Effacement, PUPPP, Group B Strep and Dilation: Qué Será

This afternoon we had the 36-week doctor’s appointment or I guess I could call it a nurse’s appointment since our doctor is still out of town.  I really hope he is enjoying Disney World with his family and is all rested and ready to go when he gets back.

We learned some new information about my state.  Titer score continues to go down so the Rh-isoimmunization concern is pretty much gone at this point.  Yay.

My Group B Strep swab came back positive which I was a little surprised by since it was negative with Belén.  I guess 25% of women carry GBS so it is not uncommon but another annoying thing to deal with during labor.  In short, once labor starts, I will need to take some antibiotics to prevent the baby from contracting the bacteria which can be quite dangerous to her.  If you are interested in reading more about it, I found this helpful article which puts the risks of the baby contracting the bacteria at 1 in 4000 if antibiotics are given.  One concern I have is that if labor goes fast would they have to slow it down until the antibiotics kick in?  I guess we will cross that bridge when we get there.

In the last couple of days I have developed an itchy belly which quickly developed little red bumps that itch like crazy.  This is called PUPPP.  According to babycenter.com,

Up to 1 percent of pregnant women develop a condition characterized by itchy, red bumps and larger patches of a hive-like rash on their bellies. This is called pruritic urticarial papules and plaques of pregnancy (PUPPP) or polymorphic eruption of pregnancy.

PUPPP usually begins in the third trimester and is more common among women carrying twins and those having their first baby. The eruptions usually show up first on the abdomen around or in stretch marks (if you have any) and may spread to your thighs, buttocks, and arms. PUPPP is harmless for you and your baby, but it can itch like crazy!

I have been getting some relief from pure Vitamin E oil but I might try some Benadryl cream as recommended by the nurse tonight as well.

Being this is our second child and that I have taken multiple pregnancy-related classes, I should be completely educated on dilation and effacement.  Turns out, I still didn’t fully get it as it has been one of those topics I sort of let my eyes glaze over when being discussed figuring I would learn it when I needed to.  Today, after much probing (the nurse clearly does not do this as efficiently as the doctor), I learned that she *thinks* I am about 75% thinned or effaced and am dilated to 2-3 cm.  Another surprise because I certainly don’t feel any different from last week.

Even after her explanation and analogy to a banana, I still didn’t get what effaced meant, so I did some research tonight and found this picture which definitely educated me on my current status.

I am thinking my cervix looks a bit like the bottommost picture on the left.  So definite progress towards labor but apparently I could stay like this for weeks.  I hope I stay this way until at least next Tuesday when my doctor is back in the office.  Actually if I have it my way she will wait to progress much more until after Belén’s Birthday Party on the 16th but these things can always be rescheduled.

My reaction to all of this new information could quite easily be panic but I have had kind of the opposite response.  I suddenly feel like the only thing I really need to do is pack my labor bag and all of the work I have left to do and items on the TODO list without checkmarks could just disappear into the fog of new babyland.  I do hope to dot some more i’s and cross a few more t’s before the day comes, but if not, once again, qué será.


Erica@PLRH April 7, 2011 at 8:07 am

You’ve got a great attitude! The best you can do is get ready and wait.

I tested positive for Beta Strep with my second son. However, he came early before the test results were back. I didn’t have any antibiotics during labor and luckily he didn’t get infected. You and baby will be just fine.
Erica@PLRH´s last blog post ..Life With Boys- Shortest Person in the House

Margy April 7, 2011 at 8:14 am

Alecia, Funny after three births my OB was not present at any of them. Sadly I would have the kids on his day off or in Taryn’s case I came so fast the St.Luke’s OB Resident and Intern were the only ones there to literally step in on such short notice. I felt sad about not sharing the birthing moment with hiim after the relationship you develop from all the prenatal visits, however when it comes right down to it all you want is to deliver the baby and you will take who you get. Good luck, it does sound like it is getting close, my thoughts are with you for a beautiful birthing experience. Can’t wait to meet little Eloise Mae!

alecia April 7, 2011 at 6:59 pm

You know it’s funny, I never understood why people thought it was such a big deal when their OB didn’t deliver their baby but now I totally get it. You DO develop a close relationship and I trust him so much, it’s hard to think about spreading my legs and trusting all will come out okay with someone I don’t even know. But I am sure it would regardless of who is there to catch Miss Eloise. Thanks for sharing your story!

Jen @ Mommy Tries April 7, 2011 at 8:27 am

Hi Alecia–I tested positive for Strep B, too, which meant I had to go to the hospital as soon as my water broke (which was very early on for me) and get hooked up to IV antibiotics for the duration of labor. I don’t know if every doc handles it the same way, but there wasn’t any room for negotiating with mine. It was a little annoying, as I’d been hoping to avoid the IV (and IV pole; I’m so clumsy with things like that) completely, but not a big deal and definitely nothing to worry about.
Jen @ Mommy Tries´s last blog post ..Book Review- Battle Hymn of the Tiger Mother

alecia April 7, 2011 at 7:00 pm

If you don’t mind me asking, did they give you one or more doses of antibiotics? I was kind of hoping they could give me my one dose and then just have a hep-lock… it seems like I read somewhere else someone had two doses of antibiotics.

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