A month ago I noticed spotting without any pain so I went to my hospital. The doctors confirmed my cervix was closed and they couldn’t determine what was causing the bleeding. The doctors mentioned placenta previa but didn’t diagnose me with it.
I was scheduled to have the full anatomy scan the following day so the doctor felt confident to discharge me. Over the course of 5 hours I was still spotting but the baby had a heartbeat and no other issues were presenting itself.
We left and went home. Unfortunately, a few short hours later the bleeding increased, then I could feel my cervix dilating. We rushed back to the hospital. Once we got up to an exam room my water broke. I delivered our son, he had a heartbeat and the nurses gasped because he was moving on the bed. Sadly there was nothing we could do, he was just too young.
This has been so difficult, we are devastated at the loss. As much I don’t want to blame myself I do question what else I could have done.
We meet with the perinatologist in a couple of weeks. But the doctor did say that chances of finding out a specific cause could be difficult which doesn’t make things reassuring. I have a known fibroid but my OB said that it shouldn’t be a cause of concern.
I am reaching out to see if anyone has any advice? Or if anyone’s had these symptoms and what came of it?

I was 21 weeks and 2 days when I woke up with pain and bleeding. Rushed to the hospital to find out my cervix was fully dialated and they could see membrane. I was told at that point the only thing we could do was wait for the water to break and me to deliver him.
When we got to the hospital his heart was still beating, I could feel him move. But because he was only 21 weeks there wouldn't be anything they could do for him, he was just too young.
That was 4 weeks ago.
Due to the amount of bleeding they think that I had a placental abruption. They also think that there could have been cervical incompetence. Both things could have lead to preterm labor they think. I have no answers, just a bunch if "we think". If we have another pregnancy it will be considered high risk and will be monitored much more closely. But I still have no real answers of why I lost my son.

I have no advice, but want you both to know that my heart goes out to you. Sending thoughts of love and comfort.

Hi Eva, I am so sorry for the loss of your boy. I went into premature labor at 24 weeks (and eventually had to have an emergency c-section because he was breech). It started with very, very light spotting at the beginning of the day and then once I started having (light) contractions it was a matter of a couple hours before he was born. There were no other options other than to deliver him as I was dilated, and could have been dilated for a couple of days. It's hard to know, I was feeling great and eating normally, feeling his kicks the days before and really up to the moment I had some heavier bleeding with contractions. I did't know I was in labor and called my midwives multiple times that day with my symptoms, and asked them explicitly if I should go to the ER, and they said no, it was not a concern.

I opted out of an autopsy for my son, who lived two days in the NICU and then passed due to a lung bleed. I had extensive blood and placental tests however. I met with a Maternal Fetal Medicine Specialist about 2 months after my loss to review my records and to try to find out what happened. I did not have a placental abruption, there was no infection, my blood pressure was normal, and my son was very healthy (they ran dozens of tests during his short life). The doc said it could have just been spontaneous labor, or that something happened such as a braxton hicks contraction triggering labor. My cervix measured thicker than average the week before I went into labor, and the MFM checked my cervix when we met and said my cervix was long. Her conclusion was that, basically, there was no conclusion, and that MAYBE it could have been a shortened cervix, so they will look for that next time. Next time I'm pregnant I will also be getting the 17P shots to help prevent spontaneous labor.

I am meeting with a renowned MFM at Mass General Hospital in August to try to learn more through the same records, and to develop a game plan for my next pregnancy (we will wait at least 12 months between my delivery and next pregnancy to let the c-section heal and to prevent preterm labor next time).

Here's some of the questions I brought with me when meeting with the MFM:
review blood work and placental analysis results
cervix issues or spontaneous labor or both? One can cause the other
any infection present?
Any inflammation in placenta?
Braxton Hicks and Irritable Uterus
What kind of care can I expect to receive next time?
Can I come in whenever I want/need to?
How often will my cervix me measured?
How often will appointments and ultrasounds be?
Progesterone injections or vaginal progesterone suppository information.

I also asked many things related to my c-section, but they aren't relevant here so I didn't include.

Wishing you healing and I hope you are getting through the days okay.

<3

Allison, I'm so sorry to hear of your loss. It's difficult to read that you felt fine and then all of sudden things turned. It just doesn't make sense to me or to anyone else including medical doctors. I hope you had some peace and solace with your son while he was alive, even though it was probably extremely painful. I am so sorry you went through all of this, but thank you for reaching out to me. I really appreciate your input. I will definitely take those questions along with me when I see the perinatologist in a couple of weeks.
I also was initially told that I had a long cervix and the doctors that saw me in the morning really didn't have much to add, it was so frustrating. I will also be asking the perinatologist about placental abruption, incompetent cervix, and spontaneous labor triggers, the fibroid I have and if that is a risk, I'm rh negative blood type so thats another thing I need to learn more about...I don't know if I will have any answers at all from the autopsy but we decided there could be a chance to find something out. We'll see.
Please stay strong, you are in my thoughts and I will light two candles this evening, one for your son and one for mine. XOXO

Eva, thank you <3

I hope you get some answers when you see the perinatologist. What I found helpful too was to have my husband take notes as we talked. My doctor also gave me a copy of her notes afterwards. If I learn anything new at my appointment with the other MFM next month I will write back here.

I'm just hoping you get the answers you need to help settle those questions in your mind, as I know I relay the events of that day over and over and over in my head wondering where things went from normal to very much not normal. Sending healing thoughts your way, mama.

Allison,
I wanted to let you know we had our Perinatology appointment and some information came back. The results showed the baby was developing normally, he was healthy and no genetic issues were found. The placenta did not show signs of an abruption, I had thought earlier in my simple deductive reasoning that that had to be it. By all means the placenta was fine and healthy as well.

What was found was that I apparently had an intrauterine bacterial infection. By the time of this visit (Hart’s death) in May, things had gotten really bad. basically even if we had seen a high risk doctor that morning I was already too far along with this infection and no intervention would have helped. The doctor does not know how or why I got this infection, but he did ask what symptoms I was exhibiting, which were the lower back pain and fatigue prior to that May visit, nothing else so to me it was same old same old. I did have an ER visit in April for dehydration and my blood work showed a slightly elevated white blood cell count but very minimal. No alarms went off but I did email my OB (I wont go into detail but I was not thrilled with the response I received).
The day Hart died (May) my white blood count was above 20,000.....so in my mind more frequent and more educated eyes could have helped in some way. Maybe the outcome would have still been the same but there could have probably been an intervention to help fight off at that bacteria...

The other thing we discussed was my cervix length, this doctor reviewed the ultrasound images with us that were taken in May during that morning visit (they discharged us after 5 hours since symptoms were not increasing and Hart was alive).
The first ultrasound image he said looked like a long cervix and closed, the morning team did the measurement and I was at 3mm or maybe it was cm but basically it was a normal cervix range to confirm no shortened cervix. but the other ultrasound images showed a funneling or almost an opening (this particular image was taken at a slightly different angle and unfortunately at the time they didn’t measure these subsequent images like that first one). So this doctor said he wont diagnose me with a short cervix because he doesn’t have all the facts to make that determination in his opinion. So we are not clear if a shortened/weakened cervix caused the bacterial infection to flourish into my uterus or if the infection may have just been present for a while (asymptomatically) and caused my cervix to shorten.

We did discuss care going forward and yes progesterone suppositories would be indicated and bimonthly appointments and I have a direct line to him in case something feels off or if I am concerned about something. Clevage (not sure if I spelled that correctly) was also discussed as he does that procedure. If you feel like writing back you can do that here or at evachm@gmail.com
Alll the best, stay strong
-Eva

New to this post but relating to every word. I had a similar situation, slightly different because I had PPROM that was caused by some unknown bleeding, or that’s what is suspected. I had bleeding at 20 weeks that led to PPROM at 21 weeks and delivery at 23 weeks. Our daughter survived 44 days in the NICU, a true fighter but I’m still left wondering what happened, why, and what next? I am anxious for any future pregnancies because I do not want the same outcome. I’ve been told the same things by my OB: next will be high-risk, it could happen again but the chances are smaller because you will get more monitoring and P17 shots. I’m still petrified. I was told a few things that I question: 1. I had an abnormal placental cord insertion that no one had mentioned as a contributing factor but after some research I found out that abnormal cord insertions almost triple the chance of preterm labor and PPROM. 2. An unseen or undiagnosed sub chrionic hematoma might have caused bleeding and increased contractions leading to preterm birth. 3. My PPROM caused me to deliver early.

No matter the cause, I can’t get over my anxiety for the future yet I can’t not think about not getting pregnant and having another beautiful baby with me here on earth. My despair is killing me. The anxiety and PTSD of my daughters birth is making life unbearable. Any words of advice on how to overcome or at least quiet those voices? Also, any update on subsequent pregnancies and the care you have received? I’m trying to schedule a pre-conception appointment with a local MFM for a second opinion.