thread for those pregnant after previous preterm birth

[KD0706]

Hi all
My DD was born at 31+1, as far as I know there was no reason found for why she came early.

I'm now 11 wks pg with DC2 and I've been told that when I have my first scan appointment I'll also have a consultant appointment to discuss how this pregnancy will be managed, answer any concerns I have etc.

I'm sure the consultant will no doubt cover everything but I thought I'd go in with a list just in case I forget something in the meeting and then later wish I'd addressed it.

My current thoughts are

1 brief chat about DD, what happened with her, confirm whether it was unexplained etc

2 chances of another prem birth (think I was told at the time 1 in 3 chance, and likely to be at same stage)

3 elcs or vbac (dd was emcs). If Caesarian then how will that be managed in a premature labour (with DD I was having regular contractions for four days before I was in 'proper' labour)

4 what if any extra scans or checks will I have? Will I have steroid injections as a matter of course - if so when?

5 I considered mentioning the progesterone pessary which I think has had some good trial results. Presumably not available on nhs but maybe privately?

6 what to do if I do start contractions again. Do I go in immediately I feel a twinge or wait till I'm sure it's something? And will they put me on the drip to try to stop it again?

If anybody has any other thoughts or any experiences they'd be willing to share I'd be v grateful.

Hi bearcrumble sounds like they're really keeping an eye on you, which can only be a good thing.
Pleased you were happy with your blood results too.

It's funny how many of us are at very similar stages. Going by scan dates I'm just a couple of days behind you.

I'm not showing at all yet, which is totally normal as I'm just 14 weeks, but I'm very anxious that I want the baby to be as big as possible in case it's early. Although not teeny or iugr, DD was only on the 9th centile and smaller than other 31 weekers who were on nicu with her.

Hello how's everybody getting on? This thread isn't exactly rocking is it??

I'm 15 weeks now. I feel quite different this time to how I felt with DD. by this stage with her I was buying little new born size clothes etc. I haven't bought anything this time and I don't intend buying anything till about 35 weeks, if I'm lucky enough to get that far.

We've had a couple of tentative chats about names but I think we're just not letting ourselves get too excited. With DD after the 12 week scan I just thought everything would be fine. But this time I'm so conscious that DD nearly died at 31 weeks so absolutely anything is possible.

Anyway... On that cheery note I will be off!

Hiya I'm 9 weeks now and waiting for my scan date and I get to see the consultant as well so hopefully that will put my mind more at rest. I'm just trying to stay positive but obviously difficult until I get to see lil bubba on the scan and hear the heart beat!
Hope everyone is doing ok! I think pretty much everyone in this thread is anxious and scared to enjoy the pregnancy but please try to I'm trying my hardest not to worry, but obviously difficult for all of us!
Positive thinking people!!!!!!!!

Hi. Just thought I'd check in. Hope everybody is well. All fine here. except me getting annoyed by the fireworks still going off at 11 pm.

I'm 16 weeks now. Not really showing and only getting the odd bit of teensy fluttering movement from baby. Midwife didn't listen to the heartbeat at my 16 week app. I think they did last time, but I understand that they often don't try because of the fairly high chance they won't hear it. It seems such a long time between the 12 and 20 week scan, but my 20 week scan is on 29 nov so hopefully the time will fly in.

Sending lots of positive vibes to everybody!!

I had twins @ 29+2 oldest was fine. youngest one (by 15 minutes) had lots of problems ( to save explanation just type in 'Joshua Ashton Dolan' on youtube). Both of his lungs collapsed.& he had to be rescucitated & put on the ventilator. He then had to be transferred to another hospital to have an inguinal hernia repair. Even though there is an higher chance of preterm labour with twins it looks as though it was brought on by a urine infection.I'm currently (accidently) pregnant with 3rd (& last). A liittle girl & I am still a little bit anxious.

Hi jemeraldx that sounds awful.
How far on are you? I'm guessing you're well into your second trimester if you know you're having a girl.

If your labour was brought on by a uti, does that mean another preterm labour is avoidable if they're vigilant enough?

I hope you have a long and not too stressful pregnancy. Are you due any tests etc?

I'm 18 weeks and due a barrage of tests, scans etc at 22 weeks. I'm actually quietly optimistic about this pregnancy as I had cramping pains on and off with DD from about 16 weeks and so far in this pregnancy I've not had any pains. Fingers crossed.

Hi all,

I'm 19w 3d now - had an appointment with the blood pressure consultant's clinic today. BP is perfect - so that's nice.

I've started to feel the odd kick which is reassuring.

My anomaly scan is at 22 weeks so on the 9th Dec.

Going back to the BP clinic at 28 weeks for a growth scan (or before if my blood pressure goes up above 140/90). Also have to do another 24 hr urine and blood tests a few days prior to that so they have the results there.

That's all my news really, so far so boring and hoping it stays that way.

Hiya, my first was born at 35 weeks which isn't very early but he was low birthweight for gestation ( he was 4lb 15oz, more like an average 33 weeker). I wasn't given a firm reason for his prem birth (waters broke spontaniously) but his placenta wasn't looking great and probably wasn't feeding him well hense the low birthweight. The doctors said it may have been a case of my body knew something wasn't right and evicted him.

I've gone on to have another 3 children, all were full term and normal weights (39+5 8lb 11oz, 40+1 8lb 15.5oz & 40+3 7lb 9.5oz). Sometimes babies are born early because something isn't quite right inside so our body gets them out because it is probably safer for the baby to be born vs staying inside a bit longer.

I was told that if there is no obvious reason found (infection, incompetent cervix etc) for the preterm birth then there is a chance that it may happen again but you are more likely to have a normal pregnancy next time, this has been true for me. I did go into preterm labour with no.2 (at 35 weeks again)but it was brought on by me having the Norovirus + another bug at the same time and I became severely dehydrated in a very short time which brought on contractions. It all settled down by itself when I was rehydrated by drip, they didn't give me steroids because if my labour had carried on it's more than likely the drugs wouldn't have had time to have any effect anyway.

Hi all had my 1st scan the other day and was amazing to see my little baby! They are putting me on the optimum trial If anyone has heard of it. Has made me feel a lot more reassured that i will find out in January if I'm likely to have another prem birth and if so get put on the progesterone trial. Need to read more about it really but feel a lot happier about it all!
Hope everyone is doing well and enjoying there pregnancies!

Hello everybody.

Nice to hear a positive story rikalaily fingers crossed I'll have my own positive story in a few months.

Good to hear you're getting on well bearcrumble

I am on the optimum trial too iowmum
I get all the tests etc on 16 December and depending on the results I will know a bit more about the likelihood of a prem birth and may be offered the progesterone trial.

I'm 20 weeks now. I had my anomoly scan on Tuesday and all was fine. To be honest I'm more anxious about the specific prematurity tests on 16 December than I was about the anomoly scan.

I agree bearcrumble that a boring pregnancy is what we should be aiming for. So I wish everybody a very boring, uneventful and long pregnancy.

hello to everyone,

hope all is well and no news is good news for all.
Going well here, still on daily injections to thin the blood and 100mg of aspirin, which i think is a fairly low dose.

20 weeks now, and have another appt next week to check the placenta.
also feeling kicks.
what are the specific prematurity tests KD0706? hope they go well.
best wishes to all on the thread.

I can't remember exactly what tests they're doing. They did explain it all to me. A whole 9 weeks ago (!!) and I can't remember.
They're definitely looking at my cervix to check length, if it's still closed etc. testing for fibronectin (presence of which can indicate likelihood of a preterm labour), and doing upper and lower vaginal swabs.

There may be other things that I've forgotten. There's nothing specific for them to test for I don't think as they don't know why DD came early.

I had been really hopeful about everything as with DD I had odd pains on and off from about 16 weeks, which when I went into labour I realised had actually been contractions / sore braxton hicks.
I hadn't had any pains at all this pregnancy and was really chuffed. But I got one this afternoon. I'm 21 weeks, which I suspect is a bit early for bh. But since it seems to have started five weeks later this pregnancy, maybe that means I'll go into labour five weeks later, at 35 weeks and have baby at 36 weeks here's hoping!!!

Hi KD0706

Thought I'd drop by. Been weeks since I posted! I'm now 24 weeks pregnant and getting very nervous as its only 10 weeks from now that my 7 month old DD was born. To date I've seen my midwife twice...and have both been replacements. Rubbish, I no.
I have seen a consultant once who has basically told me, I HAVE to have a VBAC. She started blabbing on about how much it cost the NHS per c section and I was getting very angry. She didn't even listen in even tho I said I hadn't felt anything....
I am feeling a few kicks now but it's very low down, is that normal???
Hope your getting on ok......
Merry Christmas

Hi all.

savannahrose I am feeling lots of movement this time, much more than I did with DD so I think pregnancies just vary. Do you not have a midwife appointment about now where you'll get to listen to the heartbeat? I have an appointment at 24 weeks. If you don't have one, why not phone the midwife and ask to go in, just so they can reassure you?

I had my 'special prem' tests today but to be honest I don't really think its added anything. Swabs are clear, the only thing that showed up was group b strep which they're not fussed about, certainly not from a preterm birth point of view.

I tested negative for fibronectin which is good, but I don't actually feel that reassured by it. If I had tested positive then I would have been very likely to go into labour in the next fortnight. But I'm 22 weeks now and last time went into labour at 30 weeks. And they say I only have a 1% chance of delivering before 28 weeks. But again, I was 31 weeks before I had DD. and I believe that if I have another preterm labour it's likely to be at the same time as with DD. So like I say, I just don't feel it's reassured me.

Also my cervix is still closed and is 33mm long which the docs are pleased with.

They still want me to take part in the Optimum trial. But I am unsure about what to do. It is a double blind trial, half the participants getting a placebo. The drug they are testing is a progesterone pessary.

I actually have a good feeling about this pregnancy. I've convinced myself this baby is in there for the long run. Hopefully I'll be proven correct

Also savannah have you seen that there are new nice guidelines which say that all women, regardless of previous birth history, should get allowed a c section if they ask for one. Might be worth looking into, but my understanding is that you can simply insist on a c section and they are not allowed to refuse you.

Hi

Just found this thread. Hope you don't mind if I join you?

My DS was born at 34 weeks and am 10 weeks pregnant. I went in to spontaneous labour with DS and was never given any reason as to why it happened or if it might happen again. I had gestational diabetes when pregnant so DS was actually a very healthy 6lb at birth and was bigger than many of the full term babies in SCBU. He had difficulty feeding, jaundice etc but no serious complications. Oddly my mum had both me and my brother 5 and 4 weeks early too.

My main worries are the obvious risks of going into labour even earlier and how on earth I would cope with looking after a toddler and having a baby in SCBU.

I have my booking in appointment with the midwife on Tues so should hopefully be able to chat about some of my concerns.

Hi lemontop welcome and pull up a pew.
I'm similar to you in that I went into labour spontaneously and the doctors don't know why. And yes I get the concerns about having a toddler plus a baby in SCBU. Not a nice thought!

Let us know how the booking in appointment goes.

My latest is that I've been scaring myself by googling cervix length!
Mine was 3.3cm at 22 weeks and according to dr google you wouldn't expect to see a length shorter than 3.5 until after 32 weeks!!! So it's not short enough to warrant a stitch but definitely on the short side and probably shorter than it should be.
I need to ban myself from google

I also have the worry of a toddler as well and do wonder how I would juggle it all if baby was in NICU, but feel more reassured that I'm moving in a few weeks time and will be closer to my family so they can help.
KD0706 cheers for the update on optimum trial, why do you not feel more reassured?
I may not be able to have it done now as moving so not sure how I feel about that! Not much else going on am 17 weeks and have started to feel a few flutters which is great!

iowmum just because all the tests seem geared towards predicting labour pre 28 weeks. I never thought I would go into labour before 28 weeks, I've been more worried about it happening at 30 weeks again like it did with DD.

Does that make sense? So although obviously its great that they think I'll hold on till 28 weeks, it's the unknown beyond that which scares me.

I'm not even sure if I'm going to take part in the trial as at the moment DH really isn't convinced about it. And I don't want to do it if he isn't on board. Will discuss it with him over Christmas period, but if I am taking part I need to start in a week so will need to get my skates on.

KD0706 - I don't know much about cervical length but mine was 30mm at my 12 week scan and 28 at my 22 week scan so shorter than yours and no one said anything to me about it being short! I am under King's as well so probably the best antenatal scanning dept in the country... I'm sure they would have said if it was a worry. I'm being seen again at 28 weeks so will ask then.

My pre-term delivery last time (at 35 w) wasn't because of spontaneous labour, it was for high blood pressure and IUGR.

I'm 25w 2d now. All seems well - I had an episode of quite strong Braxton Hicks on Christmas Eve evening and Christmas Day morning (great timing) and I was a bit concerned but it went away. I did wash my hand thoroughly and have a feel to make sure my cervix was still in place. It was .

Hi bearcrumble you're quite right, I've been back to hospital twice since my last post. Cervix hasn't changed at all and I spoke to my consultant who assured me google is wrong and there's nothing wrong with my cervix length.

Not much chat here. I've started the progesterone/placebo pessaries, which are fine, I don't think I'm having any effects really. I'm 25 weeks now so a bit anxious as I approach the time I went into labour with DD.

Not due back at hospital now until 31 weeks. Fingers crossed I am still pregnant then!

Hope everybody else is well.

That's good news about your cervix, KD0706 - hope you're doing ok.

Hope everyone else is doing well too - any other updates?

I've not been well this week, got horrid sinus cold thingy. Luckily my mum has taken DS today and will have him tomorrow and fingers crossed I'll be well by the weekend. I started to feel better on Tuesday but then it came back with a vengeance yesterday.

I'm going to be 27 weeks tomorrow. At least being ill has made this week go fast. It's a shame I spend a lot of time wishing the pregnancy away and not just enjoying it - starting to really worry about the repeat caesarian as well.

Just thought I'd pop in.
I'm 27+2 now. Had a scare at 25+6, started contracting and had a night in hospital. They were just medium tone contractions and didn't do anything re dilating cervix etc. I got a shot of morphine which calmed things down but I'm still having irregular painful tightenings.

The doctors are happy for me to keep an eye on it and just go back in if I get concerned again.

Anyway... Any updates from anybody else? Hope everybody is having uneventful pregnancies.

KD0706 - Sorry to hear about your scare - hope things are ok with you at the moment. When are they checking you again?

I had an appointment with my consultant yesterday. He's happy with my blood pressure and the baby's growth. He said as long as it continues like this they're looking at doing a caesarian at 39 weeks. Because the surgeon who did my caesarian last time had to cut vertically as well as horizontally I'm at much higher risk of uterine rupture should I go into labour. He didn't seem worried about my bicornuate uterus and said it could stretch to hold a a full sized baby. Baby is head down right now.

I feel quite happy and relaxed really (don't want to jinx anything by saying that!) - have another scan at 32 weeks and seeing the consultant again at 34 (28w 4d now).

hello ladies,

hope everyone is well, have had good news recently, at the doppler scan the dr said one of the uterine arteries is back to normal, so no notching which is good news. the other artery is still showing the same problem as before,but apparently we can get by with just the one functioning normally.
the last time sounds similar to yours bearcrumble, IUGR and completely failed placenta, so had to deliver straight away.
have to have the test for gestational diabetes, as the consultant thinks we have slightly too much amniotic fluid, that appt is next week.
KD0706, glad to hear the contractions have lessened a little, will be thinking of you and everyone else.