Friday, February 19, 2010

Checking in on Twoey

Today I had another appointment with the maternal fetal medicine specialist. I was just scheduled for a cervical length check and a quick consultation with the doctor to discuss my contractions. I'm happy to report that all went well - my cervix remains around 3.5-3.7 cm long, so there has not been any change since my last check. While ideal is over 4.0 cm, they are happy as long as I stay above 3.0 cms.

Much to my surprise, they decided to do another quick ultrasound of my baby girl to check her heartbeat. She is currently breech (well, butt-down). I thought she had flipped in the last day because I have been feeling her kicking (actually, it turns out punching) up higher. We actually got a beautiful little 3D picture of her face! She is still a bit young for the 3D technology, so her features were a touch blurred, but I think she might look a bit like Micah already! Yes, I'm sure NO ONE else will be able to see that from these pictures, but hey, I'm a proud mama! What do you think?

I then had a brief consultation with the doctor. My "regular" doctor there is the head of the maternal fetal medicine center, but he was out of town on vacation. I saw another doctor who was on duty today. I am certain that all of the doctors at this practice are competent, but, unfortunately, this one really does not know my history and only barely skimmed my file. We talked about my contractions, but she basically responded that as long as my cervix holds steady, they just don't care about the contractions. I tried to ask when I should worry about them and call/seek additional medication, but I do not feel like she gave me a good answer. She then asked if I considered getting the 17P shots (a type of progesterone shot administered weekly to help prevent pre-term labor). I said that I had discussed that with the other doctor early on this pregnancy, and he recommended against it because he felt it was unlikely to help my situation because the fibroid was the source of the contractions. She shrugged and said that was a possibility, but that the shots might help if the contractions had nothing to do with the fibroid. She then said that the shots are the most effective when started around 16 weeks, and since I'm already at 22 weeks, they may not even help at this point.

So...I have a decision to make. The doctor submitted the request for the 17P shots to the insurance company. If I am approved, I have to decide whether or not to take them.

  • They may reduce the contractions.
  • They may help me carry Twoey to term without other medications and horrible/scary bouts of contractions.
  • If I try to wait it out until the contractions are worse and I experience cervical changes, it would be too late. These shots are meant to be preventive so I do not have to deal with bedrest or contractions or oral medications or the discomfort (if it works).
  • I'm trying to think of more, but I think I'm out!
  • I'm needle phobic - a shot every week is a bit overwhelming for me to think about. I know I can get through it if it is best for the baby, but I have to believe that to really make this happen.
  • It may not help at all and I could put myself through the needle torture for nothing.
  • Side effects - can include vomiting and nausea (already a problem for me), headaches, dizziness, swelling, and other issues I'd prefer to avoid. Not everyone has side effects, but I'm concerned because I tend to be very hormone-sensitive (and let's be honest - I'm sure my needle phobia is playing into this fear, too).
  • It may work so well that it could cause me to be overdue or need to be induced when the time comes (an issue again because of my needle-phobia).
  • It may be unnecessary treatment - I may not end up having an issue at all with pre-term labor this pregnancy, and last pregnancy I managed just fine on the oral medications. Even if I have a repeat of last time, I could still carry to term.
Anyone have any input?


Shannon said...

I don't have any experience with this, but I can say that after seeing so many dear friends deliver babies so young and little, I would do anything to try and keep twoey baking for as long as possible...even if that means injections that might not do anything. They might not, but then again, they MIGHT!
She is a beautiful little girl:)

Jules said...

Tough call. When I was pregnant I didn't like doing the procardia / terb on a couple occasions but after having had them, I see where playing it safe can be good. I don't know though with no cervical changes if I'd go for the shots.

(however sitting on the couch for 4 months wasn't really fun either........hmmmm)

Crystal said...

Good luck with your babies - Micah is beautiful and I just love US photos.

Chele said...

That's a difficult decision. However, if you can handle the shots, it couldn't hurt and if the side effects are too bad talk to your doctor about quitting them. Fingers crossed that your cervix stays steady and you make it to full term. I wish your regular doctor was available for you to talk things over with him.