Re: a, complete-SU

[Guest guest]

Hi Sherry, I've heard of Dr. Shabib, I'm sure he is great. If you are

comfortable with him, by all means stay, much easier that attending

the clinics.

For my first pregnancy I had a baseline measurement of my cervix taken

via trans-vaginal u/s at around 12 weeks. It you haven't had an u/s

yet I would ask for one, firstly to get that first cervical

measurement, but also to be sure you only have one baby in there

(twins would require VERY serious monitoring and you would definitely

have to be transferred to the MFM clinic at the General). Twins are

more common among women in their 30s.

After 12 weeks I had a cervical check approx. every 2 weeks until 24

weeks. Women with MAs are at a higher risk (although still a remote

risk) of incompetent cervix. Some doctors believe that monitoring the

cervical length is useless as IC can strike suddenly without warning,

but I found it reassuring to have my cervical measurements taken even

2 weeks during the 2nd trimester. If your cervix does start to shorten

before 20 weeks or so, a cerclage can be put in.

After 24 weeks the main risk is pre-term labour, followed by growth

restriction and mal-presentation (i.e., breech presentation). You will

need cervical checks, probably every 2 to 4 weeks at a minimum, to

watch for signs of PTL. The baby's length etc. will be estimated

during u/s for signs of IUGR (growth restriction). Finally, the

doctors will have to be sure the babe is head down, if not, you will

have a C-section.

I know this sounds very scary and overwhelming, but you've already

gotten out the the 1st trimester, definitely the period with the

greatest risk. Most of the problems I outlined above are unlikely to

present, BUT you must be vigilent and aware of all the possible signs

of ptl. I would have a long discussion with your ob about this, read

all you can on the signs of ptl and if you ever are worried that you

may be experiencing ptl after 20 weeks, contact your ob or go to

labour & delivery at the General immediately. That is what they are

there for.

Some docs feel that MAs are no big deal and don't require any special

care, perhaps except for breech presentation. Others are at the other

end of the spectrum - MA pregnancies are terribly high risk, mothers

should be off work by 24 weeks, etc. I think the real situation is

somewhere in between - definitely MA pregnancies are higher risk than

normal, but many of us have normal or near-normal pregnancies.

Hopefully your ob agrees to be just a little more vigilent than normal

with your care.

My cervix did finally start to shorten/funnel around 29 weeks. I was

ordered off work at that point. If you haven't already, you may want

to start planning for the possibility that you will have to leave work

early, possibly for the entire third trimester, just in case.

Let me know if I can answer any other questions.

Take care,

a

Complete SU

DD 16 months

7 wks prg

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