2nd trimester monitoring/working

Hello all,

How were you all monitoring during your 2nd tri? My doctor is having me come in at 15 weeks, I talked him into an u/s because I have a subchorionic hemorrhage, he did not want to do it since he said even if it is still there it won't change their management. At my last u/s at 12 weeks they didn't see it, but I forgot to ask them to look for it. I also go in at 18 weeks for the anatomy scan and cervical check, then at 21 weeks for cervical check, 23 week for cervical check, and I think 24 week for cervical check.

My concern is that I have had a leep in the past, where they take a small part of your cervix off due to dysplasia. Am I crazy to want to get weekly cervical checks from week 18-24, when cervical incompetence is most prevalent? I realize I am probably a nervous ninny, but my husband and I have gone through IVF, thousands of dollars, months of anguish to get to this point. I feel like since I have twins and a leep in the past, weekly checks are warranted. I know that cervical shortening can happen quickly and without symptoms. I don't know how to fight for this though without being disrespectful to my doctor (who I really do like).

Also, I work full time with lots of walking and rather stressful job. What is everyone's recommendation for working? Ideally I would like to scale back or stop at 18 weeks since this is the risk period for cervical incompetence. I know this may not be necessary or a standard, but again, I want to do everything I possibly can for this pregnancy. Am I being overly cautious? Do doctors even excuse you from work just for precaution if my cervix isn't shortening?

Thanks so much for the responses

 

From my own experience I had an u/s at 6-7 weeks as a dating U/S and again around 10 weeks for bleeding. I then had nothing until week 20. I only say my doctor once a month my first 24 weeks. I went into PTL at 24 weeks, had an u/s then, was put on strict bedrest, and was told I was no longer allowed to work for obvious reasons. After that happened I had an u/s every 3-4 weeks until my baby B started showing a bigger size discordace around week 32. He always measured smaller.

I dont know what to tell you with your experience and worries. Honestly if I were you, I would probably feel the same way. I dont think you are being unrealistic in trying to make sure your babies arive healthy and happy. I dont know how you would broach the subject to your doctor though without sounding too pushy. Maybe write out a pros and cons list to have him look over as well as WHY you feel this way? Maybe that will help to present your case

 

I would just explain to him what your concerns are & ask him what he can recommend to help you feel better - ask him why he recommends the monitoring (or lack of monitoring) that he does & if you want more info, ask! Just keep the lines of communication open, try & understand his point of view the way you want him to understand yours. You will find what works for both of you. Also, ask about the benefits & risks of everything - while frequent cervical checks may make you feel better in some ways, there's also a slightly higher risk of premature rupture of membranes ("Interestingly, one common utilized procedure in modern obstetrics, the routine checking of the cervix in the weeks prior to the due date, has been shown to be linked to an three-fold increase in premature rupture of membranes.¹" Here's the entire post). There's no right or wrong choice, but it is important to understand the benefits & risks of all of your options, including waiting or not doing anything, when you are evaluating which benefits & risks are most acceptable to you.

 

Slipper and missbossy - Thank you so much for your replies.

Missbossy - are the cervical checks that may increase rupture of membranes manual? I was thinking transvaginal ultrasound check for lengths, do these too carry risks of frequent monitoring? I will definitely discuss my concerns with my doc in more depth next time. My first appointment with him there was so much to do and talk about I felt alittle overwhelmed and didn't get out all I wanted to.

Slipper - Thanks for your advice. I am glad they were able to prolong delivery for you when you went into labor at 24 weeks. Were you working full time up until then? Any warning signs or symptoms?

 

You are welcome. I was working full time up until then and was commuting by bus and subway and then walked about 15 mins to work. I did this too and from work. I did start to have BH aroound 18 weeks, but because it was my 3rd pregnancy since spring of 2007, I just chalked it up to that. I felt great. The morning I went into PTL I walked my oldest to daycare, it was pretty much up the street, then walked over for breakfast with my now ex. As soon as I sat down to eat I knew something was wrong. I had HORRIBLE back pain, the same type of pain I had when I went into labour with my oldest. I kept telling myself it was fine and just breathed through the pain. When we got to the hospital, I was going in for my 24 week u/s, I looked at Scott and said I think we should go to L&D. So up we went. Sure enough I was contracting every 2-4 mins. I was checked and I was 2 cm dialater and 60% effaced. I was given meds to stop labour, it took 2 days to calm the contractions and I was given steroid shots. I had 3 rounds of steroid shots altogther. I did carry them too 37 weeks though.

 

I remember feeling that way a lot at the OB - it always seemed like there wasn't enough time! I started carrying a small note book with me everywhere & anytime I thought up something I wanted to know or was concerned about, I'd jot it down. After that, the OB wasn't allowed to leave the appointment until I'd addressed everything in my notebook. I think she started to hate when I pulled that thing out. :laughing:

To be honest, I'm not sure if the risk is increased or not with a transvaginal ultrasound - that would be a good question to ask your doc. :good: