What are the complications to the infant born between 21 and 28 weeks? What studies have been done on emergency cerclage? How effective is this procedure?
My daughter is 21 weeks pregnant. Scans show the infant is developing normally. Her cervix is opening and thinning and the membranes are showing but not bulging. Her physicians gave two options: bedrest which may extend pregnancy 3 to 4 weeks, emergency cerclage which may extend the pregnancy as much as 28 weeks. 1. What studies have been done on this procedure? 2. What are the implications to the newborn of delivery at 28 weeks? i.e., what physical problems may arise, what are the percentages? My daughter is an OB/GYN, so has indepth knowledge of the issues, but she is the person on the other side of the desk and is as concerned as any mother to be. To terminate knowing she may give birth to an infant with the potential for multiple birth defects or to continue the pregnancy knowing the potential outcome is a psychologically traumatic event. Double with this is her first pregnancy and she is 41, concerned that she may not be able to get pregnant again. She is in excellent health. I said I would support her in any decision she and her husband make. This is not enough. I need some good data including neonatal complications and hopefully some potentially good news as most of what she is reading and has been told gives totally bleak outcomes for the health of the baby. Would appreciate answer asap. p.s. my daughter does not live in the USA. The specialists in London, where she lives, has done much research on the topic but I would like to know about research in our county. I understand studies have been done in Lehigh Valley, Pa. What do you know about this?
Thanks for your Reply!
My daughter had her baby at 25 wks 5 days ( here in the States ). After 14 weeks in the NICU he was able to come home on oxygen. There are some develpomental delays ( you have to adjust age ) but all seems well. He has chronic lung disease from being on the vent for almost 6 weeks but they say he might out grow it. He also has ROP and had a PDA.
About the only thing she can do is bedrest, feet up higher than her head....thats what they did for my daughter. And pray!!! The longer she can carry the baby the better. I think that once she gets to 23 weeks they can give her shots to help the baby's lungs.
I know its got to be hard on you being in a different country...I am sure your pacing the floors with worry. I will be praying for your daughter and the baby.
I don't know much about the studies that were done, but I have heard that the cercliages help the pregnancy reach closer to full term. I think there was someone in this forum that had it done before. But the cerclage is there to help a weakened cervix.
Candy 26, DF 37, First baby! EDD 1/6/12, Dennis Samuel or Chastity Grace. Team Yellow Rocks!!!
If it were me, I would do the cerclage. There are several studies out there about micro-preemies and while some of them do amazingly well, others have severe problems that may take years to grow out of or they may never grow out of. No one knows what the outcome of an individual baby will be in advance. The closer to 40 weeks one can get, the better.
Survival rates really depend on the level of complications present at birth. And while they show more and more of the littlest babies are surviving, many of them will be plagued with health problems for the rest of their lives.
Having dealt with European health care, the standards are pretty much the same as in the US. My son was born in Germany as we were stationed here and the experience was very similar to the US. The UK doctors are pretty comparable to the US ones, too.
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