A Little Background

The 2 obstacles that we are facing this pregnancy are 1) An antibody and 2) Cervcial Incompetence. I have posted some links on the side about each of these but wanted to give you a good summary here.

At the beginning of my pregnancy, I tested positive for an antibody called anti-Duffy. I developed this defense in my blood after being exposed to the blood of the baby that I miscarried in November of 2007, hence it has not been an issue in previous pregnancies. Due to this "alloimmunization" I now have, this baby could potentially become life-threateningly anemic. To monitor this, my blood is drawn once every month and based on the result (called a "titer") it is decided whether or not it is necessary to do a procedure called an amniocentesis, where a needle is inserted into the uterus through mom's tummy and a sample of amniotic fluid is obtained to determine how the baby's blood is looking. For those of you who are familiar with Rhesis Disease (or Rh factor issues), my condition is similar with the exception that the alloimmunization I have is much much more rare, and therefore there hasn't been a shot developed to give during pregnancy that protects the fetus.

After my miscarriage in the fall, I decided I wanted to switch doctors. At my first prenatal visit in January of this year my new obstetrician informed me after looking over my records that I might need to be considered high-risk (and this was before we even knew about the antibody). The reason being because I had suffered a significant cervical laceration (or tear) during the delivery of my last baby. I knew I had the laceration and that it was repaired, but I had no idea that it because of it, my cervix was now damaged and could potentially become weak during a subsequent pregnancy. Apparently, having a laceration like that is pretty rare, but given the circumstances, it does happen sometimes (who knew a 9lb 13 oz baby might do such damage??). So with seeing one similar case like this during her training as a resident, my OB decided it was best that I get the extra attention that might be necessary from a specialist and referred me to a doctor who specializes in Maternal Fetal Medicine (aka: an MFM). With that began multiple ultrasounds (one every week starting at 14 wks) to check on the integrity of my cervix. 3 wks into this routine, at 17 wks, it was discovered that my cervix was indeed starting to weaken and efface (thin out). The doctor (whom I was meeting that day for the first time due to the MFM I had been seeing being on vacation) decided that I should be admitted to the hospital immediately and have surgery to place a stitch called a cerclage either that night or the next morning. The surgery was done the next morning and was successful in that we avoided any of the complications that come with doing surgery at that point in pregnancy. The successfulness of the cerclage being a solution to the problem as a whole is yet to be seen. I remained in the hospital for several more days and was sent home on strict bedrest, meaning my activity privileges consist of getting up to use the bathroom and taking a shower.

So far, so good. As of late, my cervical length measurements (used to determine how my cervix is holding up and still occurring weekly) are BETTER than expected! I recently got to add sitting up at the table during meals to my short list of activities. My antibody titer is still being monitored and so far has not resulted in needing to have an amniocentesis performed. We are currently awaiting this month's blood work results...