Ah ha!

So I belong to an infertility site where there is an ask the RE forum. I still have SO many questions regarding my loss of Gavin and the more I read and the more time that passes the more questions I have.

I did submit a question to the RE and it got answered....I am so excited about that.

Here was my question and the resulting answer:

We are preparing to ttc after a loss at 20w6d. My Doctors are unable to pinpoint the reason for my loss. Basically I had some mucous discharge with a tiny bit of blood some brown some red. When I was finally checked at l & d (same day)I was found to have hourglass membranes, ultrasound revealed a cervix dilated to 3cm. This led to the initial diagnosis of incompetent cervix. We were going to attempt a cerglage however I went into real labour a few hours later and delivered. The pathology of the placenta revealed "early acute chorioamnionitis" and also a "recent retroplacental hematoma." Because I have had 1 prior full term birth (cesarean) The doctor's do not want to assume incompetent cervix, although I had a very difficult delivery which included a prolonged second stage and an extension of the uterine incision to/through my cervix. So basically we are stuck with the question of what came first.

As part of my work-up to ttc again I am having a full thrombo work-up (just in case) and another HSG just in case the chorio infection caused damage to my tubes. I basically have two questions:

I read that a lot of clinics RX antibiotics for those having an HSG. This will be my third and have never had antibiotics, but considering the recent uterine infection would it be a good idea to absolutely make sure there is no infection resulting from the HSG or even if there is something still lingering in there? (I did get IV antibiotics while in hospital during/after delivery.)

I have also read about the HSG being helpful in a incompetent cervix diagnosis. Would an HSG be able to divulge anything other that a structural abnormality?

In Victoria we routinely use prophylactic antibiotics before doing an HSG. We ask our patients to take Doxycycline 100 mg orally twice daily starting the day before the HSG.
Although an HSG might give some information about your cervical competence - your history is so suggestive of cervical incompetence that I would strongly suggest that you have an elective cerclage at around 12 weeks.
Just to reassure you - the chances of tubal damage from the type of infection you had with your midtrimester loss (chorioamnionitis) is actually quite uncommon.

All the best

Dr.Stephen Hudson
Victoria Fertility Centre.

I really feel in my gut that there is a problem with my cervix. Dh and I were discussing on the way home Friday about having a prophylactic cerclage. I am generally the type of person who is agreeable with her doctor's plan of action. But the "wait and see" plan of action that has been presented to me is scary. Especially when my gut instinct is so strong.