The Critical Time Period

I have officially entered the scary time of my pregnancy.  I am 17 weeks 4 days today.

My cervix was stable on Tuesday with a CL of around 3.4cm, it's hard to get an exact reading and they measure it multiple times!  My last appointments my CL was 3.3cm, 3.6cm and now 3.4cm so that is great.  There is no funneling or any sign of changes taking place.  The cervix is a weird organ and can change length constantly but it is unlikely, but possible that it could shorten dramatically by next Tuesday.  Dr. P just said to really watch things this week, abnormal discharge or cramping is the first sign something is wrong.

If I were going to have any cervical issues it would likely happen in the next few weeks so I am KMFX that my cervix stays nice and stable!
The other fear comes from losing Lindsey. I checked in to the hospital at exactly 18 weeks with her and had her 5 days later at 18 weeks 5 days.  Just approaching that time period in this pregnancy is terrifying.  I would love to say that I won't be nervous anymore after making it to 19 weeks without complications but that would be a lie.  I am going to be terrified until we reach 26-28 weeks when our little guy has the best chance of survival if he is premature.  Even being born at that GA is risky and he can end up in the hospital for weeks or months but we are just hoping beyond hope that I can carry him to full term, 37 weeks.

Another thing that I learned is that I am GBS + or Group B Strep +.  Many people are actually, I am just a chronic carrier.  Dr P actually thinks that this may have caused us to lose Lindsey last time because GBS is powerful enough to cause a bad infection and cause premature birth.  However, the doctors did not do the right tests after we lost Lindsey to determine what kind of infection was present.  They jumped to conclusions and decided I had IC without looking into any other possibilities, which makes no sense to me whatsoever but you can't change the past right?
After looking over my medical history with Dr. P, I tend to agree with her that the infections was first.  I did some research about GBS and my symptoms did fit.  We won't know for sure, ever, which is hard but we can make some educated guesses about what happened.
The placenta was severely infected and possibly even Lindsey.

So the biggest fear for me right now is having or getting an infection and not knowing it.  There were really no symptoms last time that would have made me think I had an infection besides the dilating but by that time I was very infected and very sick.  Dr. P indirectly said that I was lucky to have made it out of the hospital with my reproductive organs and my life.  She also disagreed with the course of treatment that I was put on.
Ok, back to infection.
I have already had GBS found in my urine and was put on ampicillian QID for 7 days to clear that up.  I make sure that my urine is checked for GBS at least every month.  I think they will do it when I ask actually because I told them that they were doing it this past appointment!  I am just totally terrified that GBS has infected me and that I won't know it and when I think about that I just panic so I try to just tell myself everything is okay.  I am going to express my concern at my next appt. on Tuesday so that maybe they can do something, like blood work or tell me something to ease my mind.  I'm just really freaking out about it more and more as i approach 18 weeks.

So what’s the plan?

Despite what has happened this past year we still have a strong desire to be parents, maybe even more so than before.  Losing a baby is probably one of the most traumatic things that a mother and father can go through and for some; this puts a halt to their journey to parenthood.  For Angel Moms and Dads, all subsequent pregnancies are tough.  We know too much to enjoy all the aspects of pregnancy that most parents do; we are no longer carefree, we have lost our innocence, as we Angel Moms say.

I believe the most important thing to do is research to fully understand what happened last time and what treatments are available to treat you and your LO next time.  Of course, another very important thing is to have a doctor that understands and can deal with your specific situation.  A good doctor will have a plan for subsequent pregnancies and will communicate that with you as my doctor has. 

All of my pregnancies from here on out will be considered high risk.  This simply means that my baby and I have a higher probability of something going wrong than a normal mother with no history of complications.  Having lost a baby at almost 19 weeks and likely having IC puts me at higher risk for complications such as preterm labor, PROM (pre-mature rupture of the membrane), infection and so on and so forth. 

As you can see in my previous post “SHG and MRI” I have had a few tests done to check for polyps, uterine abnormalities and any significant structural issues. 

So here is the plan now:

Once I get a BFP your hCG (human Chorionic Gonadotropin) levels are generally checked by doing multiple blood draws.  This is the hormone is produced by the cells that make up the placenta and is also the hormone which gives you that BFP!  They should double every 48-72 hours. 

My progesterone levels will also be tested at this time.  Progesterone maintains the pregnancy until birth.  My levels were on the low side of normal in the past so I generally use progesterone creams. 

I will also be requesting a CBC (complete blood count) to check my white blood cell, RBC, iron, etc. 

A cerclage will be placed at 13-14 weeks, or sewing the cervix shut.  Done at this time, it is called a preventative cerclage.  For the weeks after the cerclage is placed I will be on BR and antibiotics to ensure there are no infections. 

After that I will be monitored every week to every other week.  Cervical length will be checked at this time.  As long as my cervix does not shorten I should not have to be on very strict BR but will have to take it easy.  That means no working, no standing or walking for long periods of time, no exercise, no vacations or leaving the city and a lot of other “no’s!”.

Well, I think that’s enough info for now!  This process is very long and detailed but we are just hoping for the best at this point!  

Cerclage - Photo provided by Laura L. Oliver