Incompetent Cervix - stitch/cerclage - threatened labour

[LaRockera]

Welcome to our thread, Helsurf.

I'm new to this myself, but let's wait and see what the other ladies have to say.

 

[kateqpr]

Hello Helsurf,

Try not to worry. 15 weeks is the perfect time to get a stitch placed, as its before your baby starts to really pile on the weight (normally after the 18 week mark), so your timing is perfect.

The procedure is pretty simple and you should be home the same day. You'll probably have a spinal block (like an epidural) and i was in theatre for about 40 mins, the actual stitch only taking about ten mins. You're then generally told to rest in bed for a couple of days while you recover, then can resume some level of normality. You'll probably be scanned again a week or so later to measure your cervix again, and with both my stitches the cervix has almost doubled in length, so very reassuring.

I think the risk of infection tends to be higher if you've already started dilating or having the stitch placed a lot later in the pregnancy as an emergency procedure, so when the baby and the sac is more exposed to the outside world, but it doesn't sound like you're even close to that, so try not to worry.

If its any consolation, i've had loads of cervical scans, and sometimes they have real trouble measuring my cervix. Its in a tricky position and not the easiest of measurements to make. I also had a scan yesterday, and they couldn't even see my stitch, which is a big old loop of wire!

Good luck next week and try to relax and enjoy your weekend! Easier said than done, i know, but distraction is the key!

Kate

 

[lizziedripping]

Hi helsurf and welcome

Kate has really said it all as regards cervical sutures, but just to add that the infection risk is less than 1% if placed before any cervical changes (particularly funneling/dilation) have taken place. Your cervix might be on the shorter side due to the leep procedure, but it has not yet changed as a result of this baby so now is the perfect time to place the stitch.

The risks of an elective stitch are almost negligable compared with the risks of continuing without so it's really a no brainer hun. As Kate said, membranes are only usually ruptured when exposed and sitting in the vagina already, not when the cervix is still closed, same applies with infection risk - minimal unless there is an already open cervix to allow it in so to speak.

Most of the women here have an issue because they cannot get their consultants to place elective stitches, since yours is so refreshingly pro active, then please hun grab the opportunity with both hands You're gonna be fine xxx

 

[x-amy-x]

My stitch was placed under emergency... wish they'd been more proactive and done it elective! i bled quite and bit and was in a further 2 nights after my stitch...

im still here though, and still pregnant and they didnt think i would be!

 

[apsara.m]

hello helself welcome
have faith in the stitch as lots of mammas here got their bubbas through stitch lets pray all of us here will make it to term.
may 12 welcome

 

[kateqpr]

Doing bed rest, i have way too much time on hands to worry. But still, here is today's latest anxiety - infection.

Is there anything i can do to prevent it?

I've suddenly become paranoid that it will be n infection that scuppers this pregnancy. I had a UTI before my stitch, and traces of blood in my urine at my last appointment but nothing serious, but just feel so out of control with IC and all that it entails that I seem to lurch from one fear to another. It's so draining!

 

[LaRockera]

Kate, I think drinking plenty of water, perhaps cranberry juice and keeping up a good hygiene routine will help. I also know sugar encourages bacteria.

As for thrush, I'm taking probiotics daily, and use a refresh applicator once a week/every ten days.

Amazing so, I think I have thrush - for real this time. My discharge has stayed the same but I have some itchiness on my vulva that comes and goes.

 

[helsurf]

Thankyou to everyone for your responses! as I read you're post a sense of calm just washed over me!
I will definately be going ahead with the procedure, and am glad my consultant was willing to go ahead, I am still nervous and will make sure he knows that i have been possitive for group b strep in the past, but definately feel better about the whole infection, rupturing of membranes etc!

Just wondering were any of you given antibiotics during or after the procedure?

Thankyou again! I'm looking forward to keeping in touch with you all during this whole experience and pregnancy, heres hoping for a full term baby x x x

 

[heychickie]

helsurf, I was given IV antibiotics right before the cerclage was put in, nothing after. Best of wishes!

 

[x-amy-x]

Hels, i had IV anti biotics right after my surgery when i was in recovery (had mine under general)... then i was on anti Bs for a week precautionary due to my history of chlorioamniotesis(sp???). None of my bloods showed signs of infection though. I was dilated when i had emergency stitch too so id be in bracket for higher risk of infection!

So glad i got it... hope it goes well for you xx

 

[garrickbaby]

Thankyou to everyone for your responses! as I read you're post a sense of calm just washed over me!
I will definately be going ahead with the procedure, and am glad my consultant was willing to go ahead, I am still nervous and will make sure he knows that i have been possitive for group b strep in the past, but definately feel better about the whole infection, rupturing of membranes etc!

Just wondering were any of you given antibiotics during or after the procedure?

Thankyou again! I'm looking forward to keeping in touch with you all during this whole experience and pregnancy, heres hoping for a full term baby x x x

I was given an IV drip of antibiotics before the procedure and went home with two different types of antibiotics for a week. They only gave me the antibiotics before the stitch because I had a culture done a couple days before and they did not get the results back before the procedure so they gave me the antibiotics before just in case the culture would've come out positive.

 

[LaRockera]

Thankyou to everyone for your responses! as I read you're post a sense of calm just washed over me!
I will definately be going ahead with the procedure, and am glad my consultant was willing to go ahead, I am still nervous and will make sure he knows that i have been possitive for group b strep in the past, but definately feel better about the whole infection, rupturing of membranes etc!

Just wondering were any of you given antibiotics during or after the procedure?

Thankyou again! I'm looking forward to keeping in touch with you all during this whole experience and pregnancy, heres hoping for a full term baby x x x

Yes, do mention your group b strep history. The more he knows the better.

I was given antibiotics after the cerclage, both for possible bladder infections and tocolytes. I had to stop the tocolytes sooner as they raised my HB (I was on yutopar) but took the others to the end. No problems, no infections due to the stitch. Like Lizzie said, it's great that you're being offered it now, that your membranes are still high up.

After the stitch, just keep an eye for infections and the like. Make sure you drink plenty and plenty of water, wear cotton underwear, you know, personal hygiene stuff that will protect you.

When is your procedure? It's going to be absolutely fine, honey.

 

[kateqpr]

Hey everyone,

hope you're all having a good weekend.

Just wondered how many of you have had the flu jab? I was meant to have one a few weeks ago, but then things kicked off with my cervix so it all got forgotten.

I'm assuming there's nothing detrimental it can do with regards to IC and pre term labour etc? I'm on bed rest so i'm not out and about a lot mingling with lots of people, but starting to think i should get it just to be on the safe said.

Any thoughts?

Kate x

 

[lizziedripping]

Hi Helsurf - I didn't get antibiotics before or after the elective stitch, but I did have them before, during and after for the emergency stitch - my cervix was open so it was essential to keep any potential bugs at bay. Some consultants give them routinely, others don't

Kate hun - I so feel for you It is mentally draining being in a state of high anxiety trhoughout a cerclage pregnancy - I remember it well and don't envy you the next few weeks purely for that reason. Even tho my dh loves me dearly and found the whole thing stressful too, he still couldn't understand my constant sense of dread, fear and moving back and forth between worries. I cried nightly to him from 21 to 28wks convinced I wasn't gonna make it, and feeling devastated at the thought of another NICU battle - this time with two babies!

I felt constantly that the boys were going to just fall out, that the stitch might be infected, that I would go into labour any minute due the ever-present painless, yet very real contractions It is nothing short of hellish, and you don't have to explain the feeling, or justify it here even for one second - we all understand and are totally with you

As for infection, it is unlikely hun and very, very rare if the cervix is closed (even if short and closed). It does happen, but not often. There is nothing you can do as such except to get screened regularly, and/or get yourself to labour suite if you feel anything unusual or like preterm labour. I have to say tho that I could have easily gone into hospital every day with signs of early labour because I was never free of labour-like symptoms. Needless to say I still made it relatively easily to 38wks, and none of those feelings amounted to anything

It was interesting to note in the NICE guidelines that one of the IC studies showed that ladies with a stitch present to hospital more than those without, and many of them need meds to ease contractions. I was never put on a monitor, but I feel sure if I had been it would have shown uterine contractions - not enough to cause cervical changes, but enough to terrify me. I am sure that these side effects are stitch-related (and probably made worse by the fact I was carrying two), and tho usually harmless they are an added anxiety for IC women. You can't have a huge piece of typewriter-like tape sewn through your cervix without your body having something to say about it, it is a foreign body afterall!

All I can say hun is that you are doing everything that can be done to get this baby to term. Infection and preterm labour are possible with IC, but rare. Blood in your urine is essentially nothing to worry about and the bleeding indicative of preterm labour/infection is significant and unmistakable. There is really no doubting when you have moved from having a structurally weak cervix, to being in preterm labour hun. How long is it since your surgery now? Are you getting swabs done around 20wks? It is now a part of prem prevention in many hospitals.

As for flu jab, I had it at 15wks with the twins, and didn't have any issues with it. Risk of flu complications are more common in pregnant women so I didn't hesitate to get it. If it helps, my preemie daughter has had it every yr since she was born, and the rest of the family get it too - none of us has had any ill effects from it x

 

[vaali]

Hi May12.. welcome! So very sorry for your previous losses bud!..
First of all grats on this pregnancy & the proactive stitch & yes as you rightly said it, serial follow ups on the cervical length definitely gives us, the IC mommies a peace of mind & a great psychological relief (when there is an improvement in the length though..). But do remember that cervical length is not a constant one, it is variable & there are ups and downs throughout the pregnancy. For me it helps tune my bed rest accordingly than anything else coz after few weeks of complete bed rest you tend to go real nuts & moving muscles even a lil would be of a great relief both physically & mentally.

Hello Helsurf.. Grats on the plans for the cerclage & im sure its gonna go real well tomo.. If I may throw in my two cents worth, mine was an emergency one & was given IV antibiotics right before the procedure. My doc said there is no necessity for me to continue them orally/iv after the procedure since the procedure was a covered one already & it cant introduce new ones. Yet i made it a point im gonna followup the swab culture with the hospital that was done intra-op. It came out negative after a couple of days wait & i was convinced with it.

 

[helsurf]

Thanx again everyone! I go in tomorrow morning, still really nervous but think it's more about having the spinal anaesthetic now, am hoping to be home this time tomorrow but if there's delays and I don't go in till later I'll have to stay in overnight.

I actually had to go up to the hospital last night as I had some bleeding! They checked my cervix and it was still closed and heard bubbas heartbeat which was such a relief, they also did a swab for infection so hoping it will come back negative, they said they might have the results by tomorrow

I will let u all know how I get on thankyou for the support x x x

 

[kateqpr]

Lizzie -

Thanks so much for your message. It's so reassuring to hear that i'm not the only one to have had such high anxiety over these mid weeks of pregnancy. You're right - i do lurch from one worry to another.

In fact tonight my stitch is giving me sharp little pains, so i'm lying here thinking, 'Do i head to my hospital to get them to look at my stitch? Why is it hurting?' and suddenly my whole evening is just me scared that something is going wrong!

So so exhausting! I feel like a dog who is endlessly chasing their tail and wish i could give myself a good talking to. But my husband tells me i was exactly like this in my last pregnancy - and you're right re the NICE research. I seem to remember A LOT of late night visits to my labour triage needing reassurance about weird pains and sensations.

My consultant was right - bed rest is often not recommended to people, simply because the psychological impact is so tough for some people, and you end up being almost too tuned in to your body.

Right - need to distract myself. Crap TV here i come!

Kate x

 

[LaRockera]

Helsurf - good luck tomorrow, hon. It will all go absolutely fine, and it'll be over before you even realise it. You've got nothing to be scared of, honestly. It's just procedural. Let us know how it went.

Kate - I'm a self-exhauster, too. Have been like this throughout my whole pregnancy, and I suspect this will be me from now on. I worry about something, then put my mind at ease, then find something else to obsess about it. You're not alone there.

 

[lizziedripping]

Hi ladies

Helsurf, good luck for tomorrow darlin, will be thinking of you but I know you'll be fine and so relieved once the stitch is in and doing its job. The spinal is fine - I've had 5 of them and never had a problem or found them to be more than mildly uncomfortable You are doing the right thing chick

How is everyone else? MA hun, that little bub settling down for you yet hun?

Kate - the pinching you describe is normal with the stitch. I had awful pain and discomfort in that whole area until the day I delivered the babies. I was actually very relieved to have the stitch taken out because of it - I could pee for the first time in months without intense bladder pain!!! Again tho hun, if you're worried, never hurts to let them have a look xxx

 

[Mommy's Angel]

Hi Lizzie, how are you doing??

Amelia is starting to settle a little bit. Tonight was a little rough. Figures it's the night before the Dr.'s appointment and of course I'm freaked out a bit about whether she's gained weight from bf'ing or not after all the issues. She's gotten longer so I'm thinking it's starting to even itself out. I'm not going to let them freak me out. She'll gain. She's wetting and poo'ing enough.