Today I am 34 weeks and 1 day pregnant. Last night, as I lay in a room in the triage section of labor and delivery for the second time this week I couldn't help but wonder what was going to happen next. Would the contractions stop? Why was I having contractions in the first place? Would I get to go home? Would they put me on more medication to try to slow things down? I could still feel extreme pressure on my cervix and pelvic bone. Feeling extremely nervous, I couldn't get comfortable no matter which way I tried to lay down on the bed and this time with an IV hooked to my arm delivering fluids, I focused on the machine marking my contractions and recording my baby boy's movements. His movements had slowed earlier in the day, but now seemed irritated by the monitors and straps attached to my belly and he kicked them every now and then. I found this comforting and a good sign that perhaps he was not going anywhere and just wanted me to take him home so we could rest.
Since Wednesday, when I was in triage last, the contractions and flu-like feeling had not really gone away. However, by Thursday morning I started to feel a little better and was hopeful that the week was behind me, that is until evening came and then I was up most of the night tossing and turning with a stomach that felt like I was carrying a cinder block for a belly. It felt like one continuous contraction. By Friday morning though, my contractions seemed to subside. My belly felt normal again and I was able to enjoy a visit from a dear friend from childhood who I had not seen in over 20 years. Despite a few contractions here and there, it was a great morning and I was hopeful that pre-term labor was behind me. That is until late afternoon when they suddenly came on very strong and I now had pressure in my cervix. I realized at that point I had to get back to the hospital because labor seemed imminent.
With my oldest daughter, I was scheduled to be induced at 37 weeks due to my systemic lupus, however when I went in for my induction I was already having contractions 2 minutes apart and my cervix was dilated 2cm. Consequently, the issue of incompetent cervix in my first pregnancy was not a problem because although I was in hard labor my cervix would not open more than 2cm and they had to go ahead with the induction. I did start having contractions, as well as uterine irritability, with my first pregnancy at about 35 weeks, but it was nothing like I am experiencing this time around. In my last pregnancy, with my youngest daughter, I never felt nor had any contractions, my cervix just opened.
You can imagine my relief on Friday when my OB's associate (my regular OB is on vacation for the holiday weekend and won't be back until mid-week) did an exam and discovered that my cervix this time around was tightly closed and my stitches were holding. However, after the exam I began to experience uncomfortable cramping and hard contractions -- taking me back to my original theory that exams and transvaginal ultrasounds when you already have an irritable uterus and a cerclage should be avoided at all costs! Needless to say, the doctor said she had to do the exam to make sure because they couldn't send me home if my stitches were ripped and my cervix was open. So realizing that wasn't the case, she ordered IV fluids, my regular dose of 30mg Procardia XL, and more monitoring to see if my contractions would slow. Eventually they did and although I was still having some contractions they were further spaced apart and it was showing more uterine irritability than anything.
Before I was discharged from the hospital, the doctor told me that I was now on strict bedrest, and would now need to take my regular Procardia dose 4 times a day instead of 2 times a day until my regular OB returned and told me otherwise. I was glad they didn't try to give me more terbutaline, as that was a terrible drug that did nothing for my contractions and I just recently found a link dated June 2011 that advises pregnant women to avoid terbutaline due to serious side effects to the baby. (pubmedhealth, June 2011). Not exactly what I was happy to read about. I already had my mind made up that when I went back in on Friday if they suggested going on magnesium sulfate, like I received with my last pregnancy, I was going to refuse it because I seriously question the side effects it can have on the development of the baby long term. I'm just glad it never came to that and we were able to get everything slowed.
If everything goes well and I am able to stay pregnant through the weekend, I will start my weekly appointments at my doctors office on Tuesday to do the biophysical profile monitoring of me and the baby, and I am going to request corticosteroids to help the baby's lungs at that time. I think given the fact that I have already been to the hospital twice in one week for contractions should be reason enough to give me something that could help the baby's lungs should he be born before 37 weeks. It would make me feel better to know that he received the benefit of them and I did all I could do to help him have a fighting chance. I know 34 weeks is much further than 24 weeks, but I want to avoid the NICU at all costs and if we can't I want him to have the steroids just in case!
Tonight, I am taking it easy and my hubby is making dinner and taking care of the girls. I've done my best to just stay put in bed today and do "actual" bedrest, but with two young children it definitely presents a challenge. For now, all is quiet.
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