Tuesday, January 14, 2014

Meeting with our MFM

We met with our Maternal Fetal Medicine doctor today, and I left feeling rather frustrated. First, they will do an ultrasound every four weeks to check on the babies growth which is great. However, they will only be checking my cervix at our anatomy scan, and unless it is short or I show symptoms of an issue they will not check it again. She cited that there is nothing they can do, and that they don't even really recommend bed rest anymore because it hasn't been shown to help.

Okay, ummm. Yeah. I want to be proactive, and I don't see how bed rest would hurt anything. I understand that bed rest means a risk of clots, but if your cervix is shortening I would imagine that bed rest would help alleviate some of the weight/pressure off of it. I don't see how watching things and being aware of an issue could hurt either, what harm would more cervical checks do?

I left feeling very dissatisfied with things, and I do plan to talk about this more with my OB on the 28th. I'm pretty sure she said we will begin monitoring my cervix at some point, not that we would just monitor it once like this MFM said.

Otherwise, the babies both looked great. They did a very in depth scan: we saw all four chambers of their hearts, full stomachs, livers, brain parts, and all that good stuff. Both babies are measuring about a week ahead and weighing in at an estimated 4oz each. So that's great. Baby A was where I always find it with my doppler, and didn't really move from that spot during the scan. It rolled some and wiggled, but remained stationary. It's placenta is posterior, a bit to the right. Baby B was moving around all over, just like when I'm trying to find it with the doppler. It was everywhere, and very uncooperative (reminds me of how V was). The placenta was a little anterior and to the left.

My favorite bit of the scan was when she was measuring baby B's feet (or trying to) and it started kicking at baby A's feet, who in turn kicked back! And they proceeded to kick each other for a bit. It made me laugh, and it definitely made things a lot more real too.

We will be 15 weeks on Thursday. Hopefully things will continue going well, and I can do my best to ensure we get the care we need.

Edited to add for clarity- the cervical checks I'm talking about our by ultrasound to check length, not the checks performed later in pregnancy to check dilation.

9 comments:

mommacommaphd said...

This article looks more at the evidence behind bed rest- risk v. benefit.

http://www.slate.com/blogs/expecting_better/2013/08/19/bed_rest_during_pregnancy_doctor_s_orders_to_curb_premature_labor_but_there.html

Also, this study looked at the postpartum effects of antepartum bed rest and found that it hinders recovery- http://onlinelibrary.wiley.com/doi/10.1177/0884217504274416/abstract

The evidence seems mixed- or really, that there is no conclusive evidence it helps.

As for the cervial checks, my practitioners always mentioned the risk of infection as a reason to do them only when indicated. Seems your MFM only thinks it's indicated once? Seems to early to make that call, but I'm not an OB.

Glad everyone is doing well! Congrats!

jessiwallace said...

I am so glad everything is going well!! I would definitely talk to the OB about the cervical checks. My guess is they don't want to risk exposing you to infection, which is inevitably a big risk when checking the cervix at all. That said, if I was carrying twins, I'd be just as concerned about wanting to keep that cervix in check... maybe your OB would be willing to check more often for you.

AnotherDreamer said...

Yeah, I had considered the infection risk but she said it's fine to have intercourse and everything else and I would think you'd have a higher risk of infection from that than a sterilized vaginal probe, you know? The same goes with cervical irritation, just seems contrary. Her only reason for not wanting to check more often was because, as she told me, there is nothing they could do if it was shortening. Which also contradicts what she said later, about how if it was short at our anatomy scan they would check more later. Why bother if there's nothing they can do, like she said? It just seems like a logic fail to me.

Rebecca said...

Why won't they check the cervix more often if you request it?

AnotherDreamer said...

According to her there's nothing they can do, so why check. I will be discussing with my OB and requesting more checks though.

psugradgirl said...

Is there a reason that you would need cervix checks so early? It's common to not check until 36 weeks or so of pregnancy for all of the reasons listed above. They will be able to make sure it's not shortening at your ultrasounds. My MFM doctor also told me that unless they suspect an issue, it's better to leave it alone at this point. (I'm also carrying twins). Not sure if you can demand a cervical check....dr either does it early, or doesn't.

AnotherDreamer said...

I want more frequent checks because of the risk of preterm labor and incompetent cervix with twins. I have several friends who lost their twins at 20-22 weeks due to those issues. The cervical checks I'm talking about are via ultrasound, to check length, not by hand. My MFM has said that they will only check it once by ultrasound.

blueeyedtawni said...

awweeeeeee they look gorgeous . I hope your OB listens and recommends something different.
Hugs

psugradgirl said...

Got ya, yes it should only take an extra few seconds to look at the cervix during an ultrasound... That is really odd then!