PTL has begun.Ugh.

[Brinda]

Last night I started having really bad back and belly cramping. Wasn't full on contractions, but it sure hurts really bad. I took a vicodin last night about 10, but woke up still in lots of pain. DH had me take another 2 at about 10 this morning, but it still didn't take the pain away. They dropped me off at the hospital about 1pm. I FINALLY got home about 8:30pm. I am almost a full cm dilated. The nurse said I still felt really long, but she put 50% effaced into the machine. I was not having contractions, which I didn't figure I was, but the pain kept getting stronger, especially since the vicodin was wearing off. They were most concerned, because when I was feeling pains, the baby's heartrate would dip pretty low, below 90's. They called the doctor, but he wasn't too concerned about the heartrate since I just had an u/s on wednesday and the water level was normal. He chalked it up to Michael being so little yet. They did not check me again before sending me home. So, I guess I dilated to almost one without contractions. I'm still having a whole lot of pain but pretty much not to come back unless I start feeling full contractions. I see the doc in 2 weeks, so I guess I wait until then. I'm glad that at least I'm not having contractions, 21 weeks is too early yet. I would like to see at LEAST 5 more weeks, 9 optimally.

[strawberryprincess]

Oh! so sorry to hear that you are going through that! :(
do you have a history of ptl? are you on bed rest? either way, get plenty of rest, fluids, and all that, and take care of yourself.
Best of luck to you!

[mamacatsbaby]

Oh, big hugs to you mama :Hug. I've got many stay put vibes coming your way. :hug

[busybusymomma]

Oh goodness Brinda- I am hoping you will get a full-term baby this time... there's still time for your babe to cook longer. Stay in baby vibes- no more dialating!

:Hug Keep us posted.

[Brinda]

Oh! so sorry to hear that you are going through that! :(
do you have a history of ptl? are you on bed rest? either way, get plenty of rest, fluids, and all that, and take care of yourself.
Best of luck to you!

Yes, unfortunately all my babes have been preemies. Girls were 35 weekers, and Adam was a 31 weeker. This baby seems to be following along Adam's lead. I was 1cm at 22 weeks with him. I'm taking a progesterone suppository as part of a PTL study, and have been on strict bedrest for a week exactly now. I'm allowed bathroom privileges, a 5 minutes shower every other day, sit-up for meals, and am allowed a sit-down activity for 90 minutes twice a week. And I've been following it really well!

Thanks for all the well wishes everyone!!

[~*max*~]

Oh Brinda, that's gotta be so tough! We are all here for you, any time you want to talk or need us for anything. Right now we are sending lots and lots of hugs and sticky vibes. :hug :dust

[Ksenia]

Brinda, that sounds really stressful - I hope that your baby stays put.

[Unreal]

:Hug

were you in this much pain the other times as well?

It must be so hard to have your other little ones understand what is going on...

Sending lots of sticky baby vibes :sticky
Stay where it is nice and warm, baby!!!


:Hug

[lilmissimpatient@c]

:Hug Mama, I'm so sorry that you're going through this, it must be so scary! Take care of you and that babe, and please, if there's ANYTHING I can do, let me know. In the meantime, I'm keeping you and your family in my thoughts

[Brinda]

Thanks mamas! I do remember being in pain, but I don't quite remember it this early. The reason I went in this early in my last pregnancy, was because I had constantly wet underwear, and i was afraid i had a water leak. I remember the pains starting closer to 30 weeks. I was hospitalized at 27 weeks last pregnancy, but because they caught cervical funneling on my everyother week cervical u/s. The first pains I remember were at 29 weeks, when my water broke. Luckily, it resealed and delivery held off until 31 when it broke a second time. I am getting the every other week cervical u/s's again this time. I'm not sure why I get these pains. It's kinda like a contraction that starts in the VERY low uterus, but they never go all the way through the uterus, which is why they don't consider them contractions.

[radicalmama]

big hugs!

If you can use the computer in bed, at least you can do lots of research and play internet games :lol !

Hang in there mama!

[Sydnee]

Oh no mama!! Hugs to you, I will pray that babe stays and "bakes" for a loong time yet!!!! :lol We're here for you!!!! :love

[zonapellucida]

STAY PUT baby!!!!!! (((hugs)))) to you and prayers coming your way.

[newmainer]

:( so sad for you (and the babe!

but is there some comfort in knowing that you have been through it before and have 3 healthy kids?

regardless, I hope this one decides to stay and course and that you are getting lost of good rest and support at home.

hugs...

[Guinevere]

Oh, Brinda, I'm so sorry you're having these complications! :(

Just curious, did any of your docs ever suggest doing a cerclage to help you with the premature dilation/deliveries? Is it too late to do one with this pg (I think they usually do them at 18-20 wks. but can't quite remember...)?

Were you on any PTL meds with any of your other babes? Will they go that route this time? Also, have you been tested for any infections like BV (bacterial vaginosis)? It just seems like your care providers, given your history, should be more proactive and concerned about your symptoms. Will you be getting regular vaginal u/s to measure cervical length? How about the FFN test (fetal fibronectin test), which measures how likely you are to go into full-blown labor within a certain time period? Are you seeing a peri or just a regular OB?

I know a good bit about PTL from posting on a post-preemie pg board, although my preemies (33 and 31-wkrs.) were actually born early due to PROM and pre-eclampsia/eclampsia.

I'll be thinking about you and rooting for you on bedrest, and hoping that you get the best care possible and keep that sweet babe baking for many weeks yet!

Kind regards,
Guin

[Brinda]

Oh, Brinda, I'm so sorry you're having these complications! :(

Just curious, did any of your docs ever suggest doing a cerclage to help you with the premature dilation/deliveries? Is it too late to do one with this pg (I think they usually do them at 18-20 wks. but can't quite remember...)?

I can see you know a lot about PTL. ;) Lots of good questions! Some of this may be a repeat from what I've already mentioned.

First, I did ask about cerclage. A cerclage is contra-indicated in my situation, because it'll actually cause more harm than good. Cerclage can cause PTL as a side effect. It's already contra-indicated because of that. Once PTL contractions begin, you must take it out, anyway. If it's not taken out when contractions begin, they can pull the stitches, and a mom I knew on a PTL board ended up with her cervix shredded because of this. She will not be able to have any more kids. This was one of the reasons my peri stated for not doing it. I had been evaluated at 14 weeks for this, because they like to do them between 14-18 weeks before baby picks up weight.

Were you on any PTL meds with any of your other babes? Will they go that route this time? Also, have you been tested for any infections like BV (bacterial vaginosis)? It just seems like your care providers, given your history, should be more proactive and concerned about your symptoms. Will you be getting regular vaginal u/s to measure cervical length? How about the FFN test (fetal fibronectin test), which measures how likely you are to go into full-blown labor within a certain time period? Are you seeing a peri or just a regular OB?


In my first pregnancy, I was treated with oral terbutaline. I started at 32 weeks, and it help till 35. I started sooner with my second (don't remember exactly) with the terbutaline, but after a couple weeks it lost it's effectiveness and I had to combine with Procardia, and top off with some terbutaline shots as well. I did get the steroid shots, but she was born out of the danger zone, and made it until 35 as well. That pregnancy, I was tested for BV, found positive, and treated. I was given the fFn earlier, which had come up negative.

With my last pregnancy, I started getting bi-weekly cervial u/s's to measure the cervix at 22 weeks. Apparently, they don't do them sooner, because the studies that have been done, don't begin to show change until 22-24 weeks for PTL. I was supposed to start them anyway, but had gone to the hospital with what I thought was leaking fluid. It turned out not to be fluid, BUT I was dilated, and held overnight to see the peri anyway to see about an emergency cerclage. However, they stated no because of the same reasons I mentioned before. At that point, my cervix was short, 2.67cm. Apparently under 3 indicates preterm delivery. I was sent back every two weeks. I remember starting procardia to stop contractions (less side effects than terbutaline!) but don't remember when. I had the fFN I believe at 26 weeks which came back positive. At my routine cervical u/s at 27 weeks, they just happened to catch my cervix funneling. Apparently a funneling cervix indicates delivery within 2-3 weeks. I was immediately hospitalized in the tredelenburg position (feet in the air), given steroid shots, catheterized, and only allowed up for bowel movements, and a 5 minute shower every other day. Despite these measures, my water still tore/broke, at 29 weeks, when I was immediately put on magnesium sulfate. After 45 minutes, I couldn't breathe, so it was stopped, and I was given a break. We tried a second dose at 45 minutes again, but I had trouble breathing and had decreased urine output, they were concerned about it causing respiratory and kidney failure. It didn't stop labor. HOWEVER, the contractions did begin to slow gradually on their own, and within 8-9 hours I was down to contracting twice an hour, from 45 seconds long every 2-3 minutes. And I only ended up dilating 1cm. I got sooooo lucky. My water resealed, I maintained normal fluid, until it broke for good at 31 weeks and I delivered. So, I outlasted the cervical funneling prediction by a week!

I started seeing my peri this time at 14 weeks. He is doing a PTL study with Prochieve progesterone suppositories to see if they will help prevent labor. I started taking one every morning at 18 weeks, and will continue until delivery, 37 weeks, or my water breaks. Only prob, is I don't know and neither does he if I have the actual meds or just a placebo. I am getting cervical u/s's every other week to keep an eye on shortening/funneling. Last measurement at 20 weeks was 4.23cm, so it's still got really good length to it. I was put on strict bedrest by both my OB and peri at 20 weeks just in case baby's weight on the cervix has any bearing on my PTL. Normally, the peri said they don't do bedrest because in studies it's not actually shown to delay labor, just makes mom feel like she's able to do something for the baby. But, baby weight could have an effect if I'm funneling and it's not detected. Since it opens on the inside, and closes on it's own, it's almost impossible to actually catch, so we just got lucky we caught it last time. If the internal cervix opens, then the baby's weight can push on the cervix causing it to put pressure on it, and dilate. Not sure if that relates to contractions or not.

I'm not sure when they will do the fFn again this time. I'm not having actual contractions, so I don't know how that translates. I see my OB next Tuesday, and the peri again with another cervical u/s on Wednesday. After that, I'll be seeing my OB one week, the peri the next so I'll be seeing a doc every week, which we did with my last pregnancy.

Thanks for all the questions, you definitely know a lot! :thumb

ETA: I have been treated twice so far for BV, but since the last treatment it hasn't been back. :Peace

[tomtemama]

Brinda~ I hope your babe stays put. You must be feeling so much stress right now.

[Rowenta]

well, you and me are together. Except this is the FIRST Time I have done this. I started bleeding at 15 weeks (thanksgiving) and a u/s showed i was having contractions. I have been on bedrest ever since. I am still having contractions, spotting has subsided (except when i over do it) but i am also dialated to 1.
I have never had a premie and we are really praying for a full term baby. I have learned that 24 weeks is the cut off for saving him though, we are at 23 now.
I am right there with ya, keep the prayers going!

[HollysMom]

:hug Thinking of you and hoping that baby stays put for good long while.