Warning Signs for Incompetent Cervix and Pre Term Labor - Page 17

*~SugarPlums~* · 06-15-2007, 06:15 PM

Quote:

Originally Posted by sweetums
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What are 17P shots and what do they do? Is this something I should be demanding with my next pregnancy? When do you start them? Since it seems the loss of my boys was a combination of preterm labor and IC and other problems after the labor and delivery, I'm wondering if this is something I should have? I'm wanting to have a complete plan of action ready so that the next time I get pregnant, that I'm backed up with the plan and don't have to fight tooth and nail for things like I had to try to do with my boys. I want to be as informed as possible.

Manders

Those, I beleive, are progesterone shots used during and after the second tri. They help women with prom.

Nspear-I also agree you should demand a cerclage.

I really get quite upset when Drs. do the wait and see approach. Why do that if they are not sure? Cerclages place preventatively have a higher succes rate than emergent cerclages. I would never take that chance.

saluki_fan · 06-15-2007, 06:17 PM

nspear - I agree with the other gals, it seems like with your history, a preventative cerclage is a good measure. AND the 17p shots. You can't be too careful.

LaurAnnHere · 06-15-2007, 06:48 PM

The risks of a preventative cerclage are very, very low. There are risks involved. The fact is that the risk of not having one if you suspect IC are much greater than not having it. If you have IC, the odds of your baby surviving without a cerclage are really low. Not that it doesn't happen. There are ladies that can tell you about bedrest success stories, but they are rare and extremely lucky. I've spoken with and read the stories of so many women with IC. I would never be willing to suggest giving bedrest or the wait and see approach a try.

deedlebug06 · 06-20-2007, 10:22 AM

Quote:

Originally Posted by LaurAnnHere
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The risks of a preventative cerclage are very, very low. There are risks involved. The fact is that the risk of not having one if you suspect IC are much greater than not having it. If you have IC, the odds of your baby surviving without a cerclage are really low. Not that it doesn't happen. There are ladies that can tell you about bedrest success stories, but they are rare and extremely lucky. I've spoken with and read the stories of so many women with IC. I would never be willing to suggest giving bedrest or the wait and see approach a try.

What Laura said. I would have totally prefered the cerclage vs. bedrest. I got lucky, but was in no position physically to demand anything as I was totally out of it due to the meds they put me on once I my IC/PTL was diagnosed.

nspear · 06-20-2007, 10:28 AM

Just wanted to update everyone.. they have scheduled my peri appt for july 10th.. I will be seeing the dietician at 1, level 2 u/s at 2, and the Dr. at 3.. so it will be a long day... I'll keep everyone posted!

Thanks for the well wishes and advice! It is greatly appreciated.

Bunnyscott · 06-23-2007, 06:42 PM

Quote:

Originally Posted by VivC
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If you suspect IC, demand a cerclage. I know two cysters who participated in the "trials" of 17P vs cerclage...both received the 17P, and both lost their babies. A rescue cerclage may come too late to save a baby, and a preventative cerclage is far less risky - they're 95% successful! There's honestly no reason NOT to do one if IC is suspected.

ITA. I did 17P shots starting at 11 weeks, took Procardia to limit PTL and STILL was 25% effaced at 15 1/2 weeks. On transvag u/s my cvx was 4.8 cm long; however, when peri went in to do the cerclage (because we opted to treat me for EVERYTHING), my cervix had shortened in the back to 1 cm.

My OB was opposed to the cerclage (before the surgery), but even she agreed that the weekly transvag u/s weren't enough to catch the problem because you can appear long on u/s, and then get up and walk outside the door and start funneling.

Also, their is a "chicken and the egg" argument about IC and PTL. One can trigger the other. They don't fully understand the causes of either one, so if you have a loss, or premature birth, they often can't separate them. My peri said it's perfectly reasonable to think that the weakening cervix can cause contractions and the contractions can irritate the cervix, and so on. You get trapped in a dangerous cycle.

PROM can also be a presentation of IC. One of the reasons my OB didn't want me having a cerclage is that I had chorioamnionitis with my last miscarriage because I had had a small rupture and bacteria had gotten in. She didn't want me being at a greater risk for infection. BUT THE RISK OF INFECTION WITH PREVENTIVE CERCLAGE IS SO LOW, it doesn't increase the risks of an already high risk pregnancy.

Preventive cerclage is the one true thing that saved my daughter's life. I believe it was the one thing that did it -- over the 17P, bedrest, fibroid surgery, weekly doctor visits, tocolytic therapy, GD diet and BP monitoring.

More modern doctors need to get on the cerclage bandwagon, IMO.

LaurAnnHere · 06-24-2007, 04:47 PM

You're absolutely right. IC is extremely difficult to diagnose unless you "catch it in the act" which usually doesn't happen. After your cervix opens so far you will start contracting and/or your membranes will rupture. Then you are diagnosed as having PTL or PROM and IC is not even considered. Usually women have to lose several babies during the second trimester to get a tentative diagnosis of IC. I've never met anyone who regretted getting a cerclage. I've met women who had failed cerclages, but they were never sorry they did everything they could.

IC is supposed to be this rare condition, but from what I can see, it is not so very rare. I think it would be more accurate to say that it is difficult to diagnose so it is a rare diagnosis. I think there are many more cases than doctors realize. I would bet that at any one time there is at least one IC ticking time bomb in every OB office.

the1tracey · 06-27-2007, 07:21 PM

Ok now i feel sick to my stomach.

Today i saw my specialist, who's also doing my anti natals, he mention getting a "stitch" as i "could" be prone to pre-term labour because of a few things going on. I am 14weeks and 2 days and thought i was on the road to motherhood, now i could just sit here and cry.
At the time, he said "there's risks involved" but i didn't ask him what they were....Is there a list of the risks?

Also Can i have it done anyway, just to cover myself? Will it cause probs, what will happen when i go into labour/waters break?

I've so many questions, i'm sorry if i've bombarded you all, i want to go read on it, but don't want to scare myself further.

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Ty for your help ladies, my heads in a muddle now so going to go back over what's been written by you all.

Do you think he would have mentioned the cerclage if there wasn't a high chance i'd need it? maybe he was just letting me know the facts, just incase? I haven't had an internal scan yet, but maybe i'll ask for one......but my next appointment with him is 6 weeks away
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i am going to try not to panic though.

Day-n-Night · 06-27-2007, 09:49 PM

Hi Tracey, I am very curious about what "things are going on". Are you having multiples oir have you had a second trimester loss before or delivered preemies, or have you had cone biopsies or leep procedures?

Im also wondering since he said he thinks you could have PTL does that mean he thinks you have both PTL and Incompetent cervix?

The two sort of go hand in hand one can trigger the other but if he feels your at high risk for PTL then I would suggest you ask him for the P17 weekly injections starting at 16 weeks and do the cerclage if he feels needed along with it.

I was scared to death to get my cerclage but I was NOT about to lose another baby and ya know the cerclage was a breeze I mean honest to goodness for me it was a walk in the park or even easier.

The real risks are in rescue cerclages when you have little length left, dropping membranes, et-cetera. Though theres risks with everything over all preventative cerclages done at 12-14 weeks on average are so very safe!

PS another thing to ask for in addition to P17 is cervical length transvaginal ultrasounds and to get them regularly, weekly or once every 2 weeks!

Hugs and Congrats!

PS if he thinks you need a cerclage it would be silly to wait 6 weeks to have it done you'll be in the 20's then... if he really feels its necessary insist on a preventative now not later and tell him you do not want to have a rescue when you could do the preventative today.

LaurAnnHere · 06-28-2007, 03:13 AM

Don't worry. I've got the list of risks and they are very, very small. Visit my sons website and I have lots of info on IC. The risks are just astonomically small. The risks sound really scary, but please don't be afraid of a cerclage.

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Here's just the risks portion...

Quote:

Are there any risks to having a cerclage?
The risks of having a cerclage are minimal. Most physicians feels that a cerclage is a lifesaving procedure that is worth the possible risks involved. The risks are…

• Premature rupture of membranes (1-9%)
• Chorioamnionitis (Infection of the amniotic sac, 1-7%) (This risk increases with gestational age at onset of IC and is at 30% for a cervix that is dilated more than 3 cms.) This risk can be minimized by taking antibiotics following the procedure
• Preterm labor and premature rupture of the membranes
• Cervical laceration or amputation (This can be at the procedure or at the delivery, from scar tissue that forms on the cervix.) • Bladder injury (rare)
• Maternal hemorrhage
• Cervical dystocia
• Uterine rupture

I know those sound really scary, but google the risks involved in giving birth. They are scary, too. There's nothing in pregnancy that isn't scary if you read up on it too much. I can tell you that I'll be nervous when getting a preventative cerclage if I ever get to have another baby, but I won't think twice about it. I will look forward to it and look forward to actually experiencing a "normal" pregnancy, I hope.

Also, visit my IC message board. It's not very active but has a lot of stories, advice, and info on it.

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Oh, and definately don't wait on a cerclage. Preventative cercages hold few risks. Rescue cerclages are much less effective, have higher risks, and are generally harder on you as well. I've been there.

the1tracey · 06-28-2007, 09:40 AM

Ok well he only mentioned it after talking about my bicournate uterus (heart shaped) and the fact i get kidney/bladder infections (utis) on very frequent occasions.

He told me of the risk of cerclage and said he doesn't totally believe i should get it done, my bicournate uterus isn't very severe at all infact, you can hardly see the dip at the top and certainly won't cause my baby to grow in an odd position. But i think he was going over ALL things that may crop up in my future.

But of course, i'd rather he'd not said anything that he wasn't "positive i needed" because it's just scared the crap out of me, he should have read that after 10 years of ttc, this is my first and that alone should sound warning bells of "don't scare her"!.

Another thing, is he didn't speak very good english....i kinda nodded along with stuff he said, only to sit at home and think "he mentioned cerclage and pre term". He didn't mention IC.

He also said he thinks i'll be completly fine, so why mention pre term at all? All seems so confusing for me.

Thanks for you help ladies, i knew i could come here and get answers ty.

I am going to give the hospital a call later, and find out if he said it as a "you may need this" or was just saying "you don't need this, but some ladies..." etc.

deedlebug06 · 06-28-2007, 03:34 PM

Laura/Viv - please check this thread when you get a chance...

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deb_e_deb26 · 06-28-2007, 08:47 PM

deedlebug06 - I was coming here to do the same thing, link to that ladies post...I am so worried about her and her baby....they dont seem to be doing anything for her at all, even though she is at a viable gestation....

I also want to say that I think all you ladies here that have experienced IC and PTL and fight your hardest to help others are just amazing!! I honestly believe that without all your info, there would be more losses due to these 2 horrible things....we have enough losses as it is
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Laura - Was there talk somewhere about a study into IC and PCOS?? I think I read sometihng ,I thought from you, a while back about it? or was it you were trying to to get one up and running??? There seems to be so many ladies with pcos that have this, how can they not see the link? We arent doctors but can....

Anyway, you ladies truly are godsends to so many!
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LaurAnnHere · 06-28-2007, 10:32 PM

Debbie, I've been working on one. I had to let the site go for financial reasons and am hoping to get it back up and going very soon. Viv & I took a bunch of questionaires, not just looking for a relationship b/w IC and PCOS, but with as many factors as I could come up with (which is probably not all of them). My hope is not that I will accomplish a study since I have no medical background at all, but hoping that my research might be able to start the groundwork for someone in the medical community to take hold of and run with. The diagnosis is too difficult to make. If it's difficult to diagnose after the fact, how in the world are they supposed to diagnose it before it happens. I'm not sure there will ever be a way to do that. What they can do now, and I believe they should be doing now, is take more measures to detect IC early on when a emergency cerclage would be possible. A few extra transvaginal u/s during the 2nd trimester is all I'm asking for. If they could just make this available to everyone I believe there would be far, far fewer extremely premature babies and 2nd trimester losses. You don't know regret until your baby has lost their life b/c of something that could have been prevented. Knowing that you couldn't possibly have known to do anything about it is little comfort. Just knowing that maybe, just maybe things could have been different is enough.

ShelbersMama · 07-08-2007, 02:48 AM

Hi everyone.
I just had an emergant cerclage done yesterday! Im 24 weeks prego and was dialated 2 cm at the time.
This was a total shock!! I went in for a follow up u/s ( little guy didn't cooperate so well at my 20 wk scan ) and they checked my cervix to find it was shortening. So I got a trans. vag. and it was very short and funneling. Before I hardly knew what was going on, I was in the hopsital and having a cerclage put in.
Before yesterday I'd heard of a cerclage, but really knew nothing about them!
I have a 6 year old dd, who was full term and then some. I have no history of mc's. But it took me 5 years to get preggo w/ this little guy! And only got my diagnosis of PCOS ( freakin' finally ) when my OB decided to check my overies while he was dating the pregnancy.
So I guess I'd just love to hear success stories!! LOL From what I've read, my chances of going full term after an emergant cerclage arn't the best... but it could happen. Obviously Im rooting for the second one
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Are there others out there that have gone through what I just have? What should I expect? What should I ask at my next apoint?
So far Im not in labor, although while in the hosptial and after the proceedure I was having some painful ( although not hard ) contractions.
Besides being told to "take it easy" ~ which basically I've put myself on bedrest!! Im not taking ANY chances until my dr. apoint/ u/s on Monday ~ Im on 600 mg of IB every six hours.
Hopefully this will turn out ok in the end! Im scared, but at the same time Im so thankful that we caught it when we did! I'll do just about anything right now for this little guy to stay put for at the very least another 6 weeks! Idealy he wont come for another 10 weeks or longer!
Thanks for any advice/help you all can give me!
~Dez