WEEK 27 : Week by Week Incompetent Cervix Pregnancy Guide - PRETERM LABOUR

NOTE : For the regular advice on Week 27, I suppose there are hundreds of other websites to tell you how it goes. This blog serves to supplement those sites, my personal favourites being What To Expect, Baby Centre UK and Parents. Do take note, however that I am not a professional physician, I practise law for a living and the only thing I know about incompetent cervix is through my own experience as a mother of 2 and a 23 week old baking in the oven! :)  The purpose of this blog then is just to simply share the joys and heartaches, the blessings and curses, the sadness and happiness and the disappointments and the pleasant surprises of our journey as a mom with an incompetent cervix.
 

How are we all doing?  You know, one of the scariest thing to happen to us right now is to wake up in the middle of the night with a gush of water coming out from our vagina.  That is just not good.  Neither is wiping (or worse, gushing) bright red blood from under there.

This week, let us discuss what we dread : PRETERM LABOUR.  It is our main concern - heck, it is the ONLY concern of IC mommies.  Many of us know too well about how our babies were looking hale and hearty in the ultrasound scan just few days ago only to wake up the next day with a traumatised loss of a perfectly healthy baby.  For those of us who did not have a cerclage in (Read WEEK 26 on IC without cerclage), it may even be more worrying than ever, and we are probably obsessing over every little sign of a preterm labour.  If you are carrying multiples, I can only try to understand the worries that are going through your mind.  We IC mommies more often than not have turned into OCD worry warts :)  The good news is, the majority of women who have symptoms of preterm labour WILL NOT DELIVER EARLY.  But it helps to recognise some of the signs and symptoms as the earlier we catch it, the earlier we are able to seek treatment.

So what are some of the signs of preterm labour?

• Regular contractions: That is, those that come every 10 minutes (or more often) and do not subside when you change position (try lying down on your side). These are not to be confused with Braxton Hicks contractions that you've possibly already begun to feel, which are practice contractions that are no cause for concern (they’re irregular, don't intensify and subside when you change position). If you're not sure, call your practitioner anyway.
• Change in vaginal discharge: Look for blood-streaked discharge (“bloody show”) or vaginal bleeding.
• Fluid leaking from your vagina: It could be a sign your water’s broken. Take a sniff test: If it smells like ammonia, it's urine. If it doesn't, it could be amniotic fluid.
• Period-like cramps: Strong cramps you feel in your lower abdomen or lower back could be a sign of labor.
• Back pain: A constant low, dull back pain may be a sign of labor. 
• Increased pelvic pressure: If you feel a significant increase in pressure in your pelvic area, call your doctor.

Keep in mind that you can have some or all of these symptoms and not be in labor (most pregnant women experience pelvic pain/pressure or lower back pain at some point). But only your practitioner can tell for sure, so pick up the phone and call. After all, better safe than sorry.

What to expect if you experience premature labor

If you're experiencing any symptoms of premature labor, your practitioner will want to assess you – either in the office or the hospital. Here’s what to expect:
Tests for premature labor: You'll first be hooked up to a fetal monitor to check for contractions and to make sure the baby is not in any distress. Your cervix will be examined to determine if any dilation or effacement has begun, and your practitioner will probably use a vaginal swab to test for signs of infection and possibly fetal fibronectin. You might also receive an ultrasound to assess the amount of amniotic fluid and to confirm the size and gestational age of your baby. If these tests and exams show that you aren’t in labor, you'll be sent home, often with instructions to take it easy — or perhaps to go on modified bed rest.
If your practitioner thinks you're in premature labor: Because each day a baby remains in the womb improves the chances of survival and good health, your doctor’s main goal will be holding off labor for as long as possible. He or she may put you on bed rest. Or, depending on how far along in the pregnancy you are and what other complications you may be having, she may admit you to the hospital, where you may receive any or all of the following:

• Intravenous fluids: The better hydrated you are, the lower the chances of continued contractions.
• Antibiotics: You may receive antibiotics, especially if infection is believed to have triggered labor. And if you haven't yet been tested for Group B strep (the test is usually performed after 35 weeks), you'll be given IV antibiotics to prevent possible transmission of the bacteria to your baby in case you are indeed a carrier.
• Tocolytic agents: Your doctor may give you medications (like magnesium sulfate) to relax the uterus and, in theory, temporarily stop contractions. These are usually only dispensed if you're less than 34 weeks pregnant and if your baby's lungs are deemed too immature for delivery.
• Corticosteroids: If your baby's lungs are still immature, you’ll receive these medications to speed fetal lung maturity.

If at any point your practitioner determines that the risk to you or your baby outweighs the risk of preterm birth, he or she will not attempt to postpone delivery. The good news is that for about 30 percent of women, preterm labor stops on its own, and only about 10 percent of women who go into preterm labor give birth within the next seven days. (Source : http://www.whattoexpect.com/pregnancy/preterm-labor/)

 So, lesson to take home this week : PREPARE FOR THE WORST, BUT HOPE FOR THE BEST!