Failed Body or Fluke?

I have been exhausting myself the last couple of days. Literally, spending hours on hours researching on the internet about IC (incompetent cervix). I slept for almost 15 hours last night. It was much needed might I add!

So, why have I been spending so much time researching something when I was told, “It was a fluke,” anyway? Well, honestly in nature, there are not a lot of ‘flukes.’ On my pPROM loss support group sites, a lot of mom’s losses are ‘flukes.’ Then, they go on to have another pregnancy and whoa… look… another ‘fluke’ loss. So, I started digging, reading every single woman’s story (and let me tell you, I have read HUNDREDS of stories).

I have noticed that mine is different from the majority. I was able to hold off labor for nearly 7 weeks after my rupture. Most last between the minutes and days range. So, that is why I was deemed a ‘fluke’ and not a failed body, IC. Honestly, if you have read some of my posts, you know that I didn’t even go into labor. I had an emergency c-section that turned out I didn’t need to have. I could have stayed on bed rest longer and as they say, ‘kept them cookin.’ I’m not mad at that though. I might not have even been able to meet my girls if not for that (but that is a different post).
But, if James and I do try to conceive again, I don’t want to lose any more children to a ‘fluke’ or otherwise. NO MORE PRETERM LABOR OR pPROM IF I CAN STOP IT.

So, I made a list of all the facts about my pregnancy that I was given or knew.

I have ‘non-traditional’ blocked fallopian tubes (caused from scaring by multiple PCOS cyst ruptures)

My RE HIGHLY recommends that I have my tubes removed (He said they are an absolute mess via laparoscopic exploratory surgery)

I can only conceive via IVF

We transferred 2 embryos, both implanted (currently have 4 frozen)

This is was my first and only pregnancy

(Afternoon) 19 weeks 6 days I had the ‘long’ ultrasound to check on the health and growth of my twins. During this ultrasound the woman doing the ultrasound was pushing very hard and it hurt. I was in pain during it. I was told my cervix looked fine and was at 2.7 and we would need to keep an eye on it. I went back to work and had cramps all day, pains, and slight spotting. I was told this is normal after this long exam.

(Evening) That night around 10:30 PM, my water broke on twin A. I was hospitalized for 2 days then sent home on bed rest to ‘wait it out until I deliver.’

I was re-hospitalized at 24 weeks and given steroid shots.

I had minor contractions (that I didn’t even feel, they just showed up on my monitor) at around 25 weeks 5 days that lasted about 10-15 minutes.

I woke up with bright red bleeding 26 weeks 4 days and was put on a monitor. It again showed minor contractions (this time I kind of felt them) and was told not to worry, this sometimes happens. We would not be doing an emergency c-section.
The contractions stopped after about 10-15 minutes, but when the Doctor was pressing in around the top of my stomach I experienced fundal (?) pain. She said this meant we would have to do an emergency c-section. I delivered my daughters at 26 weeks 4 days. Willow lived 16 hours, and Hazel lived 8 days.

POST OB VISIT:

I was told my pPROM was a ‘fluke.’
My cervix was fine the day of pPROM and all through my time at the hospital it was fine and stayed shut. I did not have an IC. Plan of action for future pregnancy would be bi-weekly cervical scans, p17 shots, and steroid shots. I was told that pPROM is a risk with IVF pregnancies, especially those with multiples. I would always be facing this risk. I asked about a TVC, she said it was unnecessary in my case.

POST RE (specialist) VISIT:

I was told again my pPROM was a ‘fluke.’ “The only think wrong with your pregnancy is you didn’t take a baby home from the hospital with you.”

He reviewed the file and said with my cervix being checked the day of my pPROM, everything looked fine. That sometimes with IVF this happens, especially with twins. I did not have an IC.

My Questions that still remain:

If, this is true of IVF, would a cerclage (stitch in cervix) even help?

If it would, what would be the best for me? (TVC, TAC, TVCIC)

TVC: (Transvaginal Cerclage) Put in vaginally around week 12 of pregnancy to hold the cervix shut.

TAC: (Transabdominal cerclage) Put in abdominally. Can be put in before (preferably) pregnant, but also while pregnant. Is permanent and requires all future pregnancies be delivered via c-section. Is a pretty major operation from what I gather.

TVCIC: Put in vaginally and like a TAC in placement (higher up than a TVC but slightly lower than a TAC), can be placed before or after pregnancy. Permanent or removable.

Am I willing to take the risks of a cerclage?

Risks if done during pregnancy: Provided http://www.uofmmedicalcenter.org/healthlibrary/Article/40902
• Infection
• Premature contractions
• Premature labor
• Premature delivery
• Premature rupture of membranes (PROM or pPROM)
• Pregnancy loss
• Tearing or rupture of the cervix if labor begins before the stitch is removed
• Injury to bladder
• Risks of anesthesia

If I opt for a TAC, how many more c-sections can I safely have? I already had one to deliver my twin angels.

A lot of the moms on the support site are HUGE advocates for TAC over anything. But here lies my problem. The best TAC doctors are states away and most insurance doesn’t cover the surgery. I would need to get is soon, so that if James and I try again, we don’t have to wait for years. I have no time I can take off from work at this point for surgery. My job has been amazing with me, and I don’t think I could ask for more time off for a surgery. The TVCIC and TVC would require little down time, but mostly are placed while pregnant. I am firm that I will not do these while pregnant given the risks unless ABSOLUTELY necessary.

I am sooo confused as to what to do. Do I just wait, possibly try again and see where it gets me? I personally know one lady who pPROMed with both of her pregnancies! She came to visit me in the hospital, granted both of her incidents ended in happy endings with little NICU time and I believe 36w+ deliveries.

I read stories of mom’s with previous losses that had a TAC and still had pPROM. So, it may be a wash for me if it wasn’t IC that caused it.

I conclusion, I am still confused, still don’t know what to do, and still looking. God, please provide me with what to do. I am trusting you and giving you control.
I have been exhausting myself the last couple of days.