Questions for those who have or had a high risk pregnancy (including Metformin, Heparin and/or had a cerclage)

nonny
#1. June 28th, 2009, at 1:29 AM.

High risk is just a medical term that obstetricians use to describe mothers who have a higher than average risk of having health problems during their pregnancy or birth, or of delivering a baby with problems. Common risk factors are insulin-dependent diabetes, high blood pressure, or signs of premature labor. This term only reflects a statistical probability that a problem may occur in your pregnancy or with your baby; it is not an absolute prediction, and you, in fact, may have no problems at all.

We prefer the term “high-responsibility” pregnancy. Our term means more than using specialized, more attentive medical care and a high-tech hospital; it implies that you must take greater responsibility for your own care and for your own birth decisions. Instead of resigning yourself to the high-risk label by becoming a passive patient and leaving all the birth decisions up to your doctor, become a high responsibility mother. Take an even more active part in the birth partnership. You need to be more informed, more responsible, and more involved in decision-making than the average mother, and you need to take better care of yourself.

The first question you should ask your doctor after you are classified as “high risk” is what specific things should you do to lower your risk.

UNDERSTANDING A THREATENED MISCARRIAGE
Later in pregnancy a miscarriage will be more obvious. The bleeding is heavier, and often includes the passage of clots. Uterine contractions can become very intense. Sometimes these signs and symptoms signal an impending miscarriage – called a threatened miscarriage – rather than a completed one. In general, the longer the bleeding occurs and the greater the accompanying symptoms of pain, the more likely this pregnancy will end in miscarriage.

Call your doctor if you suspect a miscarriage. If you suspect you’re having a miscarriage, call your healthcare provider immediately, especially if you are passing clots or grayish-pink tissue. If your bleeding is heavy and persistent, or your pelvic pains intensify, go to your nearest emergency room. (Try to collect some of the tissue in a jar. It can be examined to confirm the presence of fetal tissue and, if desired, to determine whether or not the genetic make-up of the tissue is normal.)

If you have miscarried – your practitioner will perform a vaginal examination to determine whether the miscarriage is complete (you have passed all the tissue) or incomplete (some of the fetal tissue still remains in your uterus). Miscarriages that occur prior to eight weeks are usually complete. The later in pregnancy a miscarriage occurs, the more likely it is to be incomplete. If your healthcare provider determines that your miscarriage is incomplete, he or she will probably want you to have a D&C (dilatation and curettage). While you are under general anesthesia, your cervix will be dilated and any retained placental or fetal tissue is removed. During this procedure the doctor may attempt to determine the possible cause of the miscarriage by examining your uterus for any structural abnormalities. He or she may also send a sample of the fetal tissue to a laboratory for genetic analysis. Since there are many other reasons for vaginal bleeding, your doctor may choose to do an ultrasound to confirm the diagnosis of miscarriage before doing a D&C.

If you have not miscarried – your doctor may just send you home. Or he or she may monitor you with ultrasound and blood tests.

ONE MISCARRIAGE DOES NOT LEAD TO ANOTHER
If this was your first known miscarriage, your risk of having a second one is only slightly higher than if you never had a miscarriage, especially if your first miscarriage showed a chromosomal abnormality, it occurred early in pregnancy, or you have previously given birth to a healthy baby. Even after experiencing two miscarriages, your chances of having a third one are not much higher than if you never had one. For example, if you have had two miscarriages, you have a 65 percent chance of carrying your next baby to term; a woman who has never miscarried or has had only one miscarriage has roughly an 80 percent chance of carrying to term. After three miscarriages, however, your chances of carrying your next baby to term go down to 50 percent. After three consecutive miscarriages, you would be wise to have a complete obstetrical evaluation to see if there are any underlying medical reasons that could cause you to have future miscarriages. If no reason can be found, you may reasonably assume that you still have an excellent chance of delivering a healthy baby.

Sarah
#2. June 30th, 2009, at 11:34 PM.

I had an emergency cerclage placed at 15 weeks and placed on complete bedrest with the exception of showering and toilet use. Stool softeners don’t help me either. Eat LOTS of whole grains, fruits and veggies… but especially drink TONS of water (constipation occurs when our colons/intestines “suck” all the water from our waste). NEVER push, especially with a cerclage! Just let it gradually come out. You may be sitting on the toilet for 20 minutes or longer (I did), but do not push. It will eventually come out, however painful it may be. Also, do not hold it. If you have to have a bowel movement, the longer you wait to go, the more constipated you will be.

shears200
#3. July 1st, 2009, at 7:54 PM.

well i read this and i am very hope everything will come out okay for you and this babe. For the consitpation try flax seed in oatmeal or just oat meal period i scraffed to bowls a day at home in like 2 mins but you will go you will want to check with you md the flax never caused cramps for me but it may for you and we definately don’t want that. you may also try a colonic basically an enemma to wash you out
and the water is the best bet have you partner of a frined go to walmart you can get 5 -72oz jugs to fill with water and put ing the box fill them up at night and have one by the bed and you will never have to worry about getting dehydrated again hydration is the key to all. especailly if you cann’t push at all i hope this is helpful

p.s. also see if you can have a midwife come in sometiem they know about herbal rememdies and you her and the md can talk about something that won’t interfer with your meds and your cerclage