Hi

I posted here about two weeks ago regarding what I thought were contractions. I called my OB's office and got the midwife,and everyone here recommended I speak to an OB. I called back at 11:00 am and the OB returned my call at 4:00. He told me "what did I expect I was having triplets",to hydrate myself and take it easy. So I that's what I did. I went to the peri at High Risk the following day and a cervical length check found thatmy cervix had shortened from 4.0 to 2.89. They told me to take it easy, but that they were not concerned.

That leads to my scheduled OB appointment this week with my regular OB. I went in, felt great.. he read the report from the peri and decided to do an internal. Lo and behold I was a finger tip dilated and he sent me directly to labor and delivery. He told me to go straight there and to plan on spending the weekend there. This was New Year's Eve.

I get to the hospital and the monitor my contractions and the other OB is on call... the one I spoke to at 21 weeks.... he can't understand why I am there.. does a cervical length check and tells me I don't need to be in the hospital. He sends me home. With a see ya next week.. and ups my terbutaline from twice a day to three times a day.

So - after all that - Here I am wondering which doctor is right.. Am I having preterm labor and should I be monitored? or should I be home?

Also, how many of you use or have used HUAM. My doctors have not metioned it, and my contractins are painless most of the time so I have a hard time keeping track of them.

Thanks for listening.... I would appreciate all advice!

Annette
23 weeks
boy, girl, girl triplets
edd May 5, 2004

I am sure others will have more info, but I think you need to find a Maternal-Fetal Specialist who has experience with multiple births. I would not trust a regular ob to have enough experience to know how to handle a triplet pregnancy. Just my $.02.

Ken
Husband to Ann
Dad to Sarah-12,
Joshua, Kyle and Jessica(07-07-
03)

I too would be very concerned about the contradictive evaluations of your cervix between the OB and Peri. Is you Peri. also a fetal-maternal specialist? Does he have any experience with higher order multiples. I am 22 weeks and see my fetal maternal dr. weekly for a vaginal ultrasound, and I don't like it when he is out of town because everybody seems to have their own opinions on what is normal! Some Dr.'s don't know how to handle triplets, my Dr. turned me over to the states best specialist as soon as the triplets were discovered. I'm not saying your Dr. is not qualified, but what a horrible state to leave you in. Am I dilated or not? What confusion! I'm so sorry you have to go through this during such a crucial time in your pregnancy. I too have been having contractions daily and have been on home bedrest since 16 weeks, but have remained pretty stable and have maintained a cervical lenghth of 3cm. so far. Every week my peri. tells me to bring in my hospital bag for good luck, snd so far I have always bring them home with me. I know he is very conservative about the changing of your cervical length, and feels that when your contractions are changing your cervix you need to be admitted and medicated with constant evaluation. I know every Dr. has different views, but I really hope you can get this figured out! Until then take it real easy, and hang in there. This is not fair to you!

Kari
mommy to GG 4yr.old twins
GBG edd 5/08

Congrats on your triplet pg, what a ride you are in for!!! I would be and was really nervous too (my whole pg)! I never saw my OB during my pg, only the peri. Here's what happened to me...

At 22 weeks I thought I was getting the flu, called the peri, he told me to come right in to the hospital. They monitored me, and I was having contax, but didn't know it, plus I was dehydrated... kept me in the hospital for 2 days until I could be hooked up to a terb pump thru MAtria (home monitoring service). After that I was on strict bedrest, only up for the bathroom/dr visits... I carried to 35 weeks, all 3 were born at 5 lbs.

I had a cerclage put in around 16 weeks as a precautionary measure. Personally I don't feel comfortable with what your dr's did. I would get in with a specialist quickly if it were me...wishing you the best of luck and please keep us updated, my email is cmtk57@yahoo if you have any other questions, I do check it daily.

Carol
Mom to Rex, Owen, and Macy, born 9/4/03 at 35 weeks!!!!
Will be 4 months tomorrow!

I think being PG with triplets warrants you being seen by a peri and not an OB. When I found out I was having triplets, my OB wouln't even see me anymore. Peri's are just more experienced with HOM.

I will tell you my experience this past week. I was also 23w6d the day after Christmas. Something didn't feel right so I called my peri. They told me to goto L&D. Come to find out I was having a lot of contractions that I wasn't feeling. That previous Monday I had a routine cervical check. It measured 4.6cm. When the peri did a check of my cervix on Friday it changed to 2.3. Basically my cervix shortened in half in less than 4 days. They admitted me to the hospital. On Monday morning they checked my cervx again and it was 1.4cm. The next day on Tuesday it measured .9mm. Wednesday morning I had surgery to put in a cerclage. My peri checked my cervix on Thursday and my cervix measured 2.8cm. I am now on complete bedrest and the doctor said I most likely will be in he hospital until I deliver.

We both are at a critical time of whether or not the babies would survive. My doc wants to get me to at least 28w because then my boys have a good fighting chance.

The advice I could give you is to get to a peri to monitor your pregnancy. They are more experienced and equiped to handle this type of pregnancy. Also error on the side of consertive when it comes to your body. If you think something is happening, it probably is. My doc told me if I waited another week to come in, I would have probably lost my babies.

Good luck and you will be in my thoughts.

Shelly

Mom to identical BBB triplets born 2/18/04 at 30w5d

Annette, how confused & frustrated you must feel!

Okay, here's my take - get rid of your OB's, they are obviously NOT qualified to manage your pregnancy!!! From your description you are very likely experiencing Incompetent Cervix, a very common way to have a miscarriage in the 2nd trimester. It's just as big a threat to a triplet pregnancy as pre-term labor. The fact that your cervix had that big of a change in a short time is terrifying to me. I developed IC at 23+ weeks and had to have an emergency cerclage to save my babies. Thank the Lord my peri was more thorough and caring than what your doctors sound like, as otherwise I'd have probably miscarried!

I am just speechless that you are even seeing an OB at all, or that you are conferring with a midwife. These people are simply not trained or educated or experienced in high-risk pregnancies. Please, do whatever you have to do, say whatever you have to say, but make sure you are managed by a peri from this point forward. Do it for the sake of your babies.

FYI, home monitoring is not the normal standard of care anymore. While it is strongly touted in the Execptional Pregnancies book from TC, and while many women here have had it, it is no longer as common as it used to be.

Please take it easy. I urge you to put yourself on bedrest immediately and be extremely conservative from this point forward. Your doctors obviously do not care about you or your babies!

Tulip & The Three Amigos
Born at 35w5d on December 31, 2002 - Happy New Year's Eve!!!
Aimee, Let's bump heads!
Edward, Rollin' Rollin' Rollin', Got to keep on rollin'!
Hope, Bouncy! Bouncy! Bouncy! WHEEEEEEEEEEEEEEE!!!!

YES! You *can* breastfeed triplets!!!
http://www.tripletconnection.org/dcforum/forum1/14349.html

Tulip & The Three Amigos
GBG born at 35w5d on December 31, 2002 - Happy New Year's Eve!!!

YES! You *can* breastfeed triplets!!!

I am a Velveteen Rabbit, and the birth, love, kisses & magic that are my children has made me Real.

Bingo!!! Good for you, Tulip!!!

My doctor told me early on that the HUAM company folded back a couple of years ago, so it really is not commonly done anymore!!

What in the world is going on here? A "midwife" advising re contractions on a triplet pregnancy? Yikes.

Please get in to see a maternal-fetal specialist. The cervical changes evidence a problem -- and, upping dosages of terbutaline is questionable. First, terbutaline has a limited time-window of usefulness. Once exhausted, it will not be effective, and you can overload on terbutaline causing other types of problems. Second, if you are experiencing cervical changes, those need to be closely monitored even as they are attempting to get them stopped. There are other drugs that will likely be more effective.

If you need the names of excellent doctors in your area, please post for the names on this site, as there will surely be some women in your vicinity who can provide you with the names of competent specialists.

Cat

Cat w/3 Kittens
Caidan, Carina and Caeleigh
Born at 31 weeks, 1/8/04.

Annette,

Congratulations on your pg and making it to 23 weeks!

I would strongly encourage you to go as conservative as you can. If your gut is telling you something, follow it. If you feel like your OB isn't being conservative enough for you, change practices. I was told that contractions alone do not mean PTL, but contractions with cervical changes does. ANY type of cervical changes at 23 weeks should be treated as PTL. Your babies well beings are way to important.

My peri worked in tandum w/ my OB...it sounds like that is how your peri works, too. (Some peris deliver babies, some do not). Try asking your peri to reccomend a good OB practice that has expereince with TRIPLETS (not just multiples, since triplets are different than twins).

You want to make sure that you are comfortable with your team and that you (the team) are working together to make sure everything is being done to keep you and your babies safe.

Best of luck! I hope we here from you again at 37 weeks for your scheduled C-section

April
Mom to ^i^ Hannah, ^i^ Ryan and ^i^ Abby. My 3 little birds in Heaven.

Joey, born 5/8/05 (Mother's Day!)
Laura, born 5/26/07
^I^, ^i^

A butterfly lights beside us, like a sunbeam
And for a brief moment, It's glory and beauty belong to our world..

Hi

Thank you so much for your postings. The peri at Yale Maternal Fetal Care told me that the dilation of normal at this stage in pregnancy. I have an appointment with Yale at 12:15 on Thursday, and with the OB that released me on Wednesday.

So what I gather from reading the posts, was MY OB was completely correct in sending me to the hospital and his collegue and the hospital were wrong to send me home. (I was seen by a peri during my short visit to L & D)

I HATE to bother you guys with this but... what should I be vigilant in watching for? What indicators are there to "tell" me there might be a problem. I am modified bedrest... in bed 10-12, 2-4, and 7:30pm on.... I can get two quarts of water down, but not the recommended gallon due to severe acid reflux...(It just rolls right back up!)

All advice is again welcomed.. thank you. I trust your advice more than these doctors lately... and Yale is supposed to be one of the best!

Annette

Annette,
Hi & congrats on wk#23. It sounds like you're getting some confusing & conflicting advice from the OBs. I would only see the peri from this point forward, besides you DO NOT need to be running to all those appts, especially if they aren't giving you advice that you can easily follow or understand. From my standpoint you should have been in L&D. Are you on terb pills? or do you have a pump in place? I did have, do recommend, & would FIGHT for the HUAM. It gives much needed piece of mind knowing that something is reading contrax other then you. I had many,many,many that I did not feel at all. I went over 10 wks being a fingertip or 1cm dilated(doctors fingers come in different sizes). I had a pump, was on indocin, & used HUAM 2xs a day. I was in & out of L&D 3xs for a MAG rounds & terb shots.
Next time you are at the peri, I would have a real heart to heart about the OBs advice. Ask him for the HUAM, & if he feels that you need a stronger med to keep the uterus in check. It's hard to say what you should look for, but if you feel something is wrong then it probably is. You are the babies front line of care, & should never feel that you can't say, ask, request,or demand help, care, etc... Too dang bad if they feel you're being too proactive. What do they expect"you are carrying triplets!"(his words right?) I went to 33.4 wks & feel it was all the teamwork involved from Docs listening to me, reading stuff from TC, & fighting for my HUAM(a monitor at home costs less then 3 babies in a NICU). Plus, you hired them They didn't hire you! You are in CHARGE!
I think at this point you should be in bed FT. Sorry to say it, but you really need to stay put now. Showers & bathroom breaks were all I was allowed. It was tough, but I needed to do that for the babies. I drank as much water as possible. I know you're having trouble with it, but use Crystal Light or something to flavor it. I also drank a lot of lemonade & milk some days, just to get the fluid in me. Eat as well as you can. Many tiny meals thru the day instead of big ones. Have good snacks handy to munch on-my fave was nuts!!! No need to worry about fat content now, & they are so good for you(legumes). Another fave was Wheat Thins crackers w/ no salt. Also, go to the bathroom often. A full bladder can kick up those contrax.
Good luck at your next visit & keep us posted,
lou mom to Justin 19, Luke Zach & Jake 4 and Tess 2

Annette,

Congrats on making it to 23 wks. I would demand that I have a dr that is very aggressive. It is common to have preterm labor starting at 18 wks. I would also definitely ask to be put on a HUAM. My boys are 4 yrs old so I haven't heard about them not being used as much anymore, but if you are having contractions and/or cervical change you should definitely be monitored. It is VERY common that you will not feel any contractions, so it is really difficult to tell you what to look for....Obviously, contractions, spotting, cramping, back ache. If you were on a HUAM you would at least know if you were having contractions.

I had a dr that was very aggressive. I was put on modified bedrest at 15 wks with no complications, and then I was sent to the hospital at 21 wks just to monitor contracitons due to a very slight change in my cervix....sure enough I was having contractions every 3-4 minutes and didn't even know it. I had no dilation but was admitted into the hospital to be monitored. He could have sent me home on a HUAM, but he felt more comfortable admitting patients and having them monitored more closely. I was told I could have been having uterine irritability, but with triplets they are treating it as pre-term labor as they really don't know what causes cervical change. I'm so thankful that I was in the hospital. Throughout my hospital stay I never did feel any contractions, and my cervix suddenly dilated to 3-4 cm at 24 wks. I had no more contractions that I had been so nothing was different, I all the sudden dilated. I was put on complete bedrest and my water broke at 26 wks 2 days and my boys were delivered that evening. To this day I am so glad that I was watched so closely by my drs. My boys are now 4 1/2 yrs old and have no serious long term complications from being so early.

I was seen by an OB every 2 weeks until I went into the hospital, and was seeing my PERI every 4 wks. But my OB worked very closely with my PERI. After I was admitted to the hospital I was seen on a daily basis by both my OB and my PERI.

Good luck!

Angel (mom to Justin, Andrew, Brandon 9 yrs, Angie 15 yrs)