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Risk of pre-term labour and consultant appointment

(10 Posts)

Please humour me because I'm feeling really nervous about my first consultant appointment tomorrow. I'm not sure what to expect, partly because I had my other babies in a different area. I have to see the consultant because my obstetric history goes like this:

Pg 1- early miscarriage
Pg 2- DD1 born at 34+6 after PROM and then quick onset of contractions
Pg 3- early miscarriage
Pg 4- DD2 born at 39+2
Pg 5- DS born at 37+0 after being treated for pre-term labour at 32+6 having increasingly strong and regular contractions and cervix dilating, very short, soft and anterior.
Pg 6- currently 12 weeks pg.

I just wish I knew if the consultant was going to be laid back and send me away to simply see what happens or if she'll want to be more pro-active.

Does anyone have any experience of this? It's not like I habitually have early babies but I've only managed to get to term without help once.

OnlyWantsOne Thu 03-Jan-13 05:03:10

Congratulations on being pregnant smile
Go along with an open mind and see what they suggest. You don't have to agree to any thing right there & you could book another appt to go and finalise plans once you have thought about their suggestions.

Good luck smile let us know how you get on

LeBFG Thu 03-Jan-13 08:52:28

I think two early mc is not unusual. You have got to term twice which is a great sign. There's not much any medication can do if you really start labouring early so getting to term with DS was great. People give all kinds of feedback with consultant advice. I would go in with a list of questions (what happens after 28 weeks, bed-rest advice etc) and, if you want things like extra scans, cervix measurements, progesterone etc. ask him - put him through his paces!

TwitchyTail Thu 03-Jan-13 10:40:10

First of all, don't be nervous!

If by early miscarriage you mean less than 12 weeks, that's not relevant here as the mechanisms are completely different.

So you basically have a history of 2 out of 3 pre-term labours. That's not unusual but does increase your risk of another and it's perfectly reasonable to find out exactly how the consultant intends to manage it. It's something they come across every day so I would try to have confidence in what they suggest. I second the advice to go with an open mind but write down questions you want answers to, and if you have specific ideas or expectations, make sure you ask while you're there.

I'm a little bemused by the appointment. The SHO was bleeped about a minute in to the consultation and told that he had gone to the wrong clinic so he was in a hurry after that!

He did, however, check with the consultant about a plan. Essentially, I do have an increased risk of pre-term delivery but do not have a history suggestive of incompetent cervix. So, they said that there is no way to predict what will happen or prevent pre-term labour but they won't discharge me from consultant led care because they expect to see me back in pre-term labour at some point! Don't you just love it when doctors have a way with words?

I'm still hoping for a term delivery given that I labour quickly and live further from the hospital now than with previous pregnancies.

LeBFG Thu 03-Jan-13 12:25:34

Bit odd to say they 'expect' to see you in preterm labour as you've only had ne preterm delivery confused. Did they say what extra measures they intend to put in place? For example, I have no suspicion of IC but they still wanted to measure the cervix every two weeks from 18-26 weeks to check all was OK. Plus they are doing monthly vaginal swabs to check for infection.

Doraemon Thu 03-Jan-13 12:37:09

I have had 2 preterm labours and am under consultant with third pregnancy. Nothing has been done differently other than extra scans from 28 weeks, and that I am under instructions to go in as soon as contractions get stronger or more regular. I did have am internal at 28 weeks to check my cervix because I have irritable uterus, but mainly it's just a case of them telling me to come back when I think I'm in labour so they can delay it long enough to give steroids.

The doctor was a bit odd. He seemed to think it was a jokey matter that I "almost certainly" will "turn up contacting pre-term" and they would deal with it then. There plan is to do nothing other than watch and wait then treat me for pre-term labour if necessary. The swabs I've had done in pre-term labour (both times) have always come back as there being no infection. The doctor felt that maybe a short pregnancy is normal for me. That seemed like another way of saying that they have no idea why it's happened and are not able to prevent it happening again.

At least I have laboured enough now to have a good idea when I'm having early labour contractions. The doctors and midwives were pleased that I recognised it last time and went straight in. They had a hard time stopping my contractions to begin with and were pleased that I hadn't left it for another half hour to 'wait and see' before going in. I guess I'll do that again and just risk looking silly if it is BHs. I'm glad that I did last time!

Sorry for all the typos. I'm on my phone and am in bed. I have HG and this morning's appointment had made it much worse.

blackeyedsusan Thu 03-Jan-13 13:01:01

just tell them that they told you to come in asap and not to wiat to see what is happening. if there is nothing going on then tough luck to them. <shrug> they should not comment on it and make a fuss... iif they do reiterate that you were told to come in immediately and you have had several early births...

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