Don't be alarmed I don't plan to be having a baby ANYTIME soon! I have been admitted for a round of steroids for Audrey's lungs as well as just some monitoring to make sure things are stable (contraction and cervix wise). This isn't new by any means. I have had issues with all 3 pregnancies with both contractions and cervix stuff and this one has been no different. Each pregnancy of course is unique and has to be treated based on what is being presented as well as my history of pre-term labor/pre-term birth and current gestational age. Since I am only 23w5d the doctors here are being very aggressive with me right now because I am on the brink (but not quite yet) of viability and my body has not been behaving lately. In the past few weeks talks of cerclage vs bedrest and tocolytics have been the topic of conversation but once a patient reaches 23 weeks cerclage isn't really on the table anymore (and it never really was on the table for me anyhow)...but steroids for baby's lungs now are! While I would love more than anything to just move along through a pregnancy without all the drama :) that is not the uterus I have been dealt! It's fine though because it really is all I know. I am confident that I have many more months in this pregnancy despite what my body seems to be hinting at during my weekly checkups. We've been here before and God has brought us through it and I know He will provide exactly what we need again! Prayers are always appreciated though and each day that I stay pregnant and get closer and closer to viability...and beyond is proof that prayers are being answered everyday.
I normally don't update about this stuff very often on here because it is pretty much a weekly roller coaster that I would rather NOT consume my thoughts or the blog because I am confident it will all work out in the end. I figured that being hospitalized is probably something I will want to remember though and the story behind it as well because it is so amazing to see God's work in progress! I will post a picture below taken yesterday of my cervix. It is shortening below a point of "normal" for being 23 weeks and it's funneling (or beginning to dilate on the inside) but it is a very dynamic funnel...it has moments of looking just perfect so if you take a picture things look normal but if you stick around for a bit you will see that it has a mind of it's own!
This first picture looks great. Nice and long and I think measuring about 3.6cm-3.8cm in length and it is closed (not funneling). This is ideal. We are looking at it from the side. The baby and sack are to the left of the picture in the big black hole and baby's exit point is to the right. If you enlarge the picture you can see the white dots the sonographer has placed directly on top of the cervix almost like a tape measure to get an accurate measurement of it's length. The cervix is that horizontal black line right in the middle of the picture that almost look like a nike swoosh.
This picture below was taken about 3 seconds before the above picture. We are looking from the exact same angle (baby and sac are in the black hole on left) and you can see baby's head sitting there. That big sideways black hole triangle looking thingy is my cervix opening from the inside (funneling) and the tape measure (little white dots) is now almost half the length it was in the last picture. This measurement was about 2.4cm in length (which was a generous measurement) because it was difficult for the sonographer to find the end of the funnel since it was moving so much.Basically as I laid there my cervix just continued to open and close on it's own sometimes with contractions, sometimes if I coughed or laughed and sometimes for no reason at all.
Back up to when this started... for about 5 weeks now I have been monitored by both my regular OB and my high risk OB because of this cervix issue. Back when they first started watching closely it was shortening and funneling but only with pressure or during a cough, or if I lifted something. It funneled just a tad but over the course of the 5 weeks (at weekly appointments) it seemed to have stabilized out where it was because it was the same every time I went in. My contractions were being managed with the 17p weekly injections and nifedipine oral as needed. And I was just continuing the "light duty no heavy lifting restriction" that I had been on for quiet some time. I went to Dallas on Christmas day with the family (with permission from my regular OB as long as I took it very easy). And the night I got there I started seeing a sign of pending labor (I will spare the details of that one) but this being my third there was no question what it was. I immediately laid down and ended up going to sleep because I was having no other issues...no contractions, pressure etc. nothing making me think this was PTL. The next morning I woke up with contractions that were irritating so I laid down some more did all the tricks I knew to stop them; laid on left side, pushed water, ate breakfast, took nifedipine etc. And after a few hours they wouldn't let up. I had just had my progesterone injection so this was pretty unusual amount of contractions for being so drugged up. Finally around noon I called my friend Rachel Colon who always takes such good care of me when we are in Dallas. She is an OB/GYN NP for her dad's (Tom Sudela's) practice. We go way back and she was there for me during an issue in Dallas with Madison's pregnancy too. Being 4 hours away from my OB can be tricky when things start going south so what a huge blessing to have her and her dad there to take care of me!
Anyway, when I called her with the update she wanted me to head straight in to L&D to get on a monitor (contractions) and get a look at the cervix. I was only 23w2 days at the time so baby was not viable which meant they wanted to be extra careful and conservative. She had me take a double does of my nifedipine on my way up there and by the time I got there it kicked in and slowed the contractions way down. They put me on the monitor and did a fetal fibronectin just in case. The FFN was negative and the whole time I was on the monitor I only had about 1 contraction every 15 minutes and they were so mild I didn't even notice them.
After an hour or so they took me down for a sonogram of my cervix. The sonographer at the hospital decided to do it trans-abdominally which I asked about because I had been told by numerous doctors they always take cervix measurements trans-vaginally in order to ensure accuracy. She stuck to her ways and did it abdominally and told me she didn't know why I was even there and that it looked totally fine. The measurement she got was best it had ever looked in the whole pregnancy which didn't surprise me because it was done abdominally! I again asked about the method of measurement but she assured me she was confident in her measurement... Okie dokie! They took me back up to L&D and I was released a few minutes later because everything looked fine! I however did not have peace about it. I said to Jordan more than once that I didn't think that measurement was right. We left the hospital and went home and I took it easy, despite the fact that everything suddenly "looked fine", for the rest of the night. The next day Rachel called me to check on me and hear about what all they did at the hospital. Thank goodness for her expertise and discernment because as soon as I told her the sonographer took the measurement thru the abdomen she said "well I am pulling the trump card on this one and we are getting a repeat sono on you the right way. I will see if I can get you on the schedule for tomorrow with our best sonographer." Sure enough the moment he started the sono my cervix looked just like it does in that above picture....A HUGE funnel and half the cervical length the other sonographer measured. He was awesome he took his time and made sure to get as many measurements as possible. He let me look at the baby and showed me just how perfect she is...each and every little part. He measured and checked everything and it could not be MORE perfect in there as far as Audrey is concerned down to every last detail she is just growing and growing exactly as she should be. She is super long measuring 2 weeks ahead in her long bones and pretty much everywhere else. She looks to be about 1 pound 10oz and each body part is exactly as it should be. The ONLY concern at all is my cervix which seems to keep misbehaving.
So I left the office and Rachel and her dad decided that I needed to get home to Houston sooner rather than later (since that is where I plan to deliver) and be on strict bed rest. They both said that if I was delivering in Dallas they would most likely admit me to do a round of steroids for the baby just in case and get me on strict bed rest. They told me to call my OB on my way to Houston and update them with what has been going on and to have someone else drive me so that I could lay down in the car for the 4 hours to take the pressure off the cervix.
First thing the next morning (today) we headed down to Houston. My mom drove my car with me laying down and Jordan drove his. When I got in touch with my Houston doctor she told me to come straight in to see her when we arrived in Houston and not go home first. She said I should be prepared to be admitted for a least a few days but possibly more depending on whether things are stable.
We arrived by 1pm I saw the on-call doctor since mine was out of town. She did a manual exam and I was posterior and closed (which is excellent) but when she saw the ultrasound and my history she said she wanted to be aggressive. She called the high risk OB for a consult and they both agreed to be as aggressive as possible since I am not quite viable. SO they admitted me to L&D. I am told if things go well I will get to go home on bed rest after 48 hours of monitoring. They are doing a round of steroids for the baby's lungs JUST IN CASE. A round is actually 2 shots 24 hours apart. I got my first shot today at 3pm so my next one will be 3pm Friday and then we will go from there based on how my cervix looks and contractions and baby etc.
BUT WOW what a huge blessing for God to have put everything in place as He did. Not only for the blessing of having the Sudela's (some of my longest standing friends) to be able to take care of me in Dallas rather than me going to some random ER in a random hospital. And for Rachel and her dad to have the experience and discernment to say "no we are going to re-check your cervix the right way". For my mom to be available to drive me down to Houston at the drop of a hat and then help Jordan and the kids get settled in at the house and buy groceries and cook meals for us. For Jordan to be able to take care of EVERYTHING while I can't and for the incredible husband and father he is...I know the kids won't miss a beat while I am gone. For all the friends and family who have offered to help, or come down and make or bring meals or take the kids out to play what a HUGE blessing. For the fact that Jordan is HOME and not on the other side of the country playing ball. For the fact that we have a friend we can hire in the mornings to help out with the kids while I am on bed rest or in the hospital. For the many many prayers that have gone up on our behalf over the course of this and other pregnancies. I am totally confident that God will bring us through this as He has done before. Thank you for all of your prayers and concern. It means more to us than you know! Will update when I know more!