The Light

The Light at the end of the tunnel

By Sybil

This success story is continued from my entry at the Lost Angels page titled “Mother of Two, Parent of None.” I had a miscarriage at 12 weeks (probably genetic) in Sept. 1998. Then I had a loss at 16 weeks on 2/12/99 (my angel Matthew). The amniotic sac ruptured without any warning and I had to deliver a few hours later. I now know this was due to incompetent cervix (IC). Although the doctors weren't sure of that at the time, particularly since they all said 16 weeks was early for an IC loss. I had been having spotting and also a lot of abdominal tightening. I asked the nurse about this tightening and she just blew it off, probably because I was only 13 weeks. I know now those were painless contractions. For the full story, please see the Angels page.

I was having a lot of contractions in this pregnancy also which started about 12 weeks. I also had the exact same spotting at the exact same gestation as with my prior pregnancy, at 12 weeks and again at 13 weeks. My perinatologist felt this was not good for doing a cerclage that was not clearly indicated in the first place as he was afraid I would go into labor at a time during which drugs aren’t that affective. So, I very reluctantly took the "wait and see" approach. I had weekly ultrasound checks of my cervix from week 13 onward. I started bedrest officially about week 15 although for the previous 3 weeks I was only working part-time and bedresting when at home. On the ultrasound, it was amazing to watch all the contractions, most of which were centered just above my cervix. I could not feel these contractions. My peri commented that something about my cervix didn’t feel quite right (it was 3.5 cm long at that time and closed) and it was his theory that although my cervix was closed, it might allow bacteria in which was causing inflammation which then caused my amniotic sac to rupture in my last pregnancy. So after testing positive for Group B strep and being treated with antibiotics, my contractions (the ones I could feel) stopped. I also went on complete bedrest at this time so it was probably a combination of the antibiotics and bedrest which helped my uterus to calm down. My peri wanted the bedrest to give me the best chance of making it to 19 weeks at which time I could get tocolytics for any contractions, especially if it became clear I needed a cerclage which can itself cause contractions.

I continued to be monitored weekly with both manual and vaginal ultrasound examinations of my cervix as well as the baby. At my 22 week appointment, when I was just beginning to think I was safe, vaginal ultrasound and manual exam indicated I had lost a LOT of cervix, from 3.5 cm to 1.8 cm in a week. Of course, most perinatologists will say women usually don’t lose more than 0.5 cm per week! Yeah, right. I had just a bit of funneling as well. I got dressed and my husband and I met my peri in his office. He was already on the phone and I heard him say “Another week and she is going to have this baby, we’ve got to do it now.” I thought he was talking about another patient. Then I heard my OB’s voice on the other side and realized he was talking about me. He hung up and muttered to himself as he looked at a wall full of film of my cervix each week from week 15 “I’m glad I didn’t go to seeing you every 2 weeks.” The week before we had briefly considered going to every 2 week appointments as I was now 22 weeks (previous loss at 16 weeks) and my cervix was doing well. This change occurred even with bedrest. I was immediately scheduled for a cerclage. My peri did not consider this a rescue cerclage since I had no dilation. I was admitted that night and put on IV fluids and given something to relax my uterus to minimize any contractions caused by the surgery. I don’t remember what drug I was given. I was also given IV antibiotics. My peri was happy that I had just finished a second course of antibiotics for the Group B Strep just to make sure I remained negative. I had antibiotics for 3 days post surgery as well. Placement and recovery were very easy. In fact, after the cerclage, my cervical length was back to about 3.0 cm and my perinatolgist said my cervix had never felt better during the manual exam and I had no funneling.

Around 27 weeks I started having low-normal amniotic fluid levels, and it was painfully obvious that something wasn't right with my uterus as the baby was nearly out of room to grow. So we were having weekly fluid level checks and biophysical profiles to make sure the baby (AKA, Munchkin) was OK. Also about this time, my previously beautifully stitched cervix was now nearly 100% effaced. I still had length above the stitch however. Munchkin was still breech and with such limited space, there was no hope of him turning. My peri commented that it was better not to have that big head on the stitch as my cervix was clearly pooping out on me.

Oh geez, I almost forgot. As my fluid levels decreased, Munchkin’s umbilical vein enlarged, called an umbilical vein varix (UVV). I of course read all the literature describing still births and phoned my peri crying. He was so sweet. He said “I’m yanking your internet privledges!” The cases reported in the medical literature are the worst case scenarios and all those babies also had chromosomal defects which were evident by ultrasound. By all measurements, Munchkin was healthy. My peri said even if he does his kick counts (he said I only needed to do them 1x per day but I did them 3x per day) but you feel something is just not right, go to L&D immediately. The risk with UVV is blood clots forming in the blood vessels. Boy, does that put a lot of stress on the mom. I added Gatorade to my fluids I was drinking which made me urinate a LOT less than when I was just drinking water and lo and behold, my fluid levels rebounded, back up to about 100 mm (low normal). Now this fluid increase happened with two other pregnant women that I know of,.. doctors won’t say the Gatorade helped, but you never know, and it won’t hurt.

At my regular appointment, June 12, 2000, my fluid levels had dropped to 47-50 mm. This level is very dangerous as there is a risk of umbilical cord problems. My peri was able to get enough fluid out of the one pocket Munchkin had left. The fluid indicated his lungs were very mature, so I was scheduled for a c-section that evening as he was breech. Nathan Cole was born June 12 at 10:36pm weighing a whopping 5 lbs! I was 35.5 weeks. The small space had restricted his growth somewhat as his abdominal circumference was starting to lag behind in growth (about 1.5 weeks) compared with his femur length and head circumference. My OB found that the uterine muscle is thick, which made the inside cavity very small. She called it uterine hypertrophy - not fibroids however as we had suspected. In my previous pregnancy I did have a fibroid but it degenerated after the preterm delivery. She also commented that my uterus was very hard to cut through. Also, she said she usually lifts the uterus out of the body cavity to stitch it up but my uterus was so large, she felt she wouldn’t be able to get it back in (without making a huge incision) so she had to stitch it with it being inside the cavity. Recovery from the c-sect was OK ... the morphine makes me itch horribly which was the only downside.

I stayed in the hospital for 5 days because I was spiking small fevers ñ those darn hormones. My husband roomed in with us - we had a huge room. My mother-in-law was there during the day as well so I had lots of help with Nathan who roomed in right away. He breathed on his own and never had any problems although he sure was skinny! All I can say is a good lactation consultant is GOLDEN! Because of Nathan’s small size, a football hold worked best for us. The only challenge was keeping him awake long enough to eat. I also learned that although nurses are wonderful, sometimes they don’t have all the answers. They were saying Nathan needed to nurse at least 15 min on each breast! We were doing good to get 5 minutes on one side! So the lactation consultant brought a hospital grade pump so we could pump some and give it to him via a syringe with tubing on our fingers which takes less energy than the breast. Well, when she saw how much milk came out of me, she said no more tube feedings, he was getting plenty in just 5 minutes on one side. I think he lost about 5% of his birth weight (they allow 10%) and was back to 5 lbs by 8 days or so. By the time we left the hospital, his bilirubin levels were up so he spent 3 days on bilirubin blankets at home.

After spending basically 2 years being pregnant, and all the stress and worry and bedrest of this pregnancy, all I can say is “IT WAS SOOO WORTH IT!” Sometimes I look at him and I just want to cry out of happiness, relief, and sorry for the baby I lost. Nathan is the joy in my day. Don't get me wrong ... it is hard ... but I wouldn't trade it for the world.

Reading this wonderful website gave me the strength and courage to get pregnant again. Nathan is the embodiment of all the love and support and information I received before and during my pregnancy. I’m truly blessed to be able to add my success story to this page.

Perhaps you’re wondering about the title to this story.. Well, during graduate school I came across the saying “Sometimes the light at the end of the tunnel is the headlamp of an oncoming train.” In my first pregnancy as I was 12 weeks and had been very sick, I thought I was seeing the light at the end of the morning sickness tunnel and it turned out to be a train. In my second pregnancy, I made it to the heartbeat check at 12 weeks, and again at 15 weeks and thought I was safe again the lights turned out to be a train. In my third pregnancy at 22 weeks, I thought I was nearing the end of the “worrying about my cervix” tunnel but yet again, a train was waiting for me (i.e. the cerclage and all my other complications) but ultimately, I had my beautiful baby boy. I guess the point is that perseverance through many dark tunnels can lead to a road of such joy I can hardly describe. I hope reading this success story gives you the strength and courage to try again. Also, most people with incompetent cervix don’t have all the other complications I had so don’t let those frighten you!