Inconclusive

I was afraid of that.

I went for my follow up appointment with Dr. T this morning.

His receptionist I wish I could have smacked her in the face. I specifically told her I was not to wait in the waiting room. I asked her to please tell the nurse I was there. "Oh it will come up on her screen" says she.

So I took myself off to the side and "held it together."

Thankfully the nurse came out not to long after and took us back. We did have an awfully long and cold wait in the exam room, more than an hour! Listening to some woman in the next room talk about her long and heavy AF's. Honestly there is no privacy in those rooms.

OK well onto the nitty gritty.

Why did we lost Gavin?

Answers: none

Possibilities of what precipitated preterm labour:

Incompetent Cervix -I had painless dilation to 3cm with "show."
Contradictions- 18w3d u/s showed cervical length of 3.6 which is perfect, and I have had one term delivery in the past where I couldn't delivery vaginally after 5 hours of pushing. He examined me and said my cervix was nice and long right now, but that doesn't mean it couldn't be weak.

Infection
Placenta pathology showed Chorioamnionitis. Problem is there is no way of knowing if the infection was present before labour.
Contradictions -I didn't show signs of infection like fever.

Abruption
Placenta pathology showed there were some fresh clots. Problem again there is no way of knowing if abruption happened prior too labour or during.
Contradictions- no bright red blood. Baby was not in distress.

So what does this all mean?? We are no further ahead then we were 3 weeks ago.

When can we TTC again?

As soon as I get AF and am emotionally ready. Dr T said the sooner the better.

What does all this mean for a subsequent pregnancy?

Referral to the high risk perinatal clinic by 13-14 weeks. Cervical monitoring by u/s every week starting at 18 weeks. If cervical shortening is seen emergent cerclage will be placed. Dr T. said I could have a preventative cerclage if I wanted but he did not recommend it because we don't really know if IC is my problem. He told me a sad story of one of his patients that demanded a preventative cerlage just a couple weeks ago (he didn't feel it was indicated) and her membranes ruptured during the procedure, of course this means she lost her baby.

ETA Dr. T also said I could do progesterone therapy to help prevent PTL. In Canada only suppositories are available not the 17P shots. I will do the suppositories I don't care how messy they are!

So for the future?
Going back to work: I think I will probably go back at the beginning of March. I have to give 4 weeks notice as per the law.
TTC: I called and left a message on the nurses line at the fertility clinic. Explained the situation and that Dr. T will be dictating a letter for Dr. M but he doesn't feel I need to wait or even have a consult. I just want the nurse to confirm I can just cycle when I AF arrives and I am ready, I supposed ultimately it's up to Dr. M to decide if he will provide treatment. He is a trained OB so I respect his opinion also.

I think that is about it.

Dr. T said again he was floored when he saw my name on the board in L & D that day and he couldn't believe that happened to me. Yeah neither can I.