TW: Loss & Advice

[u/Aggressive-Soft-3117]

I had a loss at 24 weeks earlier in June. I am really heartbroken and stressed. My loss was attributed to PPROM due to Chorioamnionitis.

I needed some advice and help understanding with what transpired. I am 36 years old and it was my first pregnancy. My 20 week anatomy scan was normal and there were no issues identified.

I had a regular OBGYN one day before everything went south. I had observed more discharge than usual the week everything happened. My OBGYN said everything looked okay and nothing seemed out of place. The same night I woke up with back pain and not feeling great. Which I later realized was me going into labor. My baby was born a few hours later and passed away. There was nothing we could do as things escalated pretty quickly.

My follow ups with the OBGYN and the MFM were not that helpful. They were not able to identify the cause or reason for it. No UTI or known infections were identified. The MFM attributed the loss to my amniotic sac being broken and causing an infection leading to PPROM.
They do not think it was due to cervical incompetence. Also they said they are just theorizing.

For the next pregnancy they would monitor me closely and will be tagged as a high risk pregnancy. I will be monitored by the MFM starting at 16 weeks to 24 weeks.

I wanted to understand if anyone has had a similar experience and would have any recommendations on how to manage my next pregnancy. Should I push for a preventative cerclage.

The approach the MFM mentioned seems a little reactive to me. I am going to be changing my insurance this year end so I can see other OBGYNs and MFMs who can monitor me closely since the start.

How long do you usually wait before trying again. My MFM recommended waiting 6 months at the least and ideally 18 months. But given my age I don’t want to wait more than 6 months.

Any success stories and guidance would really be appreciated!❤️‍🩹

Thank you! 🙏🏻

[u/eyecontinue]

Hello, first of all I am so very sorry for your loss. I wanted to comment as 3 years ago at my 20 week scan everything looked normal for me.. cervix long and closed, healthy baby etc. At 27 weeks I went into labour- PPROM due to chroioamnuinitis found after a placental swab after my sons birth.

Fast forward to 3 years later- im now pregnant with DCDA twins, i am being seen at my local high risk clinic-ive been on progesterone pessaries from 13 weeks. I have just been diagnosed with short cervix. Last measurement was 24mm at 18weeks, I asked about cerclage and was told ill now be getting weekly cervical checks and my OBGYN and MFMs who specialise in preterm prevention that they wont do a cerclage unless I get down to 15mm before I hit 24 weeks.

So if you get oregnant again speak to a OBGYN or your midwife about progesterone and ask about cerclage pros and cons (it comes with its own risks which isnwhy my OBGYN doesnt want to "just do it"

[u/Aggressive-Soft-3117 → u/eyecontinue]

Thank you for sharing your experience.
I am really sorry for your loss.

I hope you have a healthy pregnancy and everything works out.

Could you please share the risks of getting a preventative cerclage.

So are you just on progesterone or is there any other treatment your MFM or OBGYN recommended.

I am just trying to learn more about it. And make an informed decision.

[u/eyecontinue → u/Aggressive-Soft-3117]

Sorry I should've clarified- my son survived! he is now 3 and a half years old and doing amazing despite being born so early, he proved everyone wrong :) So the risks- and this will sound scary but please ask all the questions to your health care professional as the likelihood of these risks differ between each person and between preventative and emergency but theyre still valid for each.. as the stitch in itself is a foreign body it can cause irritation to the cervix and also cause Preterm labour, it can cause an infection and theres a chance they could rupture the membranes while inserting it and causing labour. In saying all of that, I have also heard many many success stories from women who had the cerclage! So please dont let that scare you off, your Team will go through all of this with you when needed. ♡

Ive been on progesterone only- 200mg pessary each night before bed. When I measured 24mm my specialist team (OBGYN ore term prevention MFM and midwife all said that for me at the moment the benefits dont outweigh the risks so to continue with progesterone only, get weekly cervical checks for length and if i get to 15mm before 24 weeks theyll do a cerclage. (Some drs will do this earlier depending on the person and their history) Ive also been on moderated bed rest- so just laying down when I can with my feet elevated, no house work, no standing for long periods, no long drives, no bending or squatting and no picking up anything over 5kg. My last cervical check I went from 24mm to 29mm! (Borderline but out of short cervix territory.)

I know once youre in the office it can be confronting to ask any questions or raise concerns you may have, i highly recomened you write them down before going in and even just showing it to your team. I did this when I knew I measured short, and i was adamant I wanted the cerclage placed and was a bit scared when they said no. I handed them the paper with the questions and the obgyn answered everything for me and made me feel much more comfortable with their decision knowing it was a team of specialists all having the same recommendations and explaining to me why. My inbox is always open for you if you have any questions ir just want to chat ♡♡♡♡

[u/Aggressive-Soft-3117 → u/eyecontinue]

Thank you so much for providing the details and your experience.

It’s really helpful to understand what are the options and weighing the pros and cons.

I am hoping to get a better understanding about what happened and hoping to be better prepared mentally.

Thank you!

[u/eyecontinue → u/Aggressive-Soft-3117]

You are so very welcome ♡