do cry when I talk about it. But I still want to talk about it. I like talking about it. Sometimes I think this makes them feel uneasy. My Mom has been the best one who talks about it with me often, though, and that helps.
My next pregnancy will be far from an innocent journey. I was so oblivious to lots of things during my 1st pregnancy. I just read the books and was yet so unprepared for what happened, because what I was having for symptoms were supposedly "normal." I know from now on, I will complain about every ache, pain, and twinge I feel without worrying that they'll think I'm a superduper worrywart. I don't care if they think that 'cause I am one, especially now!
Aviva, Thanks for the info on bedrest. I know it will be tough if it becomes neccessary, but I think like you and am willing to do the most I can if only to relieve some of the stress of worrying. I think I could keep myself occupied at least some of the time. As far as working, I'm looking for something right now to keep me occupied, but I'm not exactly in the middle of some glamorous career that I couldn't possibly leave behind if I had to!
I know I will definitely mention the whole IC thing to the new high risk ob. As I read everyone's stories about it, it really does make me wonder about it. I didn't tell the doctors most of my symptoms because I thought they were normal. I've seen it mentioned once on another pregnancy website about unusual frequent urination being a possible sign. I felt like she was really pressing against my bladder. I've also seen it mentioned several times about being constipated. I never really had a problem with constipation during the pregnancy, but I felt for several weeks prior to Anna being born, a strange kind of pressure on my intestines that made me feel like I had to go to the bathroom halfway through the day again (and I would) when I had already gone in the morning. It was just unusual for me. I had noticed some mucous 4 or 5 days before she was born, but it wasn't any more than I noticed during the pregnancy or even during a regular cycle. I felt very heavy in the pelvic area and kept saying the baby must be kind of low, and though it wasn't painful, it almost felt kind of tender to the touch. I also felt this kind of intense pain on my lower right side one day while I was shopping for baby things with my Mom (this was a good month before the birth). It did go away after awhile, so I didn't think anything of it (the book mentioned if the pain goes away w/in a certain amount of time, then I didn't need to worry, I guess).
I don't know, I'm just trying to figure things out. Thank you ladies for letting me get this out with you. I'm a lot better expressing myself through writing than speaking. I know I'm driving myself crazy!
By the way, I have one more question. During one of my prenatal visits, the doctor said I had some ketones in my urine. Any input? I believe my blood sugars were ok, I certainly was not low carbing (I got yelled at that visit for gaining 11 lbs since 4 weeks before.) I did tell her that I hadn't eaten or drunk anything that morning yet (it was a morning appointment). She looked a little puzzled by it but it was never mentioned again.
Preterm Labor Question 
Because of the bulging of the sac i caught an infection of the chorio lining and this time when i get pregnat again (thinking positive here ladies) i will insist...INSIST...on a cerclage. That wonderful mom Sheri you mentioned very kindly sent me a wonderful book in the mail about bedrest and let me tell you my feets up for 6 months...no matter what they say! 
