We live in an age of medical miracles: premature infants living when born 2-3 months early, diabetics having healthy infants, infertile couples giving birth, adoptive mothers breastfeeding their newborns.This is the story of Jessica and Mark Kline* battling infertility and preterm birth. At 20 weeks pregnant they came to the OB Department of Downey Regional Medical Center, complaining of possible labor. They had been to a fertility clinic, were successful, and wanted to be reassured everything was normal. An examination showed preterm contractions, Jessica's cervix was beginning to open, and the membranes were starting to come through. Fortunately, the membranes weren't broken. She was immediately given medicine to stop the contractions and placed on bed rest, in trendelenberg, meaning the bed was positioned so her feet were elevated above her head. Jessica's physician, Dr. Kaplan, was hoping gravity would push the membranes back inside the uterus. When that didn't happen, with the assistance of Dr. Fukishima, they performed a cerclage. First they used a catheter to gently push the membranes back in place and tied the cervix shut. This actually took several attempts, according to Jessica, who lay there listening to them working to save her baby. Then it was seven weeks of bed rest in the hospital. Mark slept at her bedside every night, alternating between a floor mattress and a cot. When the immediate danger was over, Mark resumed going to work but still spent his nights at the hospital. Jessica had her hair shampooed in bed by the nurses, and they took her to the patio in bed for some sunshine. She memorized the TV schedule, got caught up on some reading, and played some video games to relieve the boredom. Finally she was allowed to go home, but still on partial bed rest. At home she relearned to use her legs and was allowed out of bed only to shower and use the restroom. At 37 weeks, Dr. Kaplan removed the cerclage and they waited for labor. Several times they came in experiencing false labor and were sent home. At 39 weeks Jessica finally gave birth. Their healthy son is almost 3 years old. He is an active and exuberant toddler, with the typical terrible two's personality. And the good news is that Jessica's current pregnancy with twins has been uneventful. She has had a cerclage since 16 weeks, is home on bed rest, and at 33 weeks all is well.
*Names have been changed to protect patients' privacy.
********** Published: June 26, 2009 - Volume 8 - Issue 10