High risk of preterm birth - what monitoring / treatment?

[Bumbers]

Hello

I was hoping others might be able to share what monitoring/treatment they received if at high risk from preterm labour (and if it was successful)?

I lost my twins at 23 weeks a bit over two years ago when I went into extreme pre-term labour. However, as it was Christmas, I was out of area with my family and so saw the consultant where I gave birth rather than my "home" hospital. His recommendation for future pregnancies was progesterone and monitoring of cervical length every two weeks, with a cervical stitch if it shows signs of shortening.

I have had a brief call with my local hospital and am due to see the pre term unit this week. However, on the phone they have already said they do not use progesterone, so at odds with the advice of my previous consultant. I am worried (especially with COVID) they will also not do the monitoring recommended. It looks like a complex area, but the NICE guidance seems to recommend progesterone.

I wondered if anyone else had any experience?

My daughter was born at 25+4 gestation. With my subsequent pregnancy, I had a cervical stitch at around 5 months gestation (can’t remember exact time, sorry), and increased antenatal appointments. The stitch was removed at 38 weeks, and I carried him for another 4 weeks before going into labour. I had to be very on the ball towards the end before the stitch was removed, and if I felt I was in labour to get to the hospital ASAP

I was under preterm surveillance with my first. As others have said, I had regular (3 weekly) cervical scans and progesterone pessaries until 36 weeks although I gave birth at 33.

I’m due to see the consultant on Friday for this pregnancy but expecting similar.

@CuppaZa thank you for sharing. Yes, hadn't thought about how on it you need to be if you have the stitch! I live not far fro the hospital, but imagine you have to be extra careful if you travel any distance to see family etc. So happy your subsequent pregnancy went to (and beyond!) term. Hope you and your family are well.

@excitednerves thank you. Seems like there is some variety over use of progesterone or not, but that regular cervical checks are the most common. I hope your first baby is well. Wishing you all the best with your current pregnancy

@Bumbers yes he’s wonderful, he was in NICU for 2 weeks when he was born which is relatively quick, no major concerns and he’s thriving now! I have a great network of preemie mums and all of our babies are doing amazingly well, you’d never know they were prem. having a preemie is scary but they’re tough little cookies!

@Bumbers you’re welcome. Yes, they need to be able to remove that stitch quickly if you go into labour (and it can’t be stalled) whilst it’s in place.
Hope all goes smoothly for you

@excitednervous aw I am so happy to hear that! So happy for you.l xx

@CuppaZa thank you! xx