Bad night

[rinlud]

Unfortunately, I'm not doing too well and just wanted to share. We ended up in Labor and Delivery at 4am last night cause I had some spotting when I wiped after going to the bathroom. By the way, I'm 23 weeks today with twins. They put me on a monitor at the hospital and I was contracting every few minutes (yikes!). They gave me an extra dose of the drug that's in my pump (I'm on the terb pump) and put me on an IV. After that, I had about 6-8 contractions an hour. They paged my different doctors and they all decided that, since I already had an 8:30am appt. with my high risk OB, that I should just keep it and go over to her office right from the hospital (she works right near the hospital). So, we went over there to check my cervix. Sadly, my cervix didn't look good. It's funneling and the stiches (got a cerclage at 17 weeks) are what's holding everything in. My cervix was 4cm last week and it's now down to 1.8. She told me I could go to the hospital or do strict bedrest at home (only up to pee, and shower every other day). She recommended the bedrest at home until I absolutely have to go to the hospital. I agreed. She also upped my dose on the pump and also added some other medications (Indocin for 48hour and then Procardia after that). I also am now on an antibiotic (Ceftin) in case I have an infection. Oh, and I now have to monitor myself for contractions several times a day (was just doing it twice). We talked about doing steroid shots for the babies but it's debatable if they'll have any affect at 23 weeks. The earliest they can be done are usually 24 weeks. So, we'll discuss the shots again next week. I go back on Monday to have my cervix checked again. I hope so much that everything will be okay. This is really scary and came out of no where (well, not out of no where....I've been having problems - cerclage, terb pump, but I've only been having 0-2 contractions when I've monitored). I would never have even known anything was wrong unless I saw the spotting.

I hope so much that I can hold out a lot longer for these babies. I'm terrified that they're going to come too early. Anyway, I hope everyone else is doing well. Sorry to be such a downer today.

[Cheryl_]

I will be praying for you that your little ones stay in longer. You take care and rest. A lot of women can do it now days with meds and monitoring.

Cheryl
29 weeks BBG

[dreamchild]

Dear Rinlud,
This is just my very humble opinion, but I feel strongly that YOU SHOULD BE IN THE HOSPITAL!!! It is simply not possible to give your babies the best chance while you are at home. Every day, every minute that you can keep the babies inside you gives them a better chance of life! You are in a very critical place, almost viable but not quite. If your babies are born now, they would have a very hard time if they can even survive at all! It is a tragedy beyond comprehension to watch babies of this gestation die or struggle for awhile and then die. YOUR BABIES ARE SO CLOSE TO HAVING A REAL CHANCE!!!!

Please!!! I am begging you to RECONSIDER YOUR DECISION TO STAY HOME!! You would be monitored several times a day by competent experienced nurses. Meals would be brought to you through no effort of your own. All you would have to do is grow your babies while everything else would be taken care of for you. There are all kinds of more aggressive actions that could be taken if you were hospitalized. In reality, taking Indocin, Terbutaline and Procardia is an indication that you should be in the hospital. You could be put on Magnesium Sulfate(MgSO4) which would give you a MUCH better chance of stopping labor If you are at home, chances are good that labor or dilitation of your cervix would be too advanced to stop by the time you got to the hospital. Your situation demands a team of experienced people to manage you and your care. It is too much for you to have the responsibility for this on your shoulders!

In 7 days, your babies would have a chance to live. In 14 days, this chance goes up significantly. In 21 days, they would have a shot at getting through their NICU time without as many complications. By 28 weeks(or 35 days), your babies would stand a great chance of not having any complications at all. 28 weeks is a HUGE milestone for babies. It is not that far off!! So what if you had to lay in bed for 35 days in order to give these precious babies the best chance of having a normal life. IT IS WORTH EVERY SINGLE SECOND IF YOU GET TO TAKE TWO HEALTHY BABIES HOME WITH YOU!!! You have worked too hard to get here to lose these babies now!!

I can say this to you because I had to lie in bed in the hospital for 30 days with my first DS. I was not allowed out of bed for any reason, not to shower, not for anything, due to a placenta previa. I was bleeding and was terrified, so I was happy to lie there and pray for him to make it. With my second pregnancy, I had triplets and went on bedrest at home at 16 weeks. At 29 weeks, I was in the hospital on total bedrest for 18 days before I delivered. I would have gladly stayed in bed for many more weeks if I could have prevented even one day of NICU time. It is unbearably difficult to watch your babies struggle in the NICU for days and weeks.

PLEASE CALL YOU DOCTOR AND INSIST ON BEING HOSPITALIZED!!! You do not want to live for the rest of your life wondering if you had just gone into the hospital, your babies might be alive or much more healthy. You do not want to hold your babies as they are dying when they are so very, very close to having a chance of living.

I am praying for you and for your babies!! Please reconsider!!

dreamchild

[rinlud]

Dreamchild - thanks for your response and i'm truly thinking about what you said. Here's the thing....they told me they wouldn't put me on Magnesium Sulfate anyway just yet. They want to try these other drugs first. Then, if they don't work, they'll put me on the mag. I just monitored at home and had one contraction in the last hour. I have the same monitoring equipment at home (and I call it in to Matria - who monitor me and control my terb pump). So, I'm not really sure how different it would be in the hospital. My peri said that she won't hesitate to put me in there if none of this is working. I'm just not sure that much would be different right now if I were in the hospital. If she tells me to go in there, I'll go in a heartbeat. The weird thing is that I was having many more contractions when in the hospital than I'm having (or have been having) at home. Anyway, I truly want to do what's best for my babies and I know how important it is to keep them inside for many more weeks. I will do whatever is necessary to do this, but I also need to listen to my doctors. They are great and are very cautious and careful with me. Thanks so much for your opinion and I will definitely give it more thought.

[dreamchild]

Dear Rinlud,
Your doctor told you that YOU HAD A CHOICE-you could go to the hospital or you could go home. Doctors are typically reluctant to insist on hospitilization unless their patient indicates that is what they choose. I am certainly not telling you not to follow your doctors orders. I am only urging you to choose the other option that she gave you.

You are incredibly high risk right now. You have 23 week twins, a cerclage that is failing, a cervix that went from 4 to 1.8 in one week and is funneling, and an irritable uterus with episodes of contractions. You are on Terb, Procardia, Indocin, antibiotics and are too early for the steroids. It is NOT too early for MgSO4, especially if it could hold your labor off until the steroids have a chance to take effect.

Your best prognosis is to be hospitalized. If you make it to 28 weeks, you can always go home then on strict bedrest and hope for a longer gestation. Right now, hospitalization could make the difference between survival and healthy or no survival at all. It is possible for babies to survive at 23 weeks, but it is rare.

I wish you the best of luck and will keep you in my prayers.

[dr j]

I am with Dreamchild here.... having lived bedrest at both home and the hospital, I would pick the hospital. There is no way you are as "good" at home as at the hospital.

You are so close.... to a great outcome- or a heartbreak, I would err on the hospital side.

I hated every minute of the hospital but it was where I needed to be.

Hang in there...

dr j

[msquaredb]

I don't know if you remember me, but I remember you asking me questions about my story with my twins. I am going to agree with the ladies above. GO TO THE HOSPITAL. My last twin was born at 24 weeks 2 days, and he didn't end up making it. The more time they have inside you, the better off they are. In my case, they wouldn't give me the steriod shots until 23 weeks 6 days. I am going to be praying for you and your situation. I know how much you have been through already.

Michelle
mommy to Lucous 10/17/01
Parker b/d 6/25/03
Karsten 7/29/03-7/30/03
and Logan, Hope and Faith

[TripletMommy]

I'm so sorry that things are not going well right now. I hope that you'll be able to keep those little ones inside for MUCH longer! I'll be thinking about you and the babies. Try to hang in there and stay laying down!!!! Plus, drink plenty of water. I've noticed that my water intake definitely influences how many contractions I have.

[maryP926]

I just want you to know I am praying for you and your babies.

[MyraVA]

I had to reply too.

Go to the hospital!!!

With my last twin PG I had a cerclage at 10 weeks due to the premature birth of my twin boys from a previous PG. I went on 4 hours at work and the rest of the day bedrest at home at 10 weeks. At 16 weeks I was on complete bedrest at home, only allowed to shower and pee. At 20 weeks my cervix started funneling. The peri did not think I needed hospital bedrest at that point and sent me home to continue my bedrest at home. At 22 weeks the membranes of my daughter had already started working their way through my cerclage and into the vagina. A cerclage does not guarantee that your cervix will not dialate (on the other side of the cerclage) and if you become funneled to the stitch like me, then the membranes can work their way through the cerclage and into the vagina which can cause infection. An infection can cause the membranes to rupture (you water breaks). Once this happens they will not try and stop your contractions if you go into labor and chances are both babies will be born. My son and daughter were born at 24w5d and I won't go into all the details here but it was a long hard road and I am very lucky that they are both still here on earth with me today. But there were tons of complications and my son has permanent brain damage due solely to the fact that he was born too early.

I cannot urge you enough that by being in the hospital not only will you be waited on hand and foot, no stepping a foot out of the bed, but you need to be in trandelenburg to take pressure off of your cervix. You need to be there so that if you do start contracting, despite all the drugs, that they can start you on something stronger like mag sulfate which they will only administer in the hospital. If you start contracting too much it is imperative that they stop they contractions as soon as possible because they cause cervical changes. The more the membranes are exposed to the vagina the higher you risk of infection, the higher your risk of having the membranes ruptured, and the higher the risk of having your babies early.

I was on IV antibiotics the whole time I was in the hospital and still got an infection and still had the membranes rupture early. I was on indocin, procardia. I also was not having contractions the whole time, only after Rylie's membranes ruptured and I went into labor. I did have one bout of contractions while in the hospital but it was due to being dehydrated and because I was in the hospital, they were stopped within the hour thanks to loads of fluids they immediately pumped into me.

My peri says that you wouldn't believe the number of women who refused to be hospitalized. I can tell you that I wouldn't hesitate in a heartbeat to spend my entire PG in the hospital, in trandelenburg, on complete bedrest if that's what it took to have my babies born near term and healthy.