Wednesday, November 3, 2010

chorioamnionitis and Incompetent Cervix

I have reading posts from a lot of women who are terrified of chorioamnionitis. In layman's terms, chorioamnionitis is a infection within the uterus during pregnancy. It is especially complicated for women with Incompetent Cervix. I am going to try to discuss it in easy to understand terms below. My hope is that it will provide information and maybe ease some minds.

The first reason it is complicated to a woman with IC is the confusion it causes while trying to get a diagnosis of IC. Because the infection can actually cause labor-including dilation, it can make doctors leery to diagnose a woman with IC. It really is a chicken or an egg problem. Did an incompetent cervix opening up allow bacteria to enter the utuerus causing the chorioamnionitis, or did the chorioamnionitis cause premature labor opening the cervix? Doctors are hesitant to perform a cerclage for future pregnancies if there is even a little possibility that something other than IC caused the dilation.

The second reason is the fear it can cause a woman after a cerclage has been placed. If infection occurs, the cerclage may have to be removed which would result in a second loss. Some doctors place the woman on preventative antibiotics, but most don't. Doctors don't like to introduce chemicals into a woman's body long term without just cause.

Now for my experiance. With Mason, the test results came back positive for severe infection in the uterus, ambilical chord, birth canal, and Mason himself was septic. However, you must remember that I was dilated for almost two weeks before I had the placental abruption which ended the pregnancy, and Mason's life. For my pregnancy with the twins, I had the cerclage, but was not placed on antibiotics. Infection did not occur this time. Anytime you introduce something into the birth canal there is a risk so I was very nervous about cervical checks, but my doctor was careful.

I hope this helps explain things and ease your mind. Feel free to post questions.


Glo said...

I would love to know what you know or your doctors have told you about getting chorio without IC. In other words how it got in there.

I am that chicken egg thing. What came first? I had acute chorio. In placenta not in cord.

Went to l & d with some change in discharge and ended up being 3cm dilated. Went into labour several hours later.

Stephanie Shaw said...

This might be a little r-rated, but here is what my doctors have said.

Essentially the vagina is an excellent breeding ground for bacteria. It is warm, wet, and that makes for the perfect temperature for bacteria to live and feed. Bacteria can be introduced in any number of ways, here are some of the most common.

1. Intercourse- a man or his partner can have bacteria on their hands from everyday life. During foreplay, the bacteria from the hands is transferred to the penis and during intercourse the bacteria from the penis enters the vagina.

2. Bacteria can be transferred from such simple things such as wiping after using the restroom.

3. Cervical checks-during routine exams, bacteria may be transferred from the donctor's hands or instruments into the vagina.

The cervix is usually your best line of defense during your pregnancy. However, with IC the open cervix allows bacteria to very easily enter the womb. Especially if a woman is unaware that she has IC and has had intercourse. During sex the man's penis pushes the bacteria right into the cervix-essentially hand delivering it right to your womb's front door.

My doctor banned intercourse from 8 weeks on to decrease the risk. It sucks, I am not going to lie, but it is amazing what you can do without complaint when it is for your baby. I had two older children who are little germ magnets, so I even took it one step further and used my own roll of toilet paper that I kept under the sink to prevent getting germs from them touching the roll with unclean hands. That may be a little extreme.

In your case, there is no way of knowing, all that you can do is try to prevent it in the next pregnancy. I am so sorry for your loss and I pray for you to get answers and have a healthy future pregnancy.