Fortunately, our doctor did pull off the difficult surgery, delivering Thomas and placing the transvaginal cervico-isthmic cerclage (TVCIC) to close Laurie's cervix. They also gave her some tocolytic drugs to stop her labor. It took a few hours, but Laurie's contractions subsided and she seemed to be stable. For the first few days, the doctor told us to just take it an hour at a time. Laurie spent about 3 more days in the hospital on bedrest. A few days later, Laurie was discharged and we headed back home. The first few weeks were incredibly stressful. Laurie was on fairly strict bedrest at home for the first week and was taking her temperature multiple times per day to watch for signs of an infection. Laurie went from not taking any medications in the first half of the pregnancy to a regimen consisting of amoxycillin, azithromycin, prenatal vitamins, Colace, vitamin C, and Motrin.
We were told that most Delayed Interval Delivery attempts fail within the first few weeks, and if we made it through 2 weeks our chances would go way up. The biggest risk was infection, which often occurs because the cervix opening for the first twin's birth breaks the important infection barrier that keeps the uterus sterile during pregnancy. The fact that Thomas' membranes didn't rupture until Laurie was in a sterile environment in the operating room was likely a significant contributing factor as to why Laurie avoided that most common Delayed Interval Delivery complication.
We were told that most Delayed Interval Delivery attempts fail within the first few weeks, and if we made it through 2 weeks our chances would go way up. The biggest risk was infection, which often occurs because the cervix opening for the first twin's birth breaks the important infection barrier that keeps the uterus sterile during pregnancy. The fact that Thomas' membranes didn't rupture until Laurie was in a sterile environment in the operating room was likely a significant contributing factor as to why Laurie avoided that most common Delayed Interval Delivery complication.
In those first 2 incredibly stressful weeks, we ended up back at labor and delivery 3 times. The first time, Laurie woke up at 3 AM about 5 days after the surgery, shaking uncontrollably and hyperventilating. Our doctors were concerned it could have been signs of an infection, but it turned out to just be a completely understandable panic attack as the emotions and stress of the week came crashing down on Laurie. One of the nurses at labor and delivery told Laurie she needed to just "get over it" during that visit. A few days later, our OB was concerned that the antibiotic regimen used after the cerclage was placed had given Laurie C Difficile, but once again it was a false alarm as the tests were negative (though we also were given incorrect instructions on how to collect the stool sample for testing, and Laurie ended up having to do that multiple times). Finally, exactly 2 weeks after the cerclage was placed, Laurie had a suture come out in the toilet when she went to the bathroom. We went into a complete panic, thinking it was the cerclage or something holding the cerclage in place, but it turned out to just be a small dissolvable suture that was supposed to come out. Nobody had told us to expect this, and the nurses made us feel kind of stupid for even thinking it could have been the cerclage. Each time we were sent home, still pregnant and clinging to hope for a miracle.
After those 3 false alarms, the remainder of the pregnancy was about as routinely as a high-risk pregnancy can be. Laurie was put onto a more modified bedrest directive and was told to just be a couch potato. We continued to have an OB appointment or ultrasound every week. She got a progesterone shot each week. Laurie's cervix quickly funneled above the cerclage, but the TVCIC held tight and she remained pregnant and stable. We soon learned that Baby B was a boy, and decided on the name Milo. Around 23-24 weeks, Laurie got a dose of corticosteroids to help mature Milo's lungs, given our extreme risk of preterm delivery.
As the weeks went by and we reached viability around 24 weeks, we finally at least had gotten to a gestation where Milo would have a chance. Every day we waited for things to destabilize. The days passed slowly at first, and then gradually faster and faster. Before we knew it, we were at the crucial 28 week mark where most babies ultimately do fine in today's NICU's. Suddenly our MFM doctors started getting more interested as it seemed like this pregnancy might actually result in a healthy baby--we weren't the only ones keeping hope alive, finally. The "finish line" for Laurie kept moving--first it was 24 weeks, then 28, and finally term at 37. We began really preparing to bring this baby home as the weeks flew by into the 3rd trimester. Laurie began having regular non-stress tests and biophysical profiles along with growth ultrasounds, but every time Milo would do great and looked "textbook perfect." Laurie was even taken off bedrest after 34 weeks.
Ultimately, Laurie made it all the way to term, in the process breaking our surgeon's personal record for the longest interval between twins at 130 days. This is one of the longest ever recorded intervals between twin births, and one of very few Delayed Interval Delivery attempts that ever reached term for the surviving multiples. We know we have been incredibly lucky, though Laurie likes to say she's just that stubborn!
Milo was born on July 10th, 2012, the same day that Laurie's TVCIC was removed at exactly 37 weeks gestation. She went straight into labor after removal and he was born 8 hours later. He weighed 5 lbs 11 oz and measured 19.5 inches long. Both Laurie and Milo did great, and he was discharged from the hospital on a normal newborn schedule after 2 days.
Next: Read the final chapter of our story and meet Milo's little sister, Nora Josephine, who was born 3 years later.
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