I just had a question. My best friend is pregnant with her first child. She is 26 weeks. She has a tilted cervix and uterus. Cervix measured 26cm to begin with at 12 weeks, then when measured at 20-21 wks it was 19cm. She has been having contractions and they have put her in the Fetal intensive care unit. they have been giving her the meds to stop contractions every two hours, which has lessened the intencity but she is still having them. she has been on bed rest for 2 weeks and they just admitted her back in the hospital today. they have given her 2 steroid shots thus far.
my question is this...whats the % rate of viablilty for a fetus that young? I want to know this for my own peace of mind. i'm not going to tell her, because i don't want to upset her. she is at one of the best hospital's here in ohio, but i think her doc is a quack! my opinion only! if anyonce can answer this or give me any info on premee's i'd appreciate it!
To answer your second question about cerclages, let me start this time by stating that I've been out of OB/NICU for awhile, so someone may have more current info than I do.
But, to the best of my knowledge, an OB will not do a cerclage on a patient who is actively contracting, for 2 reasons. First of all, a cerclage will not stop the contractions, which are the likely cause of the cervical changes, so you would be attempting to fix the wrong thing. Secondly, if the patient continues to contract, and the cervix continues to dilate, a cerclage may cause tearing to the cervix.
A truly incompetant cervix is one which dilates (usually painlessly and without warning) solely from the weight of the growing pregnancy. For these patients, who are not contracting, a cerclage may be effective in saving the pregnancy. But for a woman who is contracting, a cerclage will likely be useless, and potentially dangerous. The only circumstance I can think of when an OB would consider a cerclage on a contracting patient is if she has an incompetant cervix and contractions which are caused by an unrelated, treatable cause, such as a UTI or dehydration. Then, once the contractions have ceased, a cerclage may be in order.
A history of PTL in one pregnancy is not an indication for a cerclage in a future pregnancy. Again, if contractions are the reason for cervical changes, a cerclage would not be safe or effective even if placed prior to the start of contractions the next time around.
Thank you all for answering my questions. I used to work at a larger hospital (250-350 births per month) and now am working in a much smaller hosp. (30-35 births per month) and as such we do not usually get to treat these ladies with riskier pregnancies for long, only until the transfer team can get there, but you never know what may happen and appreciate the ability to keep current on what is recommended if for no other reason I can give accurate info. to my pts. about to be transferred.
Jolie, BSN
6,375 Posts
Brandy,
To answer your second question about cerclages, let me start this time by stating that I've been out of OB/NICU for awhile, so someone may have more current info than I do.
But, to the best of my knowledge, an OB will not do a cerclage on a patient who is actively contracting, for 2 reasons. First of all, a cerclage will not stop the contractions, which are the likely cause of the cervical changes, so you would be attempting to fix the wrong thing. Secondly, if the patient continues to contract, and the cervix continues to dilate, a cerclage may cause tearing to the cervix.
A truly incompetant cervix is one which dilates (usually painlessly and without warning) solely from the weight of the growing pregnancy. For these patients, who are not contracting, a cerclage may be effective in saving the pregnancy. But for a woman who is contracting, a cerclage will likely be useless, and potentially dangerous. The only circumstance I can think of when an OB would consider a cerclage on a contracting patient is if she has an incompetant cervix and contractions which are caused by an unrelated, treatable cause, such as a UTI or dehydration. Then, once the contractions have ceased, a cerclage may be in order.
A history of PTL in one pregnancy is not an indication for a cerclage in a future pregnancy. Again, if contractions are the reason for cervical changes, a cerclage would not be safe or effective even if placed prior to the start of contractions the next time around.