PTL. . . confused

Ok, to me this is almost unbelievable. My doctor sent me home from work yesterday due to contractions. They were 3 min 44 seconds apart. Without an exam he put me on terbutaline every 4 hours. He said I can return to work tomarrow because the contractions have dropped to maybe one an hour. I am 23 weeks 2days. Does this sound like normal practice? I thought he would want an exam. I just feel it was handled lightly.

 

Seems odd to me. I went into PTL at 24 weeks, they put the babies on a monitor and I was kept in the Labour and Delivery part over night. I was also checked twice, and I was dialating, but they managed to stop the labour. I was then moved to the ward and kept for a week, I was put on Adalat which is almost the same as you were one, told no more working, put on strict bedrest and had NST's twice a week.

 

I would ask your doc about his approach. Internal exams have been shown to increase the chance of PTL which may be why he didn't do one. But the only person who will know is him. You could also ask why he's comfortable sending you back to work & what you should be watching for. :hug:

 

Thanks ladies.

 

I'm sure different doctors handle situations differently. Get lots of rest and hopefully things will get better. Good luck.

 

As soon as PTL was detected in both of my twin pregnancies I was put on modified bed rest at home. First pregnancy in 2009 I was put on the tributeline...this pregnancy I was put on Procadria as he said he does not perscribe the tributeline any longer. If you are not comfortable ask...and if you still are not comfortable you are entitled to a second opinion. Good Luck~!

 

I am waiting for a call back now. Maybe I am overreacting but something just doesn't seem right.

 

absolutely unacceptable in my opinion.
1. always examine pt.
2. you cannot take terbutaline for this pregnancy. the american college of obstetrics and gynecology has shown fetal anomalies associated with prolonged use of terbutaline and it is not standard of practice!

 

I would think being that early and having PTL you would have been put on bedrest. I would not have been comfortable going back to work at 23 weeks after having PTL.

 

I am not comfortable either. My job is supportive so I may just stay home.

 

Follow your instincts, if it is making you feel uncomfortable then it isn't right. Did your OB call back?

 

I'm with horizon250. You should most definitely have had an exam to see if those contractions are dialating you or not. Best of luck and keep us posted.

 

Always good advice. :good: I also believe that when you go through ptl or cervical shortening it's your body saying slow down. I would be home, resting, indefinitely.

 

hmm that is strange. i know someone from our childbirth classes who just had her twins at 26w6d..she went in with contractions at 23wks and stayed in the hospital until they couldn't keep the babies in there any longer. so i'm sure they did an exam on her when she went in. i went in at 29 wks and the only reason they didn't check me was because i had just come from my OB's office and my cervix was closed. but when i went in at 31 weeks, they checked me and i was dilated.
i was put on bedrest at 22 wks because my cervix length went from a 4 to a 3 in 4wks. it was more of a precaution at that point but i am SOO glad i have been on bedrest because 2wks later my cervix was down to 2.5. two weeks after that it was still 2.5, so i think bedrest made a difference.
i have heard the same about terbutaline...more side effects for mom and baby. of course at this point, the benefits outweigh the risks, but i was put on progesterone and Procardia instead and in the hospital they used magnesium sulfate because i was dilating.
i would urge you NOT to work!!!!!!!!!!!!!!!!!!!!!!!!!!!!

 

I spoke to the nurse again (the doctor did not call back). She said just to keep the terbutaline with me and go to labor and delivery if it wasn't effective. I am just really bummed. I have never had preterm labor concerns and I feel let down by my doctor. Thanks for your opinions ladies. I will take your advice (the advice of experience) and take early leave. I am blessed to have an understanding boss and coworkers.

 

so glad you can take leave! i don't know if you can work from home or not. i did until i went to the hospital the first time for contractions.
i was also going to say...some Drs don't bother ordering bedrest because studies don't prove that it works. my friend was told to "take it easy" after the first time she was hospitalized. they told her they no longer order bedrest as protocol. two days later she was back in the hospital.
my Dr told me that while bedrest and meds are not proven to work more than a couple days or whatever, it is still better than not doing it. progesterone is not proven to work with twins, but he still recommended it for me because it can't hurt.
after reading so many bedrest success stories where doctors were amazed how far women made it with their pregnancies, i am convinced, and i don't care what the studies say. sometimes it's just impossible to prove something with a study!!

 

Stick to your mommy instincts.

I had ptl with my first starting around 30 weeks. I was in and out of hospital with terbutaline and mag sulfate. Eventually put on complete bed rest with home monitoring (the belt that connects to the phone) and a terbutaline pump. I had her at 36 weeks. My drs were very proactice about it all (I eventually had her because of pre-e, we just let the ptl go and I labored very fast)

Had ptl with my second starting at 18 weeks. Dr did exam me and put me on procardia. I was diagnosed with irritable uterus and told the contrax weren't doing anything not to worry. I didn't worry about them at all. At 35 weeks was told I was 3cm dialted, my water broke 3 days later. So he was born a day shy of 36 weeks.

With the twins I had contrax very early. I told drs, they didnt' seem concerned at all. Told them at every appt I went to that I was feeling a LOT of contrax. I would have way more than 8/hour and they never even bothered to monitor me. At my 28 week appt they noticed pre-e was settling in and I told them I had so much pressure and so many contrax. I begged for the shots for their lungs they told me they would talk about it at 29 weeks. They sent me home and told me to stay off my feet as much as I could. A few days later I went to l&d and was 5cm and 50% effaced. They were born hours later. To this day I kick myself for not standing up for myself and demanding more from my dr. I feel I got pushed aside very early on with these drs because of some things that happened earlier in my pg. I know tell everyone to never be afraid to ask to be examined or monitored. If you feel like something isn't right, just go to l&d. Better to get sent home being told its nothing.

 

Jen--omg!! i would be outraged!! first, you were high risk anyway because of your previous PTL pregnancies. adding twins to that, only further puts up a red flag!! my OB told me 6 or more contractions, i need to go to L&D. all of a sudden i had 9 so i went in and when they hooked me up, they said the contractions were 2-4 minutes apart!!! i couldn't feel half of them. i was dilating, so they did give me the steroid shots.
i'm so sorry they treated you like that!!!!!!!!!!

 

I am so sorry they are not taking you seriously. I would be looking for another OB at this point.

 

Jen, I had no idea! That is very scary.

I was ordered on hospital bed rest the day my water broke at 30 weeks. We never saw it coming. I think I'd just pushed my body too far. Rest is SO important.

 

What a difficult study it would be to show bedrest having a positive outcome when the only reason to recommend it is if the person is already high risk! Bedrest is a pain in the butt, but if it increases blood flow to the uterus and allows gravity to work with you to keep those babies where they belong, rather than against you. I don't know if it works every time but I'd hate to wonder, would it have helped if I had done nothing.

I had several episodes of contractions every 8-10 minutes for an hour at 21 weeks-turns out I have an irritable uterus coupled with a hyperdynamic cervix. I went on procardia and progesterone shots, got examined every week, and starting 24 weeks got ffn tests every 2 weeks. I also got the steroid shots at 24 wks just in case and went back on strict bedrest. I just hit 28 weeks (HOORAY) and there was a lot of speculation if I'd make it this long.

The point is, I feel like my doctor left nothing to chance and is just as invested in getting my babies to term as I am. If you don't feel that way, you should find someone else.

 

& what woman would agree to not do bedrest knowing that it *may* help keep her babies in longer?

ITA with the above.