Hi everyone. On 10/18/17, at 22 weeks pregnant, I was at work and started having contractions out of nowhere. I felt a little weird the night before, just gassy and had a little more discharge, but nothing out of the ordinary. This was my first pregnancy, but I knew because of how the pain was going in and out every few minutes that it was contractions. My husband and I went to labor and delivery about 2 hours after calling the advice nurse and they confirmed I was in labor. Sadly, I was already 5 centimeters dilated and nothing was going to stop the birth. I had to deliver our little girl and she did not survive. Thankfully Kaiser was amazing and so was my husband in supporting me. The mental pain of this happening is still very raw, and I think about it everyday. Now we are to the point of meeting with a perinatologist next Thursday (it feels like it’s taken forever to reach this appointment!). Since we only got one test result back so far (Tissue Chromosome Analysis was negative), I know they will be going over more results at the meeting since we did do an autopsy. I had a very healthy pregnancy, did the genetic testing (everything was fine), and had a long cervix on the last ultrasound I had around 19 weeks. I know it could be cervical insufficiency, or it could be something they can never explain. I’m hoping to get some ideas of what questions we should ask or any insights into similar experiences with this type of loss. Thank you!

Hi Jessica - I’m so sorry this happened to you.

I’m not 100% sure if this is the type of question you mean, but our son was born in March this year at 20 weeks, with subsequent testing (and also presenting symptoms at the time) attributing this devastating event to an intrauterine infection (although they can never be 100% sure). You could ask if any tests were conducted on the placenta? Presumably they will tell you this though.

You could also ask, if you are emotionally in this place, to ask how long they advise before you try again. Different doctors recommend different ‘pauses’.

My thoughts will be with you next Thursday xx

I’m so sorry. I would ask what the plan of Care would be if you become pregnant again? Would they put in a preventive cerclage? What other steps would they take? Maybe the autopsy/placenta report will have some clues too. Often (or at least where I live), MFM doesn’t do deliveries, hey do cerclages, amnio etc and the ultrasound techs have extra training. I found mine to be of great comfort first when I met him and his geneticist (they each spent over an hour with us) and then in my subsequent pregnancy. He and OB were great team. Sending you courage. That was a hard meeting.

Hi Jessica, I am so very sorry for your loss. I went into spontaneous labor when I was 28 weeks pregnant, and similar to you, I had a healthy pregnancy, and no symptoms until I woke up with contractions. We went to the hospital an hour after calling the nurse, and while my son was born healthy but for his prematurity, he died in the NICU when he was a week old. I have had a few appointments with a perinatologist. My goals were to understand why I went into preterm labor and what kind of care I would receive if I did get pregnant again. One of the hardest things was that I did not get any answers on why it happened, but I do have a better understanding of care.

Here are some of the things I went over:
Why
- autopsy results
- placenta analysis results
- any issues with my cervix
- Papp A results and could that have been an indicator that something was wrong
- Stress and how that could have affected my pregnancy
- Infection
- IVF and preterm labor (I conceived via ivf)

Next time
- What kind of care will I recieve
- How often will my appointments be, scans etc
- Will my cervix be measured more frequently (vaginal ultrasounds are more accurate)
- Will I be a candidate for Makena starting in my second trimester (Makena is a synthetic progesterone that has shown to reduce the risk of preterm labor by over 40%. Doctors need special approval from insurance since it costs tens of thousands of dollars).
- What about vaginal progesterone suppositoris during my first trimester?
- Should I take baby asprin during a subsequent pregnancy
- What kind of exercise should I do
- If I need to go into triage every day during my 27th/28th week, is that ok.

Hope this helps, and again, I am so sorry. Grieve well.

Thank you all so much for responding! I wrote down a lot of what you suggested and feel much more prepared for when we go in for our appointment today. I know we may not get any real answers, and that's really hard to think about. I'm just hopeful that we can try again, though that thought scares me so much too after going through this first loss. Thanks again everyone. I really appreciate it!

Hi Jessica, I am so sorry for your loss. I am curious if you ever received any answers? Your story is very identical to mine. It has only been a week since our son Bennett was born at just 23 weeks and 3 days. He fought hard in the NICU for 24 hours before passing. I also experienced some pains earlier in the day that seemed to be just gas. Later that night I started having contractions. Within an hour we were at the hospital and I was completely dilated. I had to have an emergency C section. The physical and emotional pain is unbearable. This was our first child. Our entire world has been turned upside down in a matter of hours. I just want answers. I want to know why this happened to us. I had a healthy pregnancy, no complications, no bleeding, nothing at all that would have led to this horrifying ending. I am broken. I have a post op appointment tomorrow and hope to receive some answers. Were you ever given any answers on why and how it will effect future pregnancies?

Hi Megan, first of all, I'm so so sorry for your loss. Though it has been a few months since we lost our little girl, the pain is still very raw. We have been continuing to heal emotionally, and you will start to feel that too, just know it's going to take a lot of time and a lot of difficult conversations. Our pregnancies sound almost identical.. Going to our Perinatolgist did give us some answers that we didn't think we would get. He had me go through all the events leading up to our loss (so similar to what you described) and immediately said it sounded like I had an infection. He pulled up all our results from the autopsy and confirmed that. The autopsy results showed a fetal inflammatory reaction, caused by Fusobacterium nucleatum. I guess this is usually found in people with periodontal problems, which I don’t have. But, he said we are around bacteria all the time, and unfortunately for some unknown reason, this bacteria got to our baby. It was some really, really bad luck. My Perinatologist is very optimistic that this was a one time problem, and it shouldn’t occur again with another pregnancy. Leading up to this appointment, I thought for sure he was going to say I had an incompetent cervix, but because of the fact that I had contractions (that you don't have with an IC), that was the clue that made him think infection. We are trying again and there will be a whole different plan in place with my doctors if we are able to conceive again, which is very reassuring (although I know it would eliminate my fears of another loss). We will be part of a preterm labor program, have a lot more ultrasounds and appointments. I'm more than happy to chat more or try to answer any other questions you might have, so feel free to e-mail me: jessmf5@gmail.com

I'm hopeful that you can get some answers and direction at your appointment tomorrow!