f/u appointment...update

andrea z · October 2009

I had my follow up today. I really thought it would be a physical appointment, but the high risk OB that delivered Jacob and Ethan saw us in her office. It was hard to see her again, and when I saw her I burst into tears. She first talked to us about how she was so sorry that DH was not allowed in the OR. She said that everything happened so fast, and they were trying to keep Ethan in... they just didn't have time to get everything done. The policy is no DH's in the OR until after the epidural... and I delivered before they got that done. She also let us know how upset she was personally about our loss. I think she felt bad for crying in the OR with me when Jacob passed away and Ethan was going to the NICU. I found it comforting that she cared enough to cry a few tears. While I was in the hospital, she was my doctor. I was there for over three weeks... so she was quite upset that things worked out like they did.

I got a lot of questions answered, which made me feel so much better. They originally (when I was still pregnant and on hospital bedrest) thought Jacob had a chromosonal issue, which caused his water to break... but after the aniotic fluid results came back, we know he was normal. We are still waiting on the results from his umblical sample, but the doctor said if the fluid was normal, that should come back normal too.

They sent both placentas away for testing, and they both came back with major infections... but no other problems. This means that more than likely, Jacob's placenta had an infection... which caused the water to break... and then it spread to Ethan's placenta. My doctor also said the reason I was in so much pain and the labor was so fast, was because of the major infection. She also said that was why they could not get my contractions under control to prevent Ethan's delivery. When we were admitted, they explained that an infection is usually the cause of Pprom, but it is nice to know it wasn't my cervix acting up.

She also said that because this happened, I am at risk for it happening again. I am also going to be seeing only perinatologists once we get pregnant again. She said that all of my appointments will be with the high risk specialists. She gave me a referral to go speak to them before we start trying again, so we can plan ahead for my care.

We talked for almost an hour, and she answered a lot of my questions about the delivery. She said that anestesia messed up and didn't come as soon as they should. She said that they placed the epidural as Jacob was coming out, and Ethan was showing when Jacob came out. There was no way to keep Ethan in, and there was nothing that we did wrong in anyway.

Overall a good appointment (after we got out of the waiting room) with a lot of questions answered. I feel better knowing exactly what happened and why.

MSC03 · October 2009

I'm glad that you got some answers and that they're going to watch you more carefully next time.

If you don't mind me asking, why does this increase your chances of this happening again?

schen0510 · October 2009

I think that the first appointment is the toughest. Mine was a couple of weeks ago and I cried horribly with my doctor. The placentas were fused so unfortunately they can not tell, as of now, whether the infection caused my water to break or if I got the infection after my water broke. We were able to keep my second little guy in for an extra couple of days but in the end we lost them both.

I also wanted to ask the same question regarding your doctor's comment about this possibly happening again. Mine did not say anything like that and now I plan on asking at my next visit. We are also scheduling to see internal fetal medicine to discuss the outcome and see if that doctor has any recommendations.

It is so hard to have to keep seeing all of these doctors but getting answers always helps.

((hugs))

andrea z · October 2009

My doctor said I am at a 10% higher risk of Pprom than somone who has never had it. She said that they really don't understand why Pprom happens most of the time... I had infections in both placentas, which means I most likely had an infection which caused Jacob's membrane to break... but she said there are so many different possiblities... and then sometimes it just happens. She said that the studies show that women who have Pprom, are at increased risk for it to happen again just because they usually don't know why it happened.... and have a hard time preventing it again. She said some women are more prone to infections, and I will be tested at every appointment with my next pregnancy. Some women's cervix start to thin out and that causes it. They plan to close my cervix at 13 weeks next time and I will get progesterone shots weekly after week 16. Progesterone is shown to delay preterm labor... which is another cause of Pprom.

It is scary to think that there isn't a ton they can do about it, and we are at increased risk... but my doctor said they are going to throw the book at me and try everything next time BEFORE my water breaks.

That is just what my high risk doctor said.

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f/u appointment...update

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