Wednesday, September 6, 2017

Baby #3: The Final Trimester Story

Fast forward into the third trimester, a few changes had recently occurred.

The brief return and decision
While I returned to work a week after cerclage, about 4 weeks later when I saw Prof Azurah during my antenatal check-up at the Level 1 O&G Clinic at PPUKM, she had advised me to be on medical leave until delivery.  Finally, after a thorough consideration between the pros and cons of working under the current circumstances, I have decided to be out of work for the time being in order to accommodate the need to rest post-cerclage. 

Goodbye workplace...

Moments of serenity and storm
The first 2 months post-cerclage had been smooth-sailing as far as cervical length was concerned.  

Storm awaiting beneath the serenity

However, during my last appointment at the clinic on 23/8/2017 when I was close to 29 weeks, my cervical length had suddenly decreased to less than 3 cm, with funnelling.  Oh gosh, that immediately decided that I shall spend the rest of the pregnancy with bed rest in the uncomfortable Trendelenburg position at former home sweet home Ward 2B and 2 doses of Dexamethasone injections to help speed up fetal lungs maturity just in case if touch wood, preterm labour occurs.

10, 3, 2, 1.....
Right now, I feel like a time bomb ticking away to deliver anytime… even when I’m just relaxing on the bed.  The fact that the doctors would ask me about any contraction, discomfort, leaking and bleeding each time they make their rounds, hints that I am highly at risk to deliver anytime.  

Although I feel heavy-hearted to be away from Alvin and Aaron for don’t-know-how-long, it’s better that I’m in ward now just in case of any emergency.  Otherwise, I cannot imagine how soon I can get to the hospital if the baby is suddenly going to make its way out.  With a cerclage inside, it’s even 
more dangerous.

Myth and fact
So it’s a myth that with an early elective cerclage, I can be spared from same episode of events that I once went through with Aaron. Nevertheless, what I am going through now is not totally unexpected when I changed my mind and decided to try to conceive for one more time.  

There’s a sole personal reason for trying for Baby #3, anyway let’s just keep it in the heart… Actually, I don’t mind adopting a child, but in reality, the chance of finding an infant available for adoption is even more remote than finding a needle in the haystack (note: with reference to non-Muslim child adoption). 

There's no why
I used to, and still do, wonder how am I born with cervical insufficiency? I've never had any operation done on that part of me that causes cervical insufficiency.  My mom delivered me a few days short of 37 weeks as she had PPROM at 36 weeks, and my brother at 38 weeks.  Other than GDM and hyperthyroidism, my mom had no other known issue with her pregnancy and delivery (the good thing about being a former staff midwife, my mom kept her antenatal record cards very well and they’re still around).  In any event, I won’t be able to know my family medical history fully because my mom was an adopted child and I’ve never met any of her biological family members.

As humans, we can only plan.  And to embrace whatever that comes with the decisions that we’ve made.

Prof Azurah told “I’ll be happy if you manage to hold on to at least 34 weeks”, and although I look forward to go home as soon as possible, deep inside, I feel that it’s my obligation to carry Baby #3 to at least the minimum target, or 36 weeks if things turn out alright (fingers-crossed).  37 weeks will be a miracle to me. 

Be strong..... 
(Source: Classic FM)

Despite access to a few books and internet, I do feel bored in the ward.  But I must stay strong for this last baby.  Between the baby spending a long time in the NICU and me having to stay in the ward for more than 1 month, the latter is better. 

Although the survival rate of preterm babies at 28 weeks and above nowadays is more than 90%, they nonetheless face higher risks for a list of health issues.  This explains why very preterm babies are required to attend multiple follow-up appointments at various departments after they’re discharged from hospital – to make sure that everything is fine, and to be referred for treatment or therapy if problem(s) are detected. 

Conclusion
Looking from a brighter side, I’d better take this opportunity now to rest and relax whenever I can before the baby comes out.  But at the same time, to take care not to stay upright for too long, even by sitting down and writing too much.  

I’m supposed to lie down as much as possible, something which wasn’t possible while I was on medical leave at home earlier, which is probably why I suddenly have funneling as the fetal weight increased.


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