Questions for Dr. A:
- Exactly how far along will I need to be when we place the cerclage?
- How long will I be in the hospital or on bed rest immediately following the placement of the cerclage?
- What type of cerclage do you normally place? And if it is one that can be left in do you allow that and then perform a c-section?
- When do you typically see patients w/IC going out on bed rest (how early and how long)?
- How often will I be seen by OB?
- Will I need to see any other specialist (i.e. MFM or peri)?
- When will cervical measurements start and how often will they be done? Will they be manual and U/S?
- Will you prescribe P17 shots starting in the 2nd trimester to help prevent PTL?
- Would I need to be on Heparin or Lovenox for the whole pregnancy due to the MTHFR?
- A week prior to last miscarriage I had a pretty bad fall, could that have contributed to that loss?
- Chris is A+ and I am A- so could that Rh be a factor in the miscarriages since losing Cadynce?
- If Dr. A places a cerclage that can be left in, can you do further treatment (once we get a RLB here) with it in place?
- Since we are doing another fresh cycle - would we do it the same as the last or would we change anything? If so, what would be different?
- What can I do between now and January/February that could help to increase our success rate? (i.e. vitamins, supplements etc.)
- Are there any other tests that we could run to be sure that I have no other issues we may not have tested for yet? (i.e. Lupus, Vit D deficiency)
- A week prior to last miscarriage I had a pretty bad fall, could that have contributed to that loss?
- Chris is A+ and I am A- so could that Rh be a factor in the miscarriages since losing Cadynce?
I'm not writing a lot because I really feel like I don't have that much to say since we are on a break and can't start IVF again until 2011. But I am definitely reading everyones blogs and trying to comment.
Hope you are all well.. XOXOXO
9 comments:
I don't have any information to help you. I do feel for you and have you in my prayers. It is my understanding that RH- effects the second pregnancy and shots must be given when your pregnant. Have a wonderful time visiting your Pappy.
That's a great list of questions! So much to think about...I only have a couple further questions...
Regarding the Lovenox/heparin, would it hurt to be on a prophylactic dose?(My m/cs were consecutive, unexplained, 2nd trimester and then I was diagnosed wtih Factor V Leiden. My OB decided it wouldn't hurt to do the Lovenox, even though doctors have differing opinions.)
Will they check your blood for RH antibodies that may have formed after the miscarriages? I'm not sure if this is done pre-pregnancy. I had it done in the first round of pregnancy bloodwork. Did you get the Rhogam shot with each miscarriage/delivery?
That's all I have. Good luck with your appointments!
Karin had a few of the things I was thinking--specifically with the prophylactic Lovenox--and I only have any knowledge about that because my sister has Lupus, antiphospholid (or something similarly spelled!) issues, MTHFTR, Factor V and something else...she's had 10 miscarriages and her specialist at Duke insisted with her last pregnancy (which she sadly miscarried a few months ago) that she take Lovenox that way. Karin is right, though, there are a lot of REs and peris who will have differing opinions and will produce studies for both sides.
My sister also has the RH thing and that was something she did during her pregnancy with my nephew (which was a live birth, but rough pregnancy)--something she was given after a certain period of gestation, don't remember. Do remember that it was definitely an issue, though!!!
I would push, push, push for seeing a MFM!! I see mine every two weeks and after 24 weeks, I'll see him every week. With my situation, vasa previa is so rare in the first place, it's certainly not thought to be recurrent, but if for nothing else, my peace of mind is worth those appointments! You've had 3 losses...I'd say that warrants some extra special watching!
Hoping that you get solid answers that allow you to have some hope and optimism!!
Looks like you've got a lot of great questions lined up & I hope the doctors give you some answers! If you want I can email you the LONG list of tests I've had done & see if they'll help you too?? I had my done at the OB & since unfortunately you guys have experienced 3 miscarriages, your insurance SHOULD pay for all the extra testing (I was told that b/c I hadn't had 3, my insurance might not pay for them .. not sure why that's the sucky "magical number", but that might help you out?)I think you're doing lots of great things while you're stuck in "limbo" & I definitely believe going to the gym will be the best thing you can do over these next few months - to help boost your energy levels/endorphins (not to mention maybe losing some weight .. bonus!).
P.S. thanks again for the elliptical - it's already been used quite a few times (unfortunately by Kris mostly, but I'll make up for it I promise!) :)
It's good to be thorough with the doctors. Since we have a history of baby loss, we need all the info on preventative measures that we can get. Goodluck on your appointments. And thanks for the kind words on my blog.
Those look like great questions! THinking about you and hoping all goes well in 2011 :)
Those look like great questions! THinking about you and hoping all goes well in 2011 :)
yay for progress! i have two doc appts scheduled for august too and it gives me something to hold onto, im really looking forward to meeting with the OB especially.
i hope you are well, i think of you often. i hope Cady and my girls found each other just like we did.
xoxo
lis
I started reading your blog a couple of months ago and I'm so sorry for all you've been through. I was pregnant with boy/girl twins from IVF and due to cervical insufficency I delivered them at 26 weeks after 15 days of hospital bedrest. My little boy passed away 3 days later and I was and still am heartbroken, you never get over the loss of you baby..so I am so sorry this is something we share. My daughter is doing amazing after a 16 week NICU stay and couldn't be more perfect. She did have her struggles..3 major surgeries but she's alive and doing wonderfully. We also had frozen embryos and we ended up doing 4 FET's with 1 ectopic pregnancy and 3 BFN's. With each of these we only transferred one blastocyst. MY RE recommended this due to the concerns over my cervix. In all my consultations prior we were strongly advised against transferring more than 1, especially if we had decided to pursue a fresh IVF. Anyway, we were fortunately able to conceive on our own and I now have another beautiful daughter who is 6 weeks old. I had a Mcdonald cerclage placed at 13 weeks. Most docs place them between 12-14 weeks to allow you to get past the risk of miscarriage. I came home the same day and was given bedrest orders for the next two days. After I was told no heavy lifting, no excerising and of course no sex. I had weekly ultrasounds starting at 19 weeks and started my progesterone injections at 17 weeks. I had no bedrest my entire pregnancy and I made it to 38 weeks with my scheduled c-section. I had to have a repeat and so they didn't cut out my stitch beforehand. After they delivered my daughter, they removed the cerclage. I do know the other type of cerclage is a shrod-kar (sp?) and depending on your cervix length, etc. this might be recommended. Anyway, I hope this helps you a little with some of your questions. Obviously, I know that no situation is the same but hopefully it will offer you hope that with attentive medical attention and smart choices on your part you can carry a baby to term. I wish you all the best!!!
Post a Comment