My Pregnancy Journey with Cervical Insufficiency -Part 1

My first pregnancy was back in 2010. I was 27 year old, had just got married a few months prior, and was working as an Anaesthesia resident medical doctor in a government hospital here in Johor, Malaysia. I remembered I had a slight per vaginal bleed at 16 weeks pregnant, got a few days to be off work and continued on working as usual. I had a bad case of hyperemesis gravidarum ( intractable vomiting during pregnancy) during my first trimester, but it had disappeared like magic by my 12th week of pregnancy.

All was good then, I’d never missed my antenatal follow ups, scans were normal and up to date. We were happy, expecting the pregnancy to progress smoothly. My work, at that time, was mainly in the operation theatre, running cases, also covering pain clinics and epidural in labour. Being a doctor, I was definitely active at work, not letting my pregnancy to be in the way. Little did I know, Allah had a different plan for me.

I was on call on that day. It was midnight, and I was sitting in the oncall room having just finished a case in the operation theatre. I was informed that an intraabdominal injury case was on the way to our operation theatre from the emergency department requiring an urgent laparotomy. I got up to get my theatre and team ready, when suddenly my water broke!!At 20 weeks pregnancy. A gush of fluid came out but I wasn’t in pain. Yet.

I rushed to the Labour assessment room, which coincidentally happened to be in the same floor as my operation theatre. I had a fellow colleague to check on me, and was told my cervix was 3cm dilated, and the baby I was carrying had very slow heart rate. My heart. Just. Sank. That meant I was literally on the verge of having a miscarriage, and being completely aware of it. I started to have abdominal cramps and it was painful. My husband was outstation for work and my parents was out of town too. The hospital called my husband up and he rushed back home that night.

I was scared and worried of what was going to happen. Near- panic even. They did a repeat scan on me the very next day and the baby was gone. No more fetal heart was seen on the ultrasound. I ‘delivered’ later that day in the labour room with intravenous pitocin (induced labour). To make matters worse, as the umbilical cord was too thin, it had broke mid way while trying to get my placenta out. They couldn’t get it out manually, so I had to be pushed urgently to the operation theatre for removal under general anaesthesia, or else I would have bleed profusely. How irony that was.

I was discharged the next day and was given 1 week MC (off work). No follow up was given to me, just advised to come back if anything. It was a very traumatizing experience; being pregnant, delivered, but had to go home without a baby to nurse was just too much to take on. I took my time to heal, and allowed myself to slowly get better, physically and emotionally.

Second trimester miscarriage is NOT NORMAL. Second trimester is between 13th to 27th week of pregnancy, and it is quite rare to have miscarriage this late in pregnancy, about 2-3% of all pregnancies. I don’t wish for anybody to have to go through this, but if you ever do, it warrants further investigations. Please get yourself checked post miscarriage, to try to determine the cause of it, and to let go. The answer may not be easy, or you may not even find the cause. To know deep in your heart that no one is at fault, including you, is crucial. Healing will be a long journey and it can be painful at times but you will definitely get there. Be strong.

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