She went into preterm labor at 20 weeks, but a risky procedure saved the baby’s life

After discussing the risks, the Pugh family chose to proceed — and the outcome was a best-case scenario, even more successful than anyone could have imagined.

What started as an exciting moment turned into panic for first-time parents Faith and Jake Pugh. The couple couldn’t wait for their baby’s gender reveal at their 20-week ultrasound, but once their appointment started, they quickly learned that something was very wrong.

“We found out I was in preterm labor,” Faith said. The OB/GYN “gave me a more thorough exam. Her face dropped when she saw how dilated I was. She said, you need to go to Norton [Hospital] right now.”

Faith was diagnosed with cervical insufficiency, which means the cervix is not strong enough to retain a pregnancy during the second trimester. This condition is considered an emergency and often results in premature birth and pregnancy loss before 24 weeks’ gestation — the point in time when babies are considered viable.

In a matter of moments, the Pughs went from finding out they were having a baby boy to thinking they were about to lose him. At just 20 weeks, their baby would not survive if delivered early.

Helen Y. How, M.D., an OB/GYN and maternal-fetal medicine specialist with Norton Children’s Maternal-Fetal Medicine, presented another option: rescue cervical cerclage, a surgical procedure where a synthetic suture or tape is used to reinforce the cervix. It can be a risky procedure.

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“The goal when we do the emergency cerclage is to delay delivery to viability at 23 to 24 weeks’ gestation and beyond, but there’s no guarantee,” Dr. How said. “The national statistics for rescue cerclage is a 50/50 chance to get a viable baby.”

Faith had advanced cervical dilation, which increases the risks for mother and baby. The procedure carries a high risk for rupturing the membrane, according to Dr. How, which can lead to intrauterine infection and subsequent maternal and fetal infection that results in preterm delivery. If the procedure can delay delivery long enough to reach viability, and the baby survives a premature delivery as early as 24 to 27 weeks’ gestation, it increases the potential for serious, long-term neurodevelopmental disabilities.

After discussing the risks, the Pughs chose to proceed — and the outcome was a best-case scenario, even more successful than anyone could have imagined.

“I got to 39 [weeks] and 3 days,” said Faith, who delivered a healthy, 8-pound baby boy named Samuel David.

“When I am up in the middle of the night feeding him, I remind myself and pray and thank the Lord. He is a miracle. I don’t want to take him for granted. We are so, so thrilled. So thankful,” Faith said. “It’s amazing that Faith had a healthy, full-term baby,” Dr. How said. “There is a lot to be thankful for.”

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