Warning Signs for Incompetent Cervix and Pre Term Labor - Page 24

nspear · 08-11-2008, 04:11 PM

Well let me first say don't beat yourself up over this, it has happened it's over and you can't go back and change things.. I know that is easier said then done but please try not to blame yourself!

On the cerclage thing I don't have a lot of personal experience as I made it without one being watched very closes and only getting the 17P injections weeks 16-35..

My first DD was born at 30 weeks exactly due to pPROM at 29 weeks 1 day. NO if your membranes rupture you do NOT have to deliver. I was told that at our local hospital that when my water broke I had to deliver within 24 hours.. when I got rushed to our high risk hospital an hour away they laughed and said they would keep me there and pregnant for another 5-6 weeks.. we didn't make it that long (only 5 days) but five days was five more days! They pumped me full of antibiotics and put me on mag sulfate for the week, but on the fifth day her knee fell through my cervix so we had to go for an emergency section.

My cousin delivered 9 days later with a different story (same hospital and doc) She was only 22 weeks when she got there dilated to 5 and membranes bulging.. they put her in the TB position (head down and lower ext raised) and she stayed that way for 3 weeks until her contractions couldn't be stopped.. she delivered at 25 weeks, her daughter is now almost 3. She didn't get a cerlcage because of being dilated to 5, but it still turned out. She has had a second since then and had a perventable cerclage and all went well.

With My second like I said I was on a cervical watch being manually checked along with cervical u/s's every week and had the hydroxy progesterone corporate injections weekly through week 35. I did go into PTL twice and had it stopped with trabutaline.. but did successfully carry until my scheduled c/s at 36 weeks..

I hope some of what I said answered at least one of your questions!

Sorry for your loss, try and be strong and look to the future that what you learn from some of these great girls here that have been there will help in your future pregnancies!

FYIW ~ We still aren't sure if IC or PTL causes me to deliver early, I was dilated to 4 with DD #1 when I got to the hospital after my water broke, we aren't sure which came first the dilation or the ruptured membranes. With DD #2 I was dilated to two starting at week 23 but didn't seem to progress and worse, I did have some funneling but nothing to dramatic. I was fully thinned out however at 33 weeks when my PTL got really bad.. so we still aren't sure. Even with two success stories in both my girls we don't have a diffinitive answer. And I'm fine with that.. I am just happy I found a great Peri that is willing to watch and keep a close eye on all the possibilities in the future pregnancies.

Anonykat · 08-11-2008, 04:24 PM

TrueBlue, I am terribly sorry. What a tragic and horrific loss. My sincere condolensces - if you haven't already, please visit the loss board and get some support from women who have been in your shoes.

Please, please, PLEASE do not blame yourself for what happened. I have had not IC myself, but have done plenty of reading, as PCOS puts us at risk for it. Yes, sometimes the membranes can be pushed back and a cerclage put in when you're dilated to 4... but not always. What works in one situation will not work in another. Your doctor did the best he could based on the circumstances at the time. Sometimes there are just no answers, and the what-ifs will drive you to madness. Please try not to torment yourself.

For your next pregnancy, you will need a preventive cerclage between 12 and 14 weeks.

Again, my heartfelt sympathies on the loss of your babies. You said you're "not over it" - you probably never will be. Please be kind to yourself.

VivC · 08-11-2008, 04:37 PM

I'm so, so sorry you lost your babies. Were you having contractions before you dilated, or is it still up in the air? A lot of women never find that answer and just insist on being treated for IC and PTL (PTL is treated with progesterone starting at 16 weeks, BTW).

As far as the info you asked about...it depends on the doctor. Some doctors are more willing to try than others. When I went to my OB with bulging membranes, he sent me to the hospital and referred me to a specialist who refused to do anything.

A nurse told us about a different specialist, and we pushed for a referral to him. He was willing to perform an emergency cerclage (I was 3 cm dilated, but he has performed 4 cm cerclages...he says that's as far as he's willing to go, dilationwise). Rescue cerclages are very risky once membranes are bulging because infection could have already been introduced into the uterus. That's what happened to Rivi and me. We made it two weeks before my water broke, then another six days before the specialist insisted on removing the cerclage (the infection was in my bloodstream by then).

My thing was that I just couldn't give up on Rivi...but, if that nurse hadn't referred us to the right specialist, the first specialist would have induced me then and there. And, looking back, I am so thankful that we were able to give Rivi that chance to fight.

When I got pregnant again, I told my new OB (I fired the old one for various reasons related to Rivi) that I wanted to go back to the specialist who fought for Rivi. He put in a preventative cerclage at 13W6D, and we were fine. I did funnel a little, but I never needed bedrest, and I ended up being induced at 39W. I saw both my regular OB and the specialist for the rest of my pregnancy.

I would recommend that you find a new specialist NOW, before you get pregnant. Either a maternal-fetal medicine specialist or a perinatologist. You're going to need a cerclage if IC was the cause of your loss. You're going to need progesterone if it was PTL. Either way, you need to have a specialist look over your records and come up with a treatment plan for next time that will give you and your baby the best possible shot.

And, FTR, preventative cerclages are 95% successful for IC. ((hugs)).

ETA: I know that nothing we say can keep you from blaming yourself. That's part of this crappy grieving process. Try to look at it this way - you did the best you could for your babies that you could at the time, based on your knowledge at that moment. And that's all we can ever do for our kids.

ShelbersMama · 08-11-2008, 05:25 PM

Trueblue..... Im so very very sorry for your loss! As its already been said, please dont beat yourself up over what has happend. Its such a terrible loss, but it cannot be undone.
We live and learn from our experiances, in the hopes that it wont happen again.

I had a rescue cerclage at 22W with my son. I had no PTL at all, and went in for a routine U/S because he wasn't in the best possition at my 20W u/s. All I can say is that that tech must have been Liam's guardian angel in disguise!!

I forget now how much cervix she measured, but it wasn't much. My OB offered me strict bedrest or a cerclage. When asked what he thought, he pushed for the cerclage, so that's what I got that afternoon.
When it was placed I was 2cm with visible membranes, but they were not bulging. We were very very luckly.

I ended up making it to 36w1d when he came through my first circlage and I went into labor.

I wish you all the luck with your next baby.

truebluebeliever · 08-11-2008, 05:44 PM

Thank you for your replies. I have my post-partum appointment on the 18th so I will definitely ask my doctor a lot of questions. I was having contractions a day or two before we went to the hospital, only I didn't know that what I was feeling was contractions already.

I really don't know if I should change doctors. On one hand, I went to a teaching hospital, so I know the high-risk doctors are experts on this but on the otherhand, the hospital is an inner city hospital, and the nurses are subpar at the least. Up to now, I can't help but wonder if the fact that the nurses were not 30 minutes late on the last two times I was supposed to have Inducin (medicine to stop contractions), my babies would have still been alive. I'm thinking of going to a hospital on the suburbs where mishaps like that wouldn't happen, but then again, it would be a smaller hospital and there might not be a high-risk doctor there.

Is anyone living around Philly here? I would really appreciate someone advising me on the different hospitals here.

Anonykat · 08-11-2008, 05:51 PM

Oh, I know! Ask StormsDreams, she lives near Philly - here is her profile:
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She also had a late loss due to IC, then later had a successful pregnancy. She's very nice and won't mind if you pm her, I'm sure.

truebluebeliever · 08-11-2008, 06:11 PM

Thanks, anonykat! Unfortunately, I don't have enough posts to PM her. I hope she gets my message on her profile page.

VivC · 08-11-2008, 10:23 PM

I just sent her a PM with your username and this thread link. ((Hugs)). While I was on hospital bedrest, a nurse wiped forward instead of back and I've always wondered if that's what introduced the infection into my body.

Reebekah · 08-12-2008, 12:01 AM

I'm so sorry for your loss. As you can see from my siggy, I also lost my twin girls. Please try to understand that you and your docs did the best you could with the info you had at the time. It can be VERY hard to determine the exact cause of a loss, esp. with twins. In my case, I dont know if it was really IC, PTL, PPROM, or infection. I did have a rescue cerclage when I was dilated to 1cm with bulging membranes, but it only lasted a week before it had to be removed because I was leaking fluid and I was tearing thru the cerclage. By that point, I was 4cm, losing fluid, and had a failed cerclage...they said there was nothing they could do. To answer your questions:
1. You CAN have a cerclage if you are 4cm or less dilated. ---- The overwhelming majority of docs will not perform a cerclage if you are 4 or more --- you were 4, so I dont know of a doc that I consulted who would have done one (I consulted MANY after my loss).
2. You CAN have a cerclage with bulging or protruding membranes as long as they have not ruptured. --- You can, but only if they can get them back up inside, which is not always the case, and you have to be less than 4cm dilated.
3. Your cerclage does NOT have to be removed if your water breaks. You do need to be on IV antibiotics in the hospital if this happens, but you should not be forced to deliver unless there is an infection. --- The majority of docs would not take this kind of a risk with their patients. Once your water breaks, you are at very high risk of infection. That infection can spread very quickly....it can get into your bloodstream and cause you to die.....it can ruin your uterus and cause you to have a hysterectomy, etc. Technically you dont have to induce until the infection is found, but a lot of docs (including the ones that delivered my twins) feel that if the loss is inevitable anyway, then the mothers health should not be put at risk by waiting for the infection to spread like wildfire. So, while I personally have a lot of regrets, and while I dont necessarily agree with the doctors, I dont think your docs did anything different than most other docs would have done.
After my loss, I promply fired my incompetent team of doctors and found a great new Peri who vowed to treat me and my future babies how he would treat his own. With his help and the help of 2 preventative cerclages, I now have 2 full term sons. No, they cant replace my twins....and no, they dont take the pain of the loss away....but at least I can still have a family. If I would have known then what I know now, I would have done a lot of things differently, but that just isnt how life works....please dont beat yourself up....there is nothing you could have done. i'm here if you need to talk. you are in my thoughts and prayers. good luck.

truebluebeliever · 08-12-2008, 01:27 PM

Thank you, Reebekah, for your response. Sometimes I still think everything that happened is a bad dream and my babies are still in my tummy. I hope just like you, that I will have a successful pregnancy one day, and just like you, my twins will always be in my heart the rest of my life.

angels091506 · 08-12-2008, 07:25 PM

True~I am terribly sorry for your loss...I to lost my first son almost 2 years ago and almost the same thing happened to me as what you told in your story. I just want you to know that you did all you could and please, please don't blame yourself. I know its the easiest thing to do because we are the mother and I remember coming out of the surgery room when I went in for my cerclage (I was put to sleep because they didnt know how long it would take due to bulging membranes) and hearing the doctor say I'm sorry we were unable to get the cerclage you had no cervix left. I also want you to know that you will hear over and over that everything happens for a reason and it will drive you crazy but as someone who heard it, and i know it may be hard to hear, but it is true...that being said I am now the proud mommy of 8 month old IC miracle twins and it usually does take a loss to find out you have problems such as IC because it is not checked for. If you would ever like feel free to PM me or here is my email

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if you would just like to talk or vent!!

StormsDreams · 08-13-2008, 05:52 PM

Helllo I am here! Posting from work and my internet is Funky! I will post response when i get home!
TruBlue I live in Philly and delivered at HUP...wondering if thats the hospital you are speaking about...I will post more when i get home!
HUgs...also we can go to a UNITE meeting if you like! Its a meeting held once a month for parents who have lost babies and infants. Be Back!

truebluebeliever · 08-14-2008, 11:11 AM

Thanks, angels! Girls, your stories give me a glimmer of hope, however small that is.

Storm, no I went to Temple University Hospital. CHOP recommended only three hospitals in the area: HUP, Mainline and TUH. We decided to go to TUH because it was the nearest from our house and was the one who had the earliest available appointment date when our RE told us to start looking for a high-risk doctor after the first trimester.

I'm interested in joining the UNITE meetings, and to know everything I can about my condition to prevent it from happening in the future.

deedlebug06 · 08-14-2008, 06:34 PM

Just wanted to offer my condolonces on the loss of your precious angels. Saying prayers for your family.

StormsDreams · 08-15-2008, 03:50 PM

True please email me and i will give you info on teh UNITE meetings i can even meet you there. I am having a hard time with soulcyster right now so email me and we can meet up at the next meeting!

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I lost my son at HUP and attempted to have my daughter there but was met with resistance and pure BULL ish...oddly enough the Unite Meetings are at Lankanau (mainline) and HUP. I go to the one at HUP...but i delivered sucessfully my daughter at Lankanau! Please email when you get a chance i check that everyday.