Incompetent Cervix - stitch/cerclage - threatened labour

[ChovieGirl]

Lizzie -

In your response to Ich you said...

"After that you should minimise physical activity, stay off your feet when not working and give your cervix, stitch and body a helping hand until you reach 28/30wks."


I was just wondering... What happens at 28/30 weeks that someone might be able to do a little more? Does the weight not matter as much then or is it just that the baby has a higher survival rate at that point? I would love (although I know I need to do what is best) to be able to move around a little more. I am finding it hard now to find a position that doesn't start becoming uncomfortable after laying around for so long. I have done pretty good so far on bed rest, but am really looking forward to the day I don't have to stay put as long and I am 3 weeks away from 28 weeks.

Thanks!

 

[ChovieGirl]

hi ladys just wanted to indroduce myself and tell u my bk ground.i had my first child all fine apart from birth...then had 4mc...then found i had a uterine and vaginal septum which i had taken out...i then got pregnant and carried my baby boy till 29+4 days beofre my waters went and i had a c section and that was 12 mobths ago now i am now oregnant again and had said to my consultant about cervical scans likle i had last time as my cervix was short and she wouldnt do them...so this prenancy i have been having trouble since 16 weeks well finally loosing lots of green jelly stuff which i did last time i knew it was my plug so went up the hospital for the 5th time and demanded a cervical scan and said its incompetent i can feel it against there wishes had a scan and yep my worse fears were set in stone it had shortened and funneled so was sent for an emergency cerclage day beofre yesterday they found i was 1cm dilated and not lot of cervix to work with but they tried there best im now 18 weeks and paniking i want to get to 24 weeks laest they can try and save him just wish they had listened to me b4...ive been told not to lift my 1 year old for 4 weeks and be on moderate rest any one else in same position and made it 2 24 weeks or more?? feeling very worried xxxxxxxx hope all u ladys are ok x

Wow! I know what you are going through has to be really stressful. I did not have to have an emergent cerclage, but I know that they can work. I would highly suggest staying off your feet as much as possible. I am on modified bed rest as well which is tough too, but definitely worth it. Hang in there and Big hugs!

 

[lch28]

thanks so much lizzie. She actually didn't check my cervix when she did the ultrasound, she just checked the baby and checked my cervix with her fingers. im guessing that that is not all that accurate? she said it was closed and about 2 cm. i am trying very hard not to worry .. i keep thinking maybe this will lower my chances or something=[ after your reply i am thinking i am going take 2 weeks off of work. I do have a desk job.. and literally am on the phone the entire time and only get up for lunch and to use the bathroom. Do you think this makes any difference as to when i could return? To be honest i don't mind taking time off i just have not even told my boss i am pregnant yet and did not plan on telling him anytime soon. I do have vacation time but of course with such short notice he will require further explanation. Of course - anything for the baby and my pregnancy. Just wondering if it depends on the type of work i do.

Hi Ich and sorry I didn't get here sooner

As you already said, 2cms is on the short side at 11wks, BUT from your post I'm assuming it was a nurse who did the scan and it was transabdominal? In which case her estimated cl is likely to be inaccurate anyway. The only way to get a reasonabley accurate cl is with a tvu, abdominal scans can see that a cervix is closed at the top, and give a rough idea if it is long or short, but very difficult to get an exact measurement. For that reason, I wouldn't get too hung up on the 2cms - your cervix is likely below avearge length, but not necessarily that short honey.

Secondly, resting after stitch placement is imperative in my opinion. Even if you weren't to take complete rest for the remainder of the pregnancy, you should be looking to take atleast one week off maybe two. After that you should minimise physical activity, stay off your feet when not working and give your cervix, stitch and body a helping hand until you reach 28/30wks.

There are very few clinicians who officially order rest after cerclage, and I cannot fathom why. Theoretically the stitch should be enough, and of course to a surgeon it most definitely is, but in reality I do wonder at how many women would have made it with the stitch alone but without atleast some rest as and when they can. I certainly wasn't brave enough to manage without rest, but then I had lots of pressure, aches and pains which made me too scared to do any other.

Sex and orgasms are ideally best avoided if poss, tho we have all had involuntary o's which have never been known to cause ptl and/or cervical shortening. Orgasms do cause temporary uterine contractions, but it's doubtful they are strong enough to cause any significant effects, especially when your body and that of your baby is weeks away from labour 'readiness'. That said, we took the view that anything unnecessary and even slightly risky was best avoided for what amounts to a few months.

There are so many unknowns in pregnancy, especially in ladies with a prior history of complications, so if you can Ich I would play things ultra safe and pull out all the stops this time sweet. There are so many things you can't control in pregnancy hun, but many more that you can. It's those steps that you definitely should take to help things along, no matter what the medical advice says

 

[Emerald87]

thanks so much lizzie. She actually didn't check my cervix when she did the ultrasound, she just checked the baby and checked my cervix with her fingers. im guessing that that is not all that accurate? she said it was closed and about 2 cm. i am trying very hard not to worry .. i keep thinking maybe this will lower my chances or something=[ after your reply i am thinking i am going take 2 weeks off of work. I do have a desk job.. and literally am on the phone the entire time and only get up for lunch and to use the bathroom. Do you think this makes any difference as to when i could return? To be honest i don't mind taking time off i just have not even told my boss i am pregnant yet and did not plan on telling him anytime soon. I do have vacation time but of course with such short notice he will require further explanation. Of course - anything for the baby and my pregnancy. Just wondering if it depends on the type of work i do.

Ohhh - when she inspected the cervix it was 2cm - that wasn't an TVU? Well that's EXCELLENT. Most of the cervix is internal and cannot be seen. If you've got 2cm of externally visible cervix that's loooooong. Mine was 1.2-1.5cm externally and my overall cervix length at a soon-after scan was ~3.5-4cm.

 

[lch28]

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! yay i am so glad you posted this lol.. she didn't like use a speculum and look she just stuck her fingers up there

 

[Emerald87]

Sounds perfect then

 

[chistiana]

Chovie- i m sure lizzie will clarify what she said but till then i think that after 28-30 weeks the baby is way big to jusy fall out..it would take a good lot of strong contractions to actually start labor properly and pose a problem (i think). Ow and of course after 30 weeks you re kind of off the hook as the baby has very good chances of survival (although of course you d rather it went full term!)
Anyway it seems you dont need to worry about that cervix afterall hun, yaaayyyy!

 

[lizziedripping]

Hi Chovie. As Christiana clarified, IC is no longer a threat after 28/30wks because if your cervix does dilate due to weakness, it usually only dilates to 3cms tops. At this stage the baby is too large to slip thru the gap, and unless you actually go into ptl, it won't dilate beyond this. Also, if an incompetent cervix has held up until this point, it is less likely that it will suddenly give way and open - unless again you were to contract in labour.

There is always a small risk of ptl, and maybe slightly more so in women whose cervixes are shorter and/or funneled, but if your issue is purely IC 28wks is past the 'danger zone'. I felt slightly less anxious at 30wks, but because I was carrying twins I was still concerned about ptl so thought it best to remain horizontal. I only truly relaxed at 37wks, then had a section a week later lol!

You can probably move around more after 30wks, but it depends on how you feel physically and mentally. If you feel physically fine, no pressure etc then it's probably fine for you to increase your activities - tho I'd definitely refrain from anything strenuous, or being on your feet for long periods

 

[lizziedripping]

Ich, I can't believe the nurse only did a manual exam and from that told you a cl she deemed even slightly accurate! There is no way she 'd be able to tell cl from that alone. She would be able to say if you cervix had effaced, shortened or dilated and by how much, but not determine cl. As Emerald says, any 'visible' cervix is only at the very bottom end and is minuscule. The remaining length is out of reach and certainly not measurable by hand. It's likely that yours is a completely normal length on tvu! How annoying that she didn't explain this and left you worried unnecessarily!

Hope you're feeling lots better now, and please discourage them from doing needless internals honey xxx

 

[kimbotrav]

hi ladys just wanted to indroduce myself and tell u my bk ground.i had my first child all fine apart from birth...then had 4mc...then found i had a uterine and vaginal septum which i had taken out...i then got pregnant and carried my baby boy till 29+4 days beofre my waters went and i had a c section and that was 12 mobths ago now i am now oregnant again and had said to my consultant about cervical scans likle i had last time as my cervix was short and she wouldnt do them...so this prenancy i have been having trouble since 16 weeks well finally loosing lots of green jelly stuff which i did last time i knew it was my plug so went up the hospital for the 5th time and demanded a cervical scan and said its incompetent i can feel it against there wishes had a scan and yep my worse fears were set in stone it had shortened and funneled so was sent for an emergency cerclage day beofre yesterday they found i was 1cm dilated and not lot of cervix to work with but they tried there best im now 18 weeks and paniking i want to get to 24 weeks laest they can try and save him just wish they had listened to me b4...ive been told not to lift my 1 year old for 4 weeks and be on moderate rest any one else in same position and made it 2 24 weeks or more?? feeling very worried xxxxxxxx hope all u ladys are ok x

Wow! I know what you are going through has to be really stressful. I did not have to have an emergent cerclage, but I know that they can work. I would highly suggest staying off your feet as much as possible. I am on modified bed rest as well which is tough too, but definitely worth it. Hang in there and Big hugs!

how far are u? im 19 weeks almost now and ive been trying my best to stay of my feet its hard oisnt it lol do u have other children? im just praying it holds out and labour/waters stay at bay big hugs 2 u 2 xx

 

[lizziedripping]

Hi Kimbo I remember you from your last pregnancy, and feel so disheartened that no one listened to your fears this time around I see this all too often with IC - it is so under acknowledged as a relatively frequent pregnancy complication.

At 1cm although there was limited cervix left to work with, there was enough and the chnaces are good that your cervix will remain stable if not lengthen now the stitch is in place. The stitch seems to add overall tension to a weak cervix and so whilst it was still closed with no apparent dilation, there is hope. Stay with us and if you need us, please ask - pm me direct if you need anything

 

[ChovieGirl]

Kimbo-

I am 25 weeks, no other children. I do know that others on here have other children and that it makes it a lot harder to stay in bed since you want to be able to tend to them more. You are doing great! Hang in there!

 

[Hopeful 4 #1]

I hope everyone is ok. Sorry can't reply to individual posts all the time as I am using my phone most the time and it would take me ten yrs lol. I had my swab due to yellow funny smelling discharge. They did a speculum and when he took it out it wqs covered and was def yellow. I am still having it. For some reason my results are clear. I was told my white cells are slightly elevated meaning the discharge is there for that reason. Dont really get that. But apparently I am not infected and my cervix is "long and closed"

 

[kimbotrav]

Hi Kimbo I remember you from your last pregnancy, and feel so disheartened that no one listened to your fears this time around I see this all too often with IC - it is so under acknowledged as a relatively frequent pregnancy complication.

At 1cm although there was limited cervix left to work with, there was enough and the chnaces are good that your cervix will remain stable if not lengthen now the stitch is in place. The stitch seems to add overall tension to a weak cervix and so whilst it was still closed with no apparent dilation, there is hope. Stay with us and if you need us, please ask - pm me direct if you need anything

hi thnakyou so much i just think its awful they dont base care on mother concerns and feelings as well as there medical knowledge i was made to feel like they gave me a scan to shut me the hell up and as it turns out i was completely rite i was 1cm dilated wiht not alot of cervix but still trying to remain positive. i really am hoping that all will be ok as all of us here its just such a worrying uncertain time isnt it...im also left wiht may questions for my consultant as she only bothered to see me one in my 3 day stay at hospital...i see her tueday and want to know what my care will be now..i dont have a clue weather u have more scans ext and i really wanted progesterone as well as the stitch but she wouldnt give it to me so i will be askig her again if she has the time for me thnakyou so much for your reply and i will update you all tuesday hope all is ok wiht you 2 xxxx

 

[kimbotrav]

Kimbo-

I am 25 weeks, no other children. I do know that others on here have other children and that it makes it a lot harder to stay in bed since you want to be able to tend to them more. You are doing great! Hang in there!

thnakyou so much and same to you its great to have this thread for support i will update on tuesday xx

 

[LaRockera]

Hopeful -this happened to me throughout my whole pregnancy. I always had an increased level of leucocytes, then they would stuff me with antibiotics and when the results came back it was all clear. After a couple of times I refused to take antibiotics until results came back- and, surprise surprise, nothing there at all again. It's the stitch that probably causes the leucocytes and the extra discharge, as it's a foreign body in you. This is not to say that women't shouldn't take their antibiotics, as infection can cause pprom, especially with a stitch.

I'm just saying what happened in my case.

 

[Hopeful 4 #1]

Was your discharge clear? They gave me antibiotics too so im just gna finish the course x

 

[LaRockera]

I had LOADS of discharge and it varied, from white to yellowish to clear. I even had brown discharge towards 32 weeks, and it turned out to be nothing (or rather, it was probably the stitch digging into my cervix, but not an infection).

Glad it wasn't an infection in any case.

By the way, I got urine test strips from amazon and tested my urine myself every time I suspected an infection. I'm not saying there are in any case to replace proper medical diagnoses, but they did come in handy all those times I was worried I may have had something.

 

[kimbotrav]

hi i was just wondering at what point if your getting pain to go up to hospityal i have been getting period type cramps for couple hours in back and lower front but it has now gone do i still need to go up there to be checked or see if i get any more? had m emergency stitch fitted tueday as i was 1cm dilated and not alot of cervix left i just dnt know what to do for the best thnaks xxxx

 

[Hopeful 4 #1]

hi i was just wondering at what point if your getting pain to go up to hospityal i have been getting period type cramps for couple hours in back and lower front but it has now gone do i still need to go up there to be checked or see if i get any more? had m emergency stitch fitted tueday as i was 1cm dilated and not alot of cervix left i just dnt know what to do for the best thnaks xxxx

I would hun. Or at least ring triage to let them know x