How early can dr. detect ic?

(15 posts)(5 voices)
  • Started by natasa.mudresa ago.
  • Latest reply from natasa.mudresa.
  1. Hello, I'm 37 and am currently 5 wks pg with our first baby This is my second pregnancy but I had a m/c at 12 weeks. I was wondering how soon can drs. tell if you have an ic? We're planning to ask ob if he can put a stitch in because of all what we've been through so far. Anyone have any ideas

    thanks

  2. IC in most cases is hard to diagnose until you've had an early loss usually later in 2nd trimester but before 24 weeks. After 24 weeks a loss would be caused more by preterm labor. Although there is a grey area between losses at the end of 2nd trimester and early 3rd trimester being both IC and/or preterm labor. I have both as I lost twins at 18 weeks then had twins with a cerclage at 25 weeks.

    Some lucky few have doctors who can catch it with an u/s and can have an emergency cerclage but note that emergency cerclages have a higher chance of infection and according to my peri are only about 50% chance successful while preventantive cerclages done in late first trimester/early 2nd trimester have a higher chance of success. Of course the risk of any cerclage is infection.

    If you are considering a cerclage I would only have an experienced peri do it. If you have concerns ask for a referal to a peri. I'm not sure what caused your loss at 12 weeks but it is doubtful that it would be considered IC that early.

    For me in first pregnancy I was already at risk for IC because of a LEEP I had done and was being checked weekly with a finger check (no u/s) and just two days before my loss and they still missed it. The window is very small with IC sometimes unless you are doing it with u/s and just before you can miss it which is why it is so tragically diagnosed after a pregnancy loss.

    Good luck and hopefully IC and preterm labor will not be an issue for you but if you have concerns address the with your ob and insist on a peri referral to discuss your options. Maybe more frequent monitoring in your case until you get closer to viability.

    Lauren

  3. Lauren- thanks for your input So sorry for you losses I don't think I lost the baby due to ic but.... we feel that we'd try and ask for a clerge for preventative measures. I plan to ask ob aobut it. I do know that he does u/s and I'm sure he can see it that way I guess we'll have to wait and see but I've had drs. who don't know me if I've had kids and I've why the question and they've said that my cervix looks like I've had kids which makes me wonder if I should keep a clerge in mind. Thanks again

  4. Unfortunately IC is such a tricky thing. Are you at higher risk for IC for any reason? Otherwise I suspect you might have a tough time convincing a Dr. to put in a preventative cerclage. Cerclage placement is usually between 11-14 weeks (for transvaginal), the earlier the better - but Drs. also like to get you just over that first trimester when risk of m/c is lower and they can also get the first trimester screen in. Typically IC shows up around 18 weeks, but I have heard it showing up much earlier than that.

    I have a uterine anomoly that makes me more predisposed to IC. Still my Drs, who were conservative and cautious people, did not recommend a cerclage without prior evidence. I did end up having IC, starting at 18 weeks - fortunately, caught with weekly u/s and with lots of medical management (bedrest, hospitalization 2 months, medication for ptl, no cerclage) I made it to a safe place at 31 weeks. This second time around I had a Shirodkar placed by my Peri at 12 weeks. I had a gut feeling from the start that I was going to have a rough pregnancy - so I prepared by going to the best hospital in the area with the best NICU.

    So I have to say if your gut is really telling you something - then insist on more frequent care and being treated as a high risk patient. Your Drs. should be treating you as high risk from the start since you've been through IVF, are AMA and had a prior loss.

    Best of luck on a smooth and healthy pregnancy.

  5. Thanks Mangy- I will be vigalant about this. We've seen a couple lose thier first baby at 22 wks becaue of an ic. She wa able to get pg again but had to get steriod shots every week to ensure her dc's lungs were mature in case they had to deliver him sooner which I wasn't clear on if she had a stitch? but I would feel better if we were given a stitch as I've had a loss and I'd be considered high risk or at least I was told that. I'm in the process of getting in to an ob and hopefully have some of my concerns at rest.

  6. Your friend probably had a positive fetal fibronectin (aka ffn) test which they only start at 24 weeks and has a high false positive but close to 100% false negative to indicate whether you might be going into labor. If you get a positive ffn test they usually retest in a week and if still positive they start giving you steroid shots which can mature your babies brain and lungs by 2 weeks within 48 hours. Before 48 hours they don't do much so it has be caught at just the right time.

    Basically before 24 weeks all your options are a cerclage and progesterone shots to reduce uterine irritability which might cause preterm labor. Nothing else other then bedrest can really help. After 24 weeks there is alot they can do.

    Lauren

  7. Lauren- I don't know why they put her on it. Her dh told my dh that they wre putting her on steroid shots and needed to be monitored so she had to take maternity leave earlier. I wouldn't have thought that she'd need that since she had a cerclege put in. She lots the first one at 22wks and had to go far from home to be seen by an ob because the ob she was seeing in a bigger city wasn't too worried that she needed a cerclege or not. So she was 5 hours away from her dh and she stayed with her dad until delivery which was ahh about 4 moths give or take? What is that test you wee talking about? Do all moms get tested for that? I'm going for inital prenatal screening and I have no idea what they're testing for Thanks for the info. I just remember how devestated she and her dh were when they lost their first baby Dh is the one who's insisting we consider getting a cerclege in or a stitch.

  8. The ffn test I mentioned is not a standard test but given to women at risk for IC. It can detect a hormone that your cervix excretes when it is about 1-2 weeks before labor. It has a high false positive so if it comes back positive it does not absolutely mean you will go into labor but if it comes back negative it is usually pretty confident you are fine for possibly 2 weeks. They usually start it at 24 weeks testing every 2 weeks until you get a positive then they check for a yeast infection which can trigger a positive and retest within a week. Some peris might immediately go on offensive and start steroid shots with a positive ffn test - some like mine wait a week.

    Lauren

  9. ohhhhh ok thanks, now I understand what it means Thanks, sorry for all the questions

  10. natasa.mudresa - I've had a late 2nd tri loss that the docs weren't sure whether an IC played a part or not.

    For my subsequent pg it was debated by me and my OB whether it was something I wanted to consider.

    Having a cerclage can in itself create issues so there are pros and cons to having one place and if you don't NEED it, it could be that you're actually creating more problems then preventing - esp when no previous experience has suggested ic.

    I\'m not sure why your docs think you lost your last pg, but certainly, if you've been through the ringer and you want a higher level of care (including constant monitoring) then discuss that with your doc.

    Placing a cerclage unnecessarily can create its own set of issues - though its worth noting that these complications are rare, the risk does go up.

    What are the risks of having a cerclage placed?

    The likelihood of risks occuring is very minimal, and most health professionals feel a cerclage is a life saving procedure that outweighs the possible risks involved. Possible risks could include:

    * Premature contractions
    * Cervical dystocia (inability of the cervix to dilate normally in the course of labor)
    * Rupture of membranes
    * Cervical infection
    * Cervical laceration if labor happens before the cerclage is removed
    * Some risks associated with general anesthesia include vomiting and nausea


    Also, I would do a bit more research regarding the administration of steroids once a week. I discussed and researched in detail the use and effectiveness of steroids for a potential premie and its was made very obvious by our peri and the neo-natal docs that steriods only work ONCE. And that we needed to be very aware that given too soon (ie at 24 w) if the babies made it to 27 weeks that the steroids effect would negligible and that a subsequent courses of steroids is a waste and can/is causing further harm to the baby:
    Higher steroid dose was associated with increased neurodevelopmental impairment. There is no "safe" window for steroid use in extremely low birth weight infants. Neonates with low bronchopulmonary dysplasia risk should not be exposed. A randomized trial of steroid use in infants at highest risk is warranted.

    Please do all the research you can before you demand too much unnecessary medical intervention. I know this road your on is extremely difficult especially when dealing with a pregnancy following a loss but its important to know that unless there's obvious reasons for that loss, too much medical intervention can be more detrimental then good.

    I wish you much luck in your pregnancy. I've seen your name around a time or two and know how long your road has been.

  11. nadiafilipfa- thanks for all the information. I never tought of any of those things. I felt last time I wasn't as proactive in my pregnancy and this time I want to be. I suppose it's selfish of me to want a clergge as I've had a loss already and we've used an egg donar go tet pg and unfortunatly we didn't have many embroys from her so our chances are limited. That's why dh and I have thought that a stitch would be our best option. We've also desired this because we witnessed our close friends lose a baby at 22 weeks. When they got pg again, they were given a stitch and she was given steriod every week. I"m not being naive but I never had any idea about what the risks were until you pointed them out to me. Do they put a stitch in if your pg with twins? Judging by my beta, there's a chance there could be twins? but yes, I plan to dixusss this iwth whichever ob I can get into there's some confustion over that at the moment.

    Thanks again I really appreciate it

  12. Do they put a stitch in if your pg with twins?

    IF a woman is prone to IC, getting pg with a singleton or twins will result in issues regardless.

    Do the doc's know why you lost your last pg? A m/c at 12 weeks is definitely NOT due to an incompetent cervix. The baby and sac are far too small to be putting really any pressure on your cervix.

    A 12 week loss is obviously difficult but the odds are that its not due to IC. If you are carrying twins you will be monitored more closely and by a specialist (since I'm in Canada too that's the standard care given for 'higher risk' pgs). If your carrying a singleton then for peace of mind I would request additional monitoring but you really need to know what exactly it is your concerned about.

    If you think you may be prone to ic (for whatever reasons) then additional cervix checks can be done. If you think your prone to PTL then there are different tests for that. But honestly, you will make yourself sick if you worry about every little possible thing that can go wrong. I had a high risk pg for 13 weeks. I did extra ultrasounds, extra doc appts, you name it...but still in the end there was nothing that could have prevented our loss. My subsequent pgs (I lost another baby at 10weeks following our 24w loss) again, we did extra u/s and blood work but there was nothing that could have prevented that next loss. Thus, on pg number 3 (baby #4) though I still see a high risk doc I have come to the realization that do it all doesn't necessarily prevent a loss.

    Right now I'm focused on trying not to stress. There's been a few bumps in the road that I've gone in unscheduled for a check 'just in case' and that has been enough to allieviate my fears and continue convincing myself that I am having a 'normal' pregnancy.

    It was a big job talking myself into not stressing (I still battle with it everyday) but honestly there are no indications that I have any notable 'issues' (despite a 24w loss of perfectly healthy babies and my 10w m/c) so I have to trust that my previous losses were simply bad luck and statistics (since 25-35% of pgs are m/c in 1st tri).

    What I would recommend is sitting down and setting out a reasonable game plan with your doc (or OB) on what you will feel comfortable with. Remember general docs don't have all the answers for various intervention so if your going to question whether you should request a cerclage, P17 shots, steriods or any other intervention with possible side effects then you should talk to a specialist who deals with these (ie a perinatologist or even someone who works in the neo-natal section). These specialists have the proper answers while your reg doc won\'t.

    Please know that just because someone you know has issues, there's no cause to be concerned that you do as well and if you do, the chance of those issues being the exact same are rare. The underlying cause of loss at 22 weeks is so very different than one at 12 weeks and more than likely there was nothing you could have done to have prevented it.

    Again, good luck.

  13. Play- it seems that so far, no one's treating this pregnancy with any sort of interest or concern that disturbs me and dh a bit. Not sure where in Canada you live but where I live, there's no drs in our city delivering babies unless it's an emergancy case. Since we've already had a loss and we really adore out ob/re, we wanted to go with him. However, there's some confustion as to weither he'll oversee us or not. The jury's out on what caused my last loss, there's a few therois and I know it's not ic but I do have an open cervix as it it so I wonder if I'm predispostioned for it??? Dh and I have decided to investagate our options and to be way more proactive this time. I know it may sound paranoid but..... we're paobably acting on desperation too. We do plan to discuss all of theese options with whichevr ob will take us

  14. If your worried I would ask for a transvaginal U/S everytime you go to the DR. I was preg. with twins. My Dr. noticed my cervix was at 2.5cm when I was 10 weeks preg. He said we had time to decide about a cerclage, but 2 days later I was in the ER in Labor. They thought I was going to lose the babies then. But they hung in there, contractions stopped. I had a cerclage placed at 13 weeks I had about .5cm of cervix left. They caught it on a weekly appointment I was having. I have a dynamic cervix that was funneling and always changing.
    We did everything we could do too. But at almost 18 weeks baby A's water broke and they couldn't be saved.
    I would make sure they monitor your cervix for any changes. Oh... I had a LEEP too.

  15. Seven- what is a leep? so sorry baby came eralier.

    afm- I did ask ob about putting a stitch in and he feels for now I'm not a canidate for one evern though I told him why we wanted one in. he feels that I could get an infection and paitents had to have 3 losses in order to qualify. For now, I'm going to ask at every appointment and he's doing transvaginal u/s so far.

RSS feed for this topic

Reply

You must log in to post.