Experiences of being at high risk of prem birth

[ActonBell]

I’m hoping someone can help me navigate what’s happening at the moment. I’m 18 weeks tomorrow and had an emergency cervical stitch last week. I was having cervical length monitored because of a previous procedure and went from a cervical length of 19mm (short) to 11mm (very short) in a week.

When they did the surgery they said the cervix looked okay at the front but was practically non-existent at the back. They got the stitch in and couldn’t see the membranes.

They’ve been reluctant to give me a prognosis but doing a bit of research suggests that about 1 in 4 women with that cervical length at the point of a stitch have a extreme or very premature birth, with about 1 in 3 having a moderate to late prem birth.

I’m getting reassessed in just over a week and we should know more then. If the cervix has shortened more by that point an extreme prem birth or late miscarriage is much, much more likely.

One of the things I’m struggling with massively is the level of uncertainty. I am off sick this week following the surgery but then I’m supposed to go back to work. I’m working from home and desk based but I don’t see how I’m going to be able to concentrate on anything. There’s a sizeable chance I’m going to lose my beloved baby in the next few weeks.

If we get past the next scan then we’ve got to get to 24 weeks as the next milestone. I’ve been told that if there’s any sign of preterm labour I could be admitted, possibly for several weeks, and this could happen at any moment from this point on.

Does anyone have experience of this? My head is all over the place, thinking about my little boy who is 4 and how I can’t leave him and the desperate desire to somehow protect my tiny baby.

My husband is doing loads, which is great, but we don’t have any other family near.

How do you get through times like this? Can I ask for extended sick leave whilst I’m trying to cope with this? I thought about talking to the GP about the stress I’m under.

Hey really sorry this is happening to you. I had my daughter at 34 weeks so a bit different but I understand the anxiety and stress you're under. I was monitored through the 2nd trimester and had to make the decision to have the cervical stitch or not, I decided not to and had progesterone instead. I think there is a test they can do that detects early signs of pre term labour, fetal fibroctin maybe? I had steroid injections at 23 weeks just in case anything happened. Have they mentioned these? My best advice to you would be to rest rest rest. I was really silly and did too much, my waters broke just after I'd been outside painting and I'll always wonder if maybe DD might have stayed in longer if I'd just sat down more! I think you absolutely can ask to be signed off. I worked through but had lots of time off for scans etc. I was very upfront with my manager and just said I might lose my baby, and might go off work at short notice too, they were very understanding. If your work aren't as flexible then I would get signed off by your GP. for you, and I really hope things go well for you and baby.

That sounds incredibly stressful and my heart goes out to. I had some complications with DS1 which meant being admitted to hospital a few weeks before her was born but didn't have the additional worry of another child which made it somewhat easier.

Talking to the GP and seeing if you can be signed off is a good idea.

How supportive are your employers being?

*he was born at 33 weeks.

Thank you both. They haven’t talked about steroids yet but I think it’s just too early to have that conversation.

I don’t really know about work. The colleagues I work with closely will get it I think but HR is an arms-length official process thing. I had an ectopic in January and the conversation I had with occupational health about a phased return then was awful - just a by the book thing with no empathy whatsoever.

How are you doing @actonbell?

Thanks @InpatientGardener Just hanging on really. I tried to ring the GP this morning for a sick note but couldn’t get through. I’ll be okay for another couple of days as I can self-certify.

I contacted my senior colleague and they seemed supportive. Haven’t spoken to HR yet. Seeing the midwife in a couple of days so hope to be able to talk things over again then.

Had a massive cry this afternoon. I was thinking about how, whatever happens, we will need to give them a name and for some reason totally panicked that they will die and I won’t be able to think of the right name for them. So my head is pretty scrambled at the moment.

It's not silly to be thinking about names. I named my twins Tom and Clare even though I didn't know their sexes. Names are important

Best of luck OP

I had similar. I had my cervix funnel and I started to bleed at 26 weeks, so it was too late for treatment.
Have they suggested progesterone treatment? I had that and I held off until 33 weeks. I know there was a short cervix thread on here?

I’m doing 200mg progesterone pessaries every day as well as having the stitch. Consultant was really reluctant to prescribe them and said they don’t make any difference after a stitch. I insisted but I see other people who are on 400mg so I don’t know why I have this dose.

I know someone who had the stitch and progesterone and it did work. Ask for it to be increased if needs be. Everyday counts and try and focus on that. I know it is so hard.

I was told the progesterone helps stop the womb contracting so surely even with the stitch they should be effective . If you do get 400mg, my consultant told me he prefers women to take it in one dose so you aren't disturbing 'up there ' more than you need to. Although further TMI, you can take them rectally instead.

Best thing to do is talk to your midwife and get as much information as possible and advice. I found doctors would brush me off a lot by saying what will be will be and told me not to change anything, but my midwife would constantly order me on bed rest when things went wrong.
I was told at 17 weeks I was high risk of pre-term labour for a number of reasons and I was in and out of hospital until baby was born at 30 weeks. The best thing you can do is get advice directly from your midwife, stay away from google and look after yourself.

The truth is that most of the time no one knows what will happen. I was told there was hardly even a tiny chance I'd make it to 25 weeks and no chance at all of getting any further. I made it to 30 weeks and had a healthy baby. Some people are told everything is fine and unfortunately go onto have the worst happen. You can't predict what will happen so try and prepare yourself for hospital time and just relax, take each day as it comes to you and try to enjoy pregnancy as much as you can.

Hi @ActonBell I had a similar experience - no high risks flagged until my 20 week scan when the sonographer saw my cervix was 3cm dilated (with practically no length left) and I had an emergency stitch put in the next day. I was prescribed 2x 200 progesterone pessaries (maybe push for this if you can - what harm can it do?!) but all consultants seem to have v different ideas as theres not a huge amount of research.
I was so stressed I got my gp to sign me off work for the rest of my pregnancy which they were happy to do as doctors had advised some sort of bed rest needed.
I was on modified bed rest (lay around on the sofa) until 22 weeks when they scanned me again and did a feral fibronectic test which looked like I was going into labour imminently. Extremely stressful and upsetting and I was admitted to hospital for a couple of weeks where they monitored me and after two weeks the fibronectic test had suddenly dropped loads so I was discharged.
Then I lay/sat around at home until I was 34+ 5 and went into labour and had a very healthy six pound baby.

Are you at queen charlottes by any chance (just looking at your Acton user name)

Try not to stress too much although I know
It's impossible, I think doctors always want to give the worth case scenario but I've known a few other women all in the same situ all had healthy babies

Hi @ActonBell how are you getting on?

My first baby was born at 18 weeks & died after 45 minutes

I’ve just had a second baby at 34 weeks and she thankfully didn’t need time in the nicu. My cervix was shortening at 21 weeks and I had a stitch at 24 weeks alongside progesterone, the consultant predicted I’d give birth by 28 weeks, should I not have had the stitch and cervix kept shortening.

My pregnancy was filled with anxiety and I had a lot of time off, I like you just felt like i was going to lose my baby again. My work understood and were extremely supportive.

I would advise you take time off it you feel you need it, it’s a really big thing to be dealing with. Please don’t take it lightly.

I hope your pregnancy is going well, x

@Purplegrape23 - hi, sorry I missed this somehow. And I’m so, so sorry to hear about your loss I hope you and baby 2 are doing well?

We’re still going! 26 weeks now and feeling a bit more positive. I’m still at the hospital practically every week for something or other but I’m starting to accept that’s just how it needs to be for the next little while. So far none of our scares have turned out to be anything serious.

I’m coping reasonably well working from home these days. I just do what I can and work are being super flexible which is great. I’m starting maternity leave at 34 weeks but they are fully prepared for me to go on sick leave or bring that date forward if I need to.

So generally feeling okay with the odd massive cry when it all feels too much. Starting to think I might actually need to get some baby things ready, which is scary but awesome at the same time.

@ActonBell first of all I hope you are well and little bubba is doing well, sounds like you are doing much better form the first post which is great news!

So I also had a cervical stitch with my second son who is now 20 months, I had mine at 20 weeks due to my first born being pre term (26 weeks). I'm happy to hear that you opted to take the pessaries, I was prescribed them straight away after the stitch and I got to 34 weeks and my son was healthy 6 pounds.

I'm sure you are being monitored regularly and any changes will be picked up very quickly and monitored which is great and very reassuring.

I just wanted to come on here and give you some positive thoughts and tell you it will all be fine and you should definitely start buying bits for your baby... wishing you all the luck and love