Hoping to start an active thread with cerclage recipients

[ybc]

Pressure is on - two rounding doctors have said that a c-section is scheduled on 34 weeks! Ugh. I guess that is the guideline today for delivery after water broker - if it reaches 34 weeks, then deliver, because statistically speaking, the risk of infection is now higher than risk of immaturity. But then I really don't know just how bad, and to me, even though 34 weeks is not too bad, I still don't want just deliver if the baby can stay longer. I don't know how much I need to fight/insisit, 'cause I don't have necessary data on hand.

What do you think? What would you do? What questions would you ask?

[erobin1]

I guess I would ask more about what those risks and benefits are. What a 34 weeker is going to be like. How long she is likely to have to stay in the hospital, etc, how breast feeding can be established. And then ask about the risks of infection, how high they are, how dire they are, etc. Essentially ask them to walk you through their logic & make sure that it sounds logical to you once they've explained it. Another thing you might want to do is ask for a talk/consult with one of the neonatal doctors. Your OBs aren't involved in the baby's care once it is born. So you might feel much better after talking to the pediatricians and asking about their experience with babies at this stage.

One question I have: why do a c-section rather than induce labor? Is she breech? Or is it something about the risk of an induction. Or, oh, maybe you had a c-section last time, I can't remember if you ever mentioned one way or the other.

Good luck! Ybc, wouldn't that make her born on the 23rd? She'd be a nearly Christmas baby!

I think the thing to focus on is that she is healthy, you haven't gotten an infection and 34 weeks is not that early. 34 weeks is the marker where we can deliver at the birthing center where I will deliver, where there is no pediatric team/unit. Everything will be fine! Thinking of you!! Please keep us posted on what you decide to do.

And I'm sorry that you are going through this. But, again, it will be OK, you have made it a long way since you were told your cervix was short and you have done all that to get her to this point, where she can be healthy on the outside.

[ybc]

Elena - I need to do a C-section because I had a myomectomy before I had DD. So I had a C-section for DD. So signs of labor will send me to C-section as well. Thanks for the suggestion. I need to talk to various doctors to make this decision. I already know the basic logic - that at 34 weeks, riks of prematurity is lower than risk of infection... but it's all statistically speaking and it applies to someone whose water broke at 28 weeks and someone whose water broker at 33 weeks... in another word, the woman whose water broke at 28 weeks has to go 6 weeks with much higher infection risk than the woman at 33 weeks, but they wouldn't let the woman whose water broke at 33 weeks to go to 35 weeks... this is the area that I feel that I don't agree. It's about managing risk for OBs rather than the wellbeing for baby.

Not that I want to take unnecessary risk. I'm happy that I'm almost 34 weeks, and I'd heed any slight sign from that point on to deliver. Still, if everything is stable, why should baby come out any earlier?

So you'd deliver a 34 weeker at a birthing center? No NICU nearby? I thought that a 34 weeker will have to go to NICU for sure. I'm not concerned about severe issues, but more about baby's well-being... that is, weaker immune systems, eyes, poorer digestive functions, possibly.

Well, first hope that the next 2 days is uneventful, otherwise all this debating is meaningless.

[ybc]

update - a peri came and he has no problem with me wanting to go beyond 34 weeks! So now it's 36 weeks or before if there is any sign of trouble. So basically we'd be doing the same thing - close monitoring, and deliver with any sign of anything. I'm pretty happy with this. He said that deliver at 34 weeks is the standard practice, but they do make exceptions. I asked if there were women who pushed beyond, he said "women do all sorts of things! Some want to deliver later, some even earlier"

Anyway, I'm fairly happy, and he seems to think that it really didn't put me at much greater risk since I'm monitored closerly. Much different attitude from the younger doctors who kept bringing up the risks of a full-blown infection. Again, since I'm close to 34 weeks, I'll stay on the conservative side.

[erobin1]

Ybc-- That is GREAT news!! Maybe you can have a January baby after all. Does seem reasonable since you are in the hospital and they should be able to pick up any signs of infection early. I am happy you feel good about the decision.

[ybc]

Elena - yeah, it's good. Now I want to know all about infection... just how big a risk it is, and how much time we'd have to catch it before real damage is done. But really don't have much. So at this point, just hope that don't have an infection.

Did you have as much rain/wind as we had? Last night was bad. Our roof leaked, so DH is working on that front. He over napped and didn't come to the hospital yesterday, didn't sleep much last night, so I told him not to come today either because of the bad weather. I think that I'll just take plenty of naps myself.

[erobin1]

Ybc-- They should be able to detect infection really early in the hospital because your heart rate and temperature will go up. I wouldn't worry too much-- you are in such a well controlled situation and you are on antibiotics.

Yes, this storm is insane!! We have gotten something like half of our normal year's worth of rain. We haven't had any problems at my house with it, but it is an amazing storm. I admit that being on bedrest makes me really like the rain... As if it somehow justifies my indoor existence.

[ybc]

Christmas eve! Hope that everyone is doing great, and celebrating the holiday!

Not much happening on my end. Although the rounding peri said that since my GBsomething is positive (I've always tested positive), and that's one thing that can cause infection, I should considering delivering earlier rather than later. This is the first time that somebody makes it more specific. I really don't know what to make of it. Before, i know that there is always various kind of bacteria inside our private parts, so does having this GBx change it? I don't know, but ... this is when I'd rather wish that I know less!

[Andersontwins]

I have been following everyones progress. I have had the stomach flu and I have felt so weak. I am back to 100% today. Praise be to God! I felt like I was going to die for 24 hours. My husband was a nervous wreck! I managed to stay hydrated in between the vomiting so that was a plus.

Ybc-you are in good hands. In my opinion, it is all in Gods timing! Your baby will be just fine if you deliver now or in two weeks! Since I am having twins, I will be so fortunate to make it to 34 or 35 weeks given my history! Keep up the good work! Hang in there and listen to your body.

Elena- hope you are well and enjoying Christmas eve with Sammy! We are relaxing today and dh is off work! He and dd have been baking. .
I meant to comment on your cervix post the other day! I totally understand! I am so sick of stupid cervix length! I never want to think of again after pregnancy!

Merry Christmas!

[erobin1]

Ybc-- Have they tested the amniotic fluid for fetal lung maturity? I just read up in "uptodate" (the most commonly used online medical text book) and they recommend delivery at 34 weeks if fetal lung maturity is documented from the leaking fluid, or waiting until 36 weeks if it isn't. I've had trouble finding specific data on how to change management in the case of being Group B Strep positive. Certainly antibiotics are recommended, but you are already getting them. The story with Group B Strep is that it can cause neonatal sepsis and so all women are tested for it if they either have ruptured membranes like you, or everyone is measured at about 36 weeks and those who are positive get antibiotics while they are in labor.

I know... too much information. Too little information. That is the problem. There is somehow both too much and too little-- because there probably isn't an actual study which would apply to your case.

Good luck. I am sorry, I know that sitting there in the hospital on Christmas and worrying about all this stuff is a pretty monumental bummer. But, you are 34 weeks! And you are being well monitored. All will be well, you just have to get through this time.

Anderson-- Stomach flu?!? Horrible!! I am glad you are getting better.

AFM-- I am at my mother's doing the holiday thing of I lie on the couch while everyone else cooks and the kids play. It is nice. I am having a lot of pain today, tho, which is frustrating. I do have this sense tho that my body is coming out of it. I can't explain it since i keep having bad days, but it is just a feeling I've got.

We have our big family Christmas dinner tonight, which has always been our tradition. Tomorrow will be Santa presents and then my in-laws have a kind of rambling, informal breakfast/brunch scene with Swedish pancakes and ham and a big fire (they have a monumental fireplace-- made of huge stones, it is like something in a lodge or something, perfect for Christmas). My DH's family and my family have combined forces for holidays for the last ten years or so and so we do all of it together, which makes for much less tension since we aren't trying to go between parties or figure out who is getting more time with grandkids, etc. My mother loves to do the big holiday dinners and so she does those.

I finished all the Santa wrapping last night, so we're all set, I think.

Merry Christmas!!

Elena