Wednesday, November 26, 2008

a great report

Little One, who is definitely a BOY, was all curled up in a ball, which made it impossible to get a good measurement of my cervix from the outside. So they had to resort to (as I've heard it referred to) the dildo cam. This is something that is extremely difficult for me because of my traumatic experience when my water broke with William but also because my dang uterus is still retroverted, which makes it pinch pretty bad. Difficult or not, it allowed for a good look and an accurate measurement: 4.5 cm!

Yaaaaaaaaay!!!!!!!!!!

I talked to the Peri about the contractions that I've been having and how I want to start the P17 shots. He is just a consultant, though, so I will need to wait to see my OB on Monday to get things arranged. I've decided that I am very glad that the Peri is only keeping an eye on my cervical length and not the one who is in charge of my care. He seems to think that the P17 shots and tocolytics really don't help prolong a pregnancy. He says that the research just doesn't back it up. He says that if I were to go into PTL that he would recommend tocolytics to hopefully buy a couple of days so we could get the steroids on board. I disagree with how he interprets the research. I know that the P17 shots don't help everyone, but I think there is strong evidence that they do help many women. And likewise, many women need tocolytics to not only stop all out PTL but to keep their uteruses "calm." Fortunately my OB is the one who manages my care, and I am well educated and have a Mother In Law who advocates for me as well. So if it came down to it we would have me on terbutiline--or whatever--if that is what it would take to keep things under control. OK, the rant is over.

7 comments:

Julia said...

That's great length there. Wheeeee!!!!

As for the Peri, I think he is wrong about P17 (except in multiple gestations), but he may be right about terbutaline. Epidemiologically, it doesn't seem to have results (as in prolonging pregnancy, not stopping contractions), though anecdotally of course there are many examples where that was the therapy given, and the outcome was good.

I was actually on it for a bit under a week this past summer, for symptomatic relief of unproductive contractions (they were coming every 4 mins or so, making it impossible to sleep or even rest). I was put on it by the attending who was on the floor when I came into the hospital, but next week at the office visit my MFM wanted me to stop taking it. He hates the stuff for its side effects, many of which are not good (for me the main reservation was the impaired glucose control, since I was already having problems in that department). By that point the contractions have slowed back down to occasional, so I wasn't taking the stuff anymore anyway.

Long way of saying that I understand the Peri's point-- the side effects are well known and not insignificant, while the efficacy isn't exactly proven. So I can see how he would have reservations about putting a patient on this therapy. On the other hand, this is your pregnancy and your body, so I say you are the one who gets to make judgment calls.

Please let us know what your OB says, ok? And have a nice movie day tomorrow. :)

Becky said...

Wow wow wow!!! That's a wonderful length! I'm so happy for you!!

Congrats on the little boy, too!

I think the Peri's wrong about the p17 as well. Personally, I think the positive far outweighs the risks.

But I do agree, as Julia said, about the terbutaline. I didn't like when they gave it to me for 6 hours to stop contractions with L...let alone for 4 months or so. I don't think there is enough research to support that it works in longer term situations. Basically, I agree with Julia : )

Let us know what your OB says, but I would push for the p17 if that's the way you decide to go.

Congratulations again! I'm so happy for you :)

Monica H said...

Congratulations on the boy parts and the cervical length. Both wonderful turkey day news!

Ange said...

Wonderful news re your little boy. Congrats!! And good for you being your own vocal advocate. You just gotta be in all things medical don't ya. xx

Anonymous said...

oh good news. I am SO happy for you guys. just take it a day at a time, seems like it drags but take it from me...it does not ha ha.

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