Incompetent Cervix - stitch/cerclage - threatened labour

[sunkiss]

hey ellie, yes lizzy told me the same n she is absolutely right, the ladies here are very knowledgeable n we can gain alot through their experiences, thank God for them n this thread!! the p17 shots are progesterone, i believe it is used to help keep the cervix relaxed n closed. i am going to ask about that again when i return on friday. the bulging membranes is wut i worry about the most since my last loss my waters broke too early but i didnt have the stitch last time so for the most part i have some prevention going in my favor

thank u so much helen

 

[millieboo1111]

Sunkiss- yes i heard of this p17 too and my husband asked his mum who is a midwife and she said they usually give it earlier in pg. i will ask again also. We also lost Baby Eric due to PROM at 19 weeks which was never explained but must have been IC and same situation this time. i remember them doing the speculum and saying my cervix was closed though!? i dont know i wonder if anyone knows anything sometimes

seriously if it wasnt for this thread i dread to think what situation we would be in. i truly believe God brought me here because i pretty much demanded admittance into hosp and bedrest. the lady in the bed across from me was told to go home a month ago and she refused and demanded the doctors have another look at her scan and then they agreed she should stay i mean it is wacko. yesterday they gave me an injection and then came back to give it again a few hours later because mw had not put it in the notes!! we have to take control of our own destiny. last time i was having contractions but i didnt know so everyone said stop being a baby they are just growing pains. i wont be fobbed of this time. I thank God for you ladies.

Thank you Helen Ive got to stay positive I call it game face because if i didnt im such a drama queen i would fall apart so badly id be neither use nor ornament to anyone and babba needs me to fight for him/her. i see these as my first lessons in being a mum. am i willing to give up feeling sorry for myself for my son or daughter? yes i am!! (just for today and i'll take the rest as it comes lol) i have alot of faith and God breathed life into this child for a purpose and God has a plan so im going with it

 

[lizziedripping]

Hi ladies

Millie, sunkiss and dani - glad to see you're all hanging in there and helping support each other through the scariest point in an IC pregnancy 10mms is not catastrophic especially with a stitch in place, but it is definitely a sign that you should be resting. Millie, your cervix probably looked closed last time with a speculum exam because a cervix opens from the top down, so can be funneled from the inside but look closed at the bottom (the outside). The only true way to be certain is with a detailed tvu.

Remember ladies that I only had 1.8cms of closed cervix below the stitch at 25wks with the twins. This didn't matter, because my cervix was closed below the stitch and only funneled to it. The remaining length doesn't matter too much, what counts is that it is closed below.
You would need strong regular contractions (early labour) to exert force on the stitch and dilate the cervix through it, that's a seperate issue and very rare once an elective stitch has gone in.

Dani - wow, over 2cms of closed cervix and no funneling!? Brilliant news. Do you realise how great that is, especially with twins? At 27wks to be in this position is a very good sign. Your cervix is looking better than mine did, and I was carrying very big boys. If I could get to term, then the chances are very good that you will too. The stitch has definitely worked for you hun, and now the threat of IC has passed so you should feel confident that your pregnancy is going well and you can get to 30wks and beyond

Christi - howre you sweet? Your doc is right about the stitch, but you would surely know that labour had been properly established before your cervix dilated through the stitch anyway. Contractions would be strong and regular before any bleeding or dilation Hun. Keep resting xxx

Hi Helen, thanks for your message. Good to hear from you

Xxxxx

 

[SquirrelGirl]

I've just been silently stalking as a few weeks ago I thought I was having IC too. My measurement went from 4.1 to 3.2 in 3 days so I was panicking. Now I think I just have Irritable Uterus and my cervix has stayed above 3 and getting TVUs every week. In any event, I still really like this thread and all the positive support whether I truly belong here or not!

Millie, I started the 17P shots at 21.5 weeks, so I don't see why you couldn't start now. Yes, I think they generally start them around 16 weeks for those that are predisposed to IC, but I can't imagine how it would hurt to start them now?

I think someone asked recently what the 17P was for, and I'd read that the 17P is supposed to help strengthen the cervix. Studies have shown it works well for those having singletons with past issues with IC. It hasn't been proven to work with multiple pregnancies, but it won't hurt anything either. So I asked my OB and he said it sounded like a good idea for me to try anyway.

 

[chistiana]

Hey Hellen so glad to hear from you! God our exams are approaching, i only tutor 3 kids now and i cant even stand that pressure...i can imagine just how busy you were! Thanks for your kind words, i am so happy to reach 34 weeks tomorrow (grrrmmfff it should have been sunday gone but doc changed my dates!) if only i can make it to 36weeks now! (hihihi always wanting some more!) Do you think a baby a bf at 34weeks if she were to come now?

LIzzie hey sweety, i ve been feeling really heavy in the last few days plus the movements have reduced (i can still feel her but less intensely) so i think she migt have engaged. I know this doesnt necessarily mean anything but i m getting more nervous and more excited as the days go by! I so wish i can make it to stitch removal!!

Ellie i just need to say it one more time just like hellen...your attitude is inspirational!!

Squirrel it doesnt sound like you have ic hun but you re very welcome to the thread!!!

 

[lizziedripping]

Hi ladies

Welcome Squirrel, glad you decided to come over from tt&m It's great that they're keeping a close eye on you especially because you're carrying two. It's likely that your cervix is simply feeling the effects of the extra pressure which is common in twin pregnancy but doesn't necessarily mean that you have genuine IC x

To the other ladies asking about progesterone, Squirrel mentioned that it is thought to strengthen the cervix which is true. Towards term progesterone levels drop hugely in preparation for labour which, along with other hormones, allows the cervix to soften.

Studies have been very positive, but it does not yet have a proven track record so some centres are more reluctant to prescribe it than others. It has been shown to be as effective as stitch placement in some women, so it is impressive. I begged my consultant to give it along with the stitch, but she wouldn't Turns out I was fine without it. I think it's great that so many of you are able to have it, it certainly can't hurt.

It's use in early pregnancy is either for women with known low progesterone issues, or those who have had IVF - it helps maintain the uterine lining when IVF treatment might have disrupted the body's own normal processes.

Christiana, thanks for the update. It sounds like lo is gearing up for the big day, but as you say that might be weeks away yet. Thinking of you xxx

 

[JJEE]

Hi ladies,

I hope everybody is doing ok and these troublesome cervix's are behaving themselves?!
I am just waiting to leave for my scan..I never know what the abbreviations are for all of these procedures! I actually feel sick I am so nervous..My other half has his " I told you you have been doing too much " speech ready! It is so difficult as you all know who have other little ones at home..I feel incredibly guilty, so I have slipped into doing little bits and pieces..I definitely don't overdo it, but am doing more than I was 2weeks ago...I have tried to balance out my bad behaviour with 3days of staying on the sofa!!
Well..time to leave and hopefully be receiving fab news of a very well behaved cervix...will update later!!
xxx

 

[lizziedripping]

Good luck darlin'

 

[book.fish2011]

I hope everyone is okay. I spent the weekend in the hospital because I had severe pain behind my old incision and was bleeding fresh blood. Duty doc was convinced that I may be heading towards uterine rupture. They did a ctg and found it okay. They also found a UTI. I was discharged after two days of IV augmentine and other fluids. Am still hanging here.

 

[bluestarlight]

Hi,
I'm new here. Not sure if I should be posting in this thread yet. I had an ultrasound on april 27th when I was 18 weeks for my anomaly scan. Everything they could see looked good, including my cervix it was 3cm, but baby didn't cooperate with some things so I had to come back today. Well, they still couldn't get the head and cervix measurement because she was down really low so they did a tvu and found my cervix was only 2cm and funneling. Now i'm panicking, they wanted to wait 4 weeks and check it again and have me do progesterone, but then they changed their minds and just told me to rest, not lift anything over 10lbs and they will check it again next week and go from there. Not sure how fast things can progress from here? I'm only 19 weeks and 5 days, no way they would save baby now if it came. How short does it have to be to start contractions or labor? I can't wait til next week...it seems so far away...How will I know if i'm doing the wrong things and making it worse. My first pregnancy was fine, no problems. I had her at 37 plus 3 because my water broke but i never went into labor so they induced me. I only got a graze, no birth complications. Can they put a stitch in now or is it too late and my only options are bedrest and progesterone? Sorry if this seems long, just kinda freaking out a bit and hunting for answers.

 

[HelenGee]

Hi Bluestarlight,

Please try not to worry hun, I know it's easy to say, but it sounds as though your doctors are trying to do the right things for you. Thank heavens for the follow up scan this week.

I would definitely ask for a stitch now though, as funnelling is a sign that the cervix is weakening and shortening under pressure. The stitch can strengthen and hold a weak cervix under the weight of the baby. The risks of the stitch are minimal and outweigh the benefits of closing and lengthening a shortened cervix.

You must be going out of your mind with worry. You've had a real shock and it takes a while to work out the best course of action. Bedrest, being horizontal on your side for as much time as possible will help to take the weight off your cervix, so your doctor is right.

I want to give you a bit of hope that this might work out and you will be holding your second full term baby. My story was incredibly similar to yours apart from the labour with my first was complicat by a ventouse then a section. However, the waters breakingn and induction was just like yours. 2nd pregnancy, I then went to 18 weeks with a closed, long cervix on an abdominal ultrasound, to 21mm, no funnelling at 19 weeks (I was told I'd need a follow up tvu no more than 10 days later). I was given options of resting and progesterone if the next tvu showed further shortening. I then went for my next tvu 5 days later, I was 13mm with funneling and was given a stitch the next day. With a stitch in place, progesterone and full bed rest, only getting up for the toilet and the odd circulatory walk around, we went to 38 weeks plus 3.

The stitch really isn't anything to be scared of, and it is well worth asking if they can do your next tvu sooner with a view to placing a stitch. Some doctors are reluctant to do the procedure, taking a more cautious approach, but there is a limit to the time span they can place the stitch. Mine was done at 20 plus 5, and most docs would rather not do it past 22 weeks.

Stay strong, this can have a positive outcome. Wishing you lots of luck x

 

[chistiana]

BF- grrrmffff so so sorry you ve had another scare hun...GOd this pg is keeping you on your toes...good thing they found nothing too worrying other than the uti..was rhe bleeding related?? On a positive note...YOU RE 30w!!!! Such a great milestone!well done hun! Anyway, hope the pain eases off and fxed no more trips to the hospital for you!

Bluestar- welcome to the thread! Sorry you too have to be going through such a worrying time. I think 2cm is not very very short but it is definitely under what should be an average length. I have no personal experience but from the stories i ve read on this thread a cervix can shorten in a very short time but likewise it can stay the same or even lengthen with bed rest. I m
Not sure if contractions start after the cervix has shortened to a certain length but i know contractions can cause it to shorten. At the week you re at i d think they are right to wait and monitor for another week with strict bed rest...if next week your cervix is shorter then i guess even an emergency stitch will be worth the risk...if not then maybe strict bed rest along with progesterone can do the trick for you. Again i m no expert and maybe lizzie can help you a lot more as she s been there with her dd. i hope it all goes well hun, stay off your feet conpletely for now and if you feel too worried or if you re in any kind of pain please dont hesitate to contact your doc or go to the hospital to get it checked.

 

[chistiana]

Aaaahhh there you go, helen, we were writing together! So bluestar, there you have it, a very similar story to yours with a very happy ending! And i guess as she has been through it and knows more of the signs, i d follow helen s advice re the stitch and push for it!

 

[HelenGee]

Hey Bookfish-sorry you're suffering my sweet. You must have been beside yourself worrying about uterine rupture, especially after the sad loss of your friend's baby I've heard that bleeding can be caused by uti's, how worrying for you though. Here's hoping that there will be no more stress for you

Christiana- you sound much more relaxed, it's lovely to read. Hope Nic is settling down and looking forward to meeting his baby sister.

 

[book.fish2011]

Thank you Helen and Chris. I was having lot of BH. Very painful that I almost thought they were contractions. Triggered by UTI? And these painful contractions irritated the cervix and caused bleeding? I don't know.*

A manual internal scan said that my cervix looks fine. Helen, as you said, I was totally scared hearing my friend's sad story. Doc was telling me that a low transverse incision won't cause rupture on its own. A classical one may; my friend's was classical.

In my last appointment, doc said about checking the cervix and removing the stitch if it's causing too much pressure..and see how long I will hold on.*

Am experiencing tremendous pressure everywhere. On the cervix, I can feel my uterus stretching like crazy. Both babies are head down and are pushing against the cervix. The ends of the old incision ache sometimes. Terrible back pain.*

Am not complaining about the discomfort but am just listing out the symptoms hoping these are normal things associated with twins. Lizzie, please help.*

Chris, you are so close. I hope all our friends who are busy with their new born little ones are fine. And welcome to new ladies.

 

[kateqpr]

Hello lovely ladies!

Sorry for my disappearance - I had underestimated again just how tiring those first few weeks are, especially with Poppy testing the limits since Millie's arrival. Plus even though breast feeding is now working well, I'm only averaging about three hours sleep a night so feeling frazzled and brain dead. But happy - very happy with my new little bundle who caused me so much worry over the last nine months!

Bookfish - so sorry to hear you're still being tested to the limit - but wow - thirty weeks! That is just brilliant. Who'd have thought it, all those months ago when it seemed impossible. I'm guessing your family must be so excited about the arrival of your twins - some light and happiness to look forward to for you all. BF you are almost at the winning line now, and you've done brilliantly, with real strength and determination even in the darkest times. I'm very proud of you and in awe of your strength of character.

Christiana - yay your baby is on it's way soon! And yes you sound so light and happy! I'm so pleased you've made it this far. Are you now up and about like a normal pregnant lady? Are you scheduled for a c section or vsginsl birth- cant remember. If its any consolation I found my second birth so much easier, I actually weirdly enjoyed it. I think after the stress of a high risk awful pregnancy, the labour was a real relief, to have made it to the finishing line still in tact ( and with my sense of humour back!). I found myself singing cbeebies theme tunes at the top of my voice at the end of each contraction, just to
pass the time.

Helen / lizzie - I hope you wonderful
Ladies are doing well and am so grateful you both find the time to respond to everyone on this forum. It really is invaluable when you're in that tunnel of fear that a dodgy cervix brings.

Hello to everyone else whose recently joined the forum. I promise you your chances of a happy ending are high, especially of you have a stitch and just listen to your doctors and your own instincts. I've had two stitches now in two pregnancies, had months of paralysing fear whilst on bed rest ( particularly those scary second trimester weeks...) but now have two beautiful daughters to show for all that hard work. You can and will do it too . And this forum is a lifeline when you most need it.

Best of luck everyone and am still here, lurking but normally on my iPhone in the wee small hours while I'm feeding, so responding isn't always an option.

Lots of love

Kate ( ignore my many mistakes - writing on my phone with a small bundle just about to wake up on my lap!!)

 

[book.fish2011]

Kate: your words brought tears to my eyes. Thank you thank you. I just hope I can make it and bring my healthy babies home. My mom is here in Dubai now, only two months after she lost her grown up son so tragically. There's no dearth of sorrow in our household. I just want these babies alive, healthy now, more for my husband, my parents, my surviving little brother (we were three kids to my parents).

Glad to hear your bundle is doing great. Soon your Poppy and she will be great frends and make a great sibling pair.

 

[lizziedripping]

Bf hun My heartfelt thoughts go out to you and your poor Mum who has had such a traumatic time over event weeks

ALL the symptoms you describe are absolutely normal with twins. I felt like I was in labour from 20wks, as did my friend who was also carrying twins at the same time. She had very painful bh contractions from 28wks, but still got to 39wks.

It is not surprising to me that your scar is giving you some problems given the extra stretching your uterus has to do. This is ok and to be expected as the scar tissue expands. At 30wks you are probably carrying 7Ibs of baby plus the additional water and extra placenta. This is the equivalent of a full term uterus with a singleton so the stretching is immense. Your cervix however is closed, and likely to stay that way so long as you keep resting and giving your body a helping hand.

Keep focusing on the fact that I had the equivalent of 24Ibs in my uterus by 38wks but my cervix didn't change at all from 25wks. True I didn't have a section scar to contend with, but there have been many twin ladies who have, but haven't had any issues with it.

A lady over in the twins section had one set of big twins via c section (6 and 7Ibs) at 37wks, then went on to get pregnant with a second set within 6mths of the first and they were both 7+Ibs! She made it to her section date again at 37wks, but didn't have any scar rupturing problems despite her first section being so recent. She was an ideal candidate for scar rupturing since her twins were big, and her first scar so new, but she was fine. Her aches and pains were like every other twin lady's, excrucitating!

I didn't really sleep for more than an hour at a time from 28wks, so I know that the discomfort was constant and pretty bad. Everything hurt, particularly low down in my abdomen and pelvis.

Twins have a habit of delivering early hun, but this is usually around 34/35wks, not 30. I think you'll easily make that gestation so try to hang on and have faith my darlin'. Love to you all, and please send my warmest regards to your parents. They don't know me, but I think of them and their terrible loss often

Bluesstar hun, so sorry that you've had the shock news about your cervix. The lovely Helen and Chris have said it all really so I don't want to ramble on needlessly, except to say that their advice is brilliant and that you should be pursuing the stitch option if at all possible.

I presented at 23wks with my second baby, but by then my cervix had dilated with membranes bulging. Had I been checked a few weeks earlier, funneling would have been seen, and a stitch could have rescued the pregnancy. You are currently in a brilliant position for a stitch to work well. Tho there is shortening and funneling, it isn't catastrophic and your membranes are still intact. Stitching could work wonders.

All that said, there have been women here with more extensive cervical changes who have staggered on to term with just rest and progesterone alone. Even with no intervention there are likely some ladies who go on in pregnancy oblivious to cervical changes, yet still make it. I would say tho that now you are aware of a potential issue, it's time to act and demand the maximum support if you can.

Keep us posted honey, lots of love x

Kate - lovely to hear from you Lo sounds gorgeous, but totally knackering as the little darlings always are You're doing well even to have posted this much. Thanks for the update, will be thinking of you

 

[chistiana]

Helen- yes, thanks hun, i have to admit i m more relaxed now even though i think we probably wont make it too much longer...i feel sooooo so heavy! Nic is constantly hugging my belly and calling out for his sister and saying things like "i love youououo" which is so cute! I just wish he finds her as cute when she s actually here!!!

Kate- hey hun, so great to hear from you and how great your liitle bundle is doing!!! 3 hours sound good to me considering nic would only do 1.5 hour stretches so well done with bf girl!! How s poppy taking to her new sis? I m going for vaginal birth if all goes well and i really really hope it is going to be easy! I too believe that after so much it will be mainly relief! I m finally out and about and soooooo enjoying it! One more week and i can allow myself to shop too!! Anyway, as the other ladies said, your story is inspirational, thanks so much!!!

BF- how are you doing babe? Has the bleeding and pain stopped?

 

[book.fish2011]

Thank you Lizzie. Those are such kind words. I will tell my parents about you and this thread. What you said about that twin momma is encouraging. I hope I can emulate her in a miniscule way. I don't want 6lb babies. 4-5 healthy babies will be more than enough for me. 4 lb without any mishaps will be a great target. I've never been this tensed anytime in life. This is the toughest test so far, even considering that my life hasn't been exactly a picnic in the last couple years.

Chris - discomfort persists but thankfully no bleeding. Are you mobile these days? Going out of the home for a stroll?

Bluestar- as Lizzie said, get the max support which you can. You seem to be at a good position with regards to number of weeks to make the correct decision