# Abdominal vs Cervical Cerclage?



## AmyLouise89

Which is better? Safer, etc? I just lost my 2nd baby at 5 months so my Dr is talking about measuring my cervix in a few weeks & seeing if he can do a cervical cerclage AFTER I get pregnant or should do an abdominal cerclage BEFORE I get pregnant. I got an emergency cervical cerclage done at 19 weeks but infection dried up fluid around baby & attacked membranes so I had to deliver at 20 weeks 5 days. Has anyone on here had an abdominal cerclage? Just need some opinions. I know that the abdominal cerclage would be permanent & I'd have to have C sections each time but I don't care as long as I can carry a full term healthy baby.


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## Babyface179

I am so so sorry for your loss. How heartbreaking. I personally don't have any experience of IC but wanted to wish you all the best and send you lots of virtual hugs. X


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## lizziedripping

Hi Amy. When IC presents itself in a first pregnancy, and before 20wks, it can be a sign that the cervix is very weak. In some women (myself included), IC develops more unusually after they have carried atleast one baby to term. In those cases, the IC emerges later in pregnancy - often after 22wks i.e. the cervix is weak, but doesn't begin to shorten and efface until later, somewhere between 22-26wks.

For ladies like me, the vaginal stitches - if placed electively at 12wks - work very well. They seem to add an overall tension to a weakened cervix. There are also many women for whom the same stitch has worked in a first pregnancy once they have been identified has having a short or potentially incompetent cervix. In my experience, cervical cerclages are good and work for most people most of the time.

In your case, it could just be that your IC was not identified soon enough, and the stitch placed too late to be as effective. My emergency stitch didn't really work either - tho my IC didn't become a problem until 23wks, so the stitch bought us enough time (1 week) to get to viability.

I believe that if a shirodkar stitch is placed early and before ANY cervical changes have begun, then it works brilliantly. It got me to 38wks with 16Ibs of baby, and a very "floppy", weak cervix. It is a very specialised stitch that on ly some clinicians can place, but I would urge you to push for it hun. 

As an alternative, the abdominal stitch works brilliantly too - particularly for women in whom all other options have failed. Those women are among the rare few in whom the standard cervical stitches don't work, and often have extremely short cervixes before they conceive. This is why your doc probably wants to check the pre-pregnant length of your cervix. If it is short, and coupled with the fact that your IC seems to develop quite early on in pregnancy, I would give serious thought to the abdo cerclage. If your cervix has a good length, then I'd give the cervical stitch a chance. Remember hun, no one has tried any kind of stitch for you yet.

If I hadn't had the stitch in my last pregnancy, I would have lost the boys at 16wks :( Though my IC was considered "mild", and my cervix has a proven track record of taking a baby to term, it was very "atonal" by 12wks with the twins, and would not have held up for long. Despite this, the stitch did the trick and held very strong against the huge weight I was carrying. There are some women whose cervixes just don't seem to stay closed even with an elective stitch, but at the moment I am doubtful that you are one of them.

Things will become much clearer after your scan hun, so maybe then you'll be better placed to make an informed choice. Get back to me if you need any advice/thoughts etc xxx


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## AmyLouise89

Thank you :)


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## AmyLouise89

Also Dr mentioned I have a hour glass shaped uterus...is that bad??? I was drugged up at the time so didn't ask what he meant but now I'm wondering.


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## ALANA71

I have been diagnosed with IC after two losses at 19 weeks. I opted to have the abdominal cerclage. I cannot bear go through that loss again. There is a higher rate of success with the TAC.


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## rensben

AmyLouise89 said:


> Also Dr mentioned I have a hour glass shaped uterus...is that bad??? I was drugged up at the time so didn't ask what he meant but now I'm wondering.

hi Amy,

Just a question...did you have a lot of contractions with the pregnacy (even braxton hicks or tightenings?) I had a mishapen uterus before having surgery years ago before getting pregnant. A weak cervix often goes hand in hand with malformations of the uterus. These types of uteri can be irritable and contract easily. These mild contractions are harmless for most women but can (in cases like mine) open the cervix even with a stitch.


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## MrsAnt

Hi Amy

I have been diagnosed with IC after 2 losses. Personally I have opted for the abdominal stitch pre-pregnancy. My consultant told us that the vaginal stitch has around 70% success rate, whereas the abdominal stitch is more like 90%. I have also read that the abdominal stitch carries less risk of infection than the vaginal stitch. The abdominal stitch requires major abdominal surgery and quite a long recovery time but for me, I am of the opinion that surgery will be nothing in comparison to suffering losing a baby. I also want the procedure doing pre-pregnancy as after my experiences the less medical intervention during a pregnancy the better! It's an entirely personal decision and I know there are many success stories of both methods.

Good luck x


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## Agiboma

In my last pregnancy i had 2 stitches put in place and the secound one failed me @ 25 weeks when i had my son. tbh i am not a good candidate for a vaginal stich next pregnancy so i am opting for an abdominal stitch after i get pregnant. tbh i think its the only way i will come close to carrying full term.


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## lizziedripping

If you haven't had a previous full-term baby and/or elective stitches placed at 12wks haven't worked for you, then you are a definite candidate for TAC rather than further vaginal stitches xxx


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## BabyDoll25

Hey Ladies, 
I'm new here and not too familiar with posting on here, but wanted to share my story with you. I lossed my first baby on 2-8-10 and was determined after that I had an incompetent cervix. My dr. said that they would place a vaginal cerclage in my next pregnancy between 12-14 wks... so we got preg. again and I had the tvc placed at 14 wks. and everything went well! I was so sure I was going to have a full term baby! Lo' and behold.. at 18 weeks they noticed that my cervix had shortened tremendously.. I cried! And my dr. was like.. aw.. you'll be okay... blah blah (showed no concern). Then at 20 weeks I was re-living my nightmare all over again. I lossed my 2nd lil' baby on 12-31-10. I joined the Abbyloopers support group for women w/ IC and was totally on board to get an transabdominal cerclage (TAC). I had mine placed laparoscopically with a dr. here in NC, Dr. Yalcinkaya, at Wake Forest Baptist Hospital. (Lovely dr. by the way). If I can help prevent someone from losing a child.. I will. I am definitely Pro-TAC!!! I will be TTC after I get my AF this month...praying for the best outcome! Hope this helps... please feel free to ask me ANY questions you may have. 
(((Hugs)))
Christina


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## rensben

BabyDoll25 said:


> Hey Ladies,
> I'm new here and not too familiar with posting on here, but wanted to share my story with you. I lossed my first baby on 2-8-10 and was determined after that I had an incompetent cervix. My dr. said that they would place a vaginal cerclage in my next pregnancy between 12-14 wks... so we got preg. again and I had the tvc placed at 14 wks. and everything went well! I was so sure I was going to have a full term baby! Lo' and behold.. at 18 weeks they noticed that my cervix had shortened tremendously.. I cried! And my dr. was like.. aw.. you'll be okay... blah blah (showed no concern). Then at 20 weeks I was re-living my nightmare all over again. I lossed my 2nd lil' baby on 12-31-10. I joined the Abbyloopers support group for women w/ IC and was totally on board to get an transabdominal cerclage (TAC). I had mine placed laparoscopically with a dr. here in NC, Dr. Yalcinkaya, at Wake Forest Baptist Hospital. (Lovely dr. by the way). If I can help prevent someone from losing a child.. I will. I am definitely Pro-TAC!!! I will be TTC after I get my AF this month...praying for the best outcome! Hope this helps... please feel free to ask me ANY questions you may have.
> (((Hugs)))
> Christina


I am so sorry for your losses Christina. It still amazes me how doctors can be so dismissive. Just wondering what happened with your second? did you go into labour with the stitch in? I have a stitch that was put in at 16 weeks. It's holding but i have shortened and funnelled with it place. I have so far made it to 29 weeks and hoping for more. Good luck to you!


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## BabyDoll25

rensben said:


> BabyDoll25 said:
> 
> 
> Hey Ladies,
> I'm new here and not too familiar with posting on here, but wanted to share my story with you. I lossed my first baby on 2-8-10 and was determined after that I had an incompetent cervix. My dr. said that they would place a vaginal cerclage in my next pregnancy between 12-14 wks... so we got preg. again and I had the tvc placed at 14 wks. and everything went well! I was so sure I was going to have a full term baby! Lo' and behold.. at 18 weeks they noticed that my cervix had shortened tremendously.. I cried! And my dr. was like.. aw.. you'll be okay... blah blah (showed no concern). Then at 20 weeks I was re-living my nightmare all over again. I lossed my 2nd lil' baby on 12-31-10. I joined the Abbyloopers support group for women w/ IC and was totally on board to get an transabdominal cerclage (TAC). I had mine placed laparoscopically with a dr. here in NC, Dr. Yalcinkaya, at Wake Forest Baptist Hospital. (Lovely dr. by the way). If I can help prevent someone from losing a child.. I will. I am definitely Pro-TAC!!! I will be TTC after I get my AF this month...praying for the best outcome! Hope this helps... please feel free to ask me ANY questions you may have.
> (((Hugs)))
> Christina
> 
> 
> I am so sorry for your losses Christina. It still amazes me how doctors can be so dismissive. Just wondering what happened with your second? did you go into labour with the stitch in? I have a stitch that was put in at 16 weeks. It's holding but i have shortened and funnelled with it place. I have so far made it to 29 weeks and hoping for more. Good luck to you!Click to expand...

Hey dear! First off I want to congratulate you on 29 weeks! You are well into viability and that is awesome!!!! I didnt intend for my post to scare anyone and you shouldn't be! ((( Hugs )))
To answer your question, no I didnt go into labour; that's the scariest thing about IC, because its painless dilation of the cervix; basically my cervix is just too weak to hold a growing baby (even at 20-22 weeks). My nurses kept asking if I was hurting and I was like "no, I feel fine....what are you talking about".. in hopes that they really didnt know what they were talking about. My cervix just opens prematurely, w/o pain, until it was too late, with bulging membranes, exposed to the vagina, which leads to infection (sorry tmi). I never made it pass 22 weeks.. so again you have done great and I wish you many many more uneventful weeks of pregnancy! 
Sincerely,
Christina


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## Agiboma

Well i will be getting a tac next pregnancy i had 2 stitches last pregnancy and still had my baby @ 25 weeks because of IC, i am very pro tac and have already discussed this with my high risk ob


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