Incompetent Cervix - stitch/cerclage - threatened labour

[lch28]

hey honey so sorry you are going through this.. i think you should talk to another dr? maybe get a second opinion?

 

[Myownjoy]

Thanks Ich. I will see if I can be referred to another hospital.

 

[ChovieGirl]

thanks ladies.. the stringy stuff went away.. now it is just some pinkish tinged discharge. less then i was expecting. i am seeing my doctor next week . is that not soon enough?

i am very very relieved to have gotten this done. i was so scared that all the doctors would say i would only get it if my cervix shortened. this is what the first one said. then i found my new doctor =] we are so pleased with him.

My follow up appointment was a week after my cerclage was placed. I think it is about the norm, but if you have any concerns before then, give your doctor a ring.

 

[ChovieGirl]

Hello ladies, I've been following this thread and have gained a lot from it but I need your advice, please.

I'm 12 weeks today (thank God). At 11 + 2 weeks, i had intense pain which I initially thought was wind but after 2 nights of not sleeping, I went to the hospital where I was told that baby was fine but my cervix was funnelling and measuring at 29mm. I asked about having a stitch put in but the Dr said it wouldn't make any difference at that point and neither would bedrest. He said I had to get to 16 or so weeks before considering a stitch. The scan also revelaed a small area where there was blood and i was given dihydrocodeine for the pain. Pain went away for 3 days and came back today.

Has anyone had any experience of funneling at such an early stage? I put myself on bedrest though the Dr said it won't make any difference. I have also been drinking loads of water and praying a lot.

I have a follow up appointment next week to check my cervix but I am trusting God that it will not be worse.

I agree with Ich that you might should get a second opinion, especially since your cervix is funneling. I have read on here that some of the ladies really had to push to get their doctor to do the stitch. Usually preventative cerclages are put in between 12 and 14 weeks. I had mine placed at 14 weeks. You are doing the right thing by putting yourself on bedrest and being cautious. I was already funneling at 14 weeks and have been on bed rest since. You should definitely have a doctor that you feel comfortable with and one that really listens to your concerns.

Saying prayers!

 

[bluestarlight]

Thanks ladies.. it's nice to hear from ladies who are in the same position.

Bluestarlight and I do seem to be in the same sort of situation. It's pretty hard living day to day. I just wish someone could just let me know which day she'll be born and then I'd be all good, haha.

I'll definitely keep you updated as to how things go..

Hi, yes it sounds very similar to how I started. This is my second but first with IC, they saw I was shorter than normal at 2cm at my 20 week scan, told me to take it easy and would measure me 4 weeks later. I started vaginal progesterone inserts around then too. At 24 weeks, I had 0.7cm of cervix left and 2cm dilated. I was placed on hospital bed rest until 28 weeks then home bed rest until last wednesday. I hadn't changed at all, still 2cm dilated and depending on the doc, 50-80% effaced. They also haven't done another TVU on me since 24 weeks, just checking manually. At 20 weeks they told me it was too risky for a stitch, so I haven't had one, but said I was good for one next pregnancy since my cervix has been shortening without any signs or preterm labor. Last wednesday, they said I still hadn't changed and let me go back to work as long as i did mostly sit down things. I was only back for 2 days when I went into preterm labor friday night. I really think it was the heat more than anything, but who knows. Anyways, 2 hours of contactions was enough to dilate me to 4cm, though the doc said I was still only 50% effaced. They haven't checked again, just sent me home and said the next time I go into labor that will be it, so to rest and try to hold things off hopefully for another week or two. But my cervix has still been holding things in, but I haven't had any contractions since saturday morning. I'm pretty sure the contractions are what changed things at this point, has your doc said anything about yours? I do feel great to have gotten this far, baby is less in danger even if she will be in nicu for a bit. I was absolutely terrified at 24 weeks compared to now. Now i'm just bored and itching for the end to come so I can resume a more normal life and have my little girl here to join her family.

 

[bluestarlight]

Hey ladies,
I haven't spent much time in this thread because I haven't had a stitch, and it seems like most ladies here have had.

But I am hoping for some advice on what to expect.

I was at 1.6 cm long and 1 cm dilated at 26 weeks...

At 32 weeks now, my cervix is 3 cm dilated, still short at about 75% effaced (they won't do an exact measurement again)... and very soft and anterior. On top of that, baby has dropped and I'm feeling a lot of pressure.

I have had contractions constantly for the last 6 weeks, lasting anywhere between 40-90 seconds and occurring every 5-90 minutes. Quite irregular, but strong.. so I'm sure they're responsible for the change in cervix.

My doctors won't really give me any answers, as they're not sure what to expect either.

I haven't had a stitch, as I mentioned, because it was too late when they found out. And they didn't start me on progesterone because I have no history of ptl or miscarriage (this is my first pregnancy).

I've been going weekly for fetal fibronectin and it has always been negative... and that's where I get a bit uneasy. A negative fFN should mean I have at least 2 weeks.

But this baby feels like she's falling out of me. And I'd like the chance to get the steroids for her lungs if she will be here soon.

Anyone know what I should expect with that sort of a cervix? Seems to me that it's ideally ripe for labor and it won't be long.

Thanks so much for listening

I'm feeling her more lower down too since have the preterm labor. How come they haven't tried to stop your contractions yet if you have been having them for 6 weeks? that isn't good, I would think that would change your cervix and they would want to give you steroids. They are in 2 shots, 1 every 24 hours and the second shot needs 24 hours to circulate fully to the baby. They told me the steroid are good until they are about 34 weeks then its less effective because baby is already producing its own surfactant in its lungs. If your doc won't do anything, have you called your local L&D to see what they would suggest? This is my first pregnancy with IC so i'm learning as I go along, I only have my limited experience to offer so far from what my doctors have done or what I have read up on here and elsewhere.

 

[Myownjoy]

Thanks Chowiegirl, I intend to see another Dr.

 

[lch28]

my bleeding is pretty much gone. my doctor said i didnt have much during the procedure and he has seen more. so is a TVU bad for the stitch? i am supposed to get one at 16 weeks. also.. i have been taking vaginal suppositories since 5 weeks. anyway when i started them my dr told me to clean out any "build up" with my fingers so the next dose can absorb. its called crinone and it builds up its gross. but do you think its a bad idea to go poking around in there with my fingers right now? cause i do!

 

[lizziedripping]

Hi aegle, so glad to see you made it this far Your cervix is certainly behaving as if it is in slow labour, BUT this can happen early on with baby still making it to term, and there is no way to predict absolutely if it will happen sooner rather than later. You are obviously at increased risk of delivering early, but then you've been like this for several weeks without delivering so your situation is very unpredictable.

Feeling pressure low down is to be expected because you are 3cms dilated - the same position I was in at 23wks with my second baby, and the pressure and bulging sensation was immense. Until you have stronger, more regular contractions however, youre not likely to dilate much further - stronger contractions could of course start at any moment but because your ffn is still negative this is probably not immediately imminent.

As for steroids, some docs are happy to give them routinely every couple of weeks throughout, whilst others are more cautious about giving them too often. Because their effects only really last a week or so, it's a gamble. Give them too hastily, baby doesn't deliver and then they have to prescribe them again within weeks - not ideal. It's very much a guessing game based on probabilities - there are no guarantees.

Sit tight, keep an eye on those contractions and if you feel anything at all unusual for you 'scream' as loud as you can to get those steroids. After 34wks they aren't necessary, so not a couple more weeks now Hun. Good luck xx

My joy - your situation is unusual honey. 11.3 wks is very early to experience an incompetent cervix, and I would have said that because of your pains and presenting with a dilated cervix that this is less consistent with genuine IC. Some ladies do have weak cervixes which begin to shorten very early on, but before 14wks is very unusual, and even then the cervix changes without pain. This is possibly why your docs are taking a 'wait and see' approach because your case isn't typical of IC. If you had presented with painless dilatation/funneling at 12-14wks then there would be a definite case for an early stitch. Stitching if you were experiencing an early miscarriage for example (I'm not suggesting that you are btw) could be dangerous and cause tearing of your cervix if you were to have more contractions with it in place. With an uncertain diagnosis this early on makes this a very tough call.

All that said, if you continue to experience sporadic pain without bleeding, then by all means ask for another check and push them on the point. IC doesn't always run a predictable course, and neither does pregnancy - you could be one of the few who has very early IC and would benefit from a stitch. I am so sorry that you're experiencing this stress anyway, pregnancy when it doesn't run smooth is a nightmare whatever the reason. Keep us posted, and let me know how you are feeling later on today xxx

 

[lch28]

im having some back pain. nothing intense.. should i call my dr?

 

[ChovieGirl]

my bleeding is pretty much gone. my doctor said i didnt have much during the procedure and he has seen more. so is a TVU bad for the stitch? i am supposed to get one at 16 weeks. also.. i have been taking vaginal suppositories since 5 weeks. anyway when i started them my dr told me to clean out any "build up" with my fingers so the next dose can absorb. its called crinone and it builds up its gross. but do you think its a bad idea to go poking around in there with my fingers right now? cause i do!

I don't think there is an issue with a TVU after the stitch. I have had quite a few since mine. In fact, the more accurate way that they can get an actual length reading of your cervix is by a TVU. I am also on the Crinone and I hate the way it builds up; however, my doctor told me different than yours. She does not want me putting my fingers up there to prevent getting any sort of infection. Since I already have to put the applicator in there (carefully) when I am pulling it out, I lightly wiggle it around a little to see if it will pull some of that stuff out. Usually when I go to my doctor, she will really clean some of it out. I have been on the Crinone for about 13 weeks now and so far so good. I was told that Crinone is some of the best stuff out there right now to help your cervix.

 

[ChovieGirl]

im having some back pain. nothing intense.. should i call my dr?

If this is your second day after you cerclage and the pain is not intense, then you are more than likely okay. I would be worried more if it felt like really bad menstrual cramps. You might want to call your doctor just to ease your mind though. I call my doctors anytime I have a question or am really worried about something. I think they know who I am now. LoL.

 

[lch28]

lol.. no it does not feel like period cramps.. my doctor seems so relaxed about everything. he does not even want me on bed rest. =\ i trust him but it just worries me. it is good to hear that about the crinone. i have been on it since 5 weeks due to low progesterone. i really think i would have had a mC after. my doctor says its up to me if i want to continue the crinone or switch to p17 shots . do you think crinone is better?

 

[ChovieGirl]

lol.. no it does not feel like period cramps.. my doctor seems so relaxed about everything. he does not even want me on bed rest. =\ i trust him but it just worries me. it is good to hear that about the crinone. i have been on it since 5 weeks due to low progesterone. i really think i would have had a mC after. my doctor says its up to me if i want to continue the crinone or switch to p17 shots . do you think crinone is better?

My normal OBGYN and high risk doctor both seem to think that the Crinone works a little better than the shots. I think that this is due to the fact that it goes directly to your cervix. I don't have any experience with the p17 shots, but I have seen several ladies on here that have used them and did just as good too.

 

[lch28]

the p17 shots are much more expensive. ill talk to my dr. to be honest id love not to have the build up. it really grosses me out =[ i just feel like my dr is crazy lol!! he has done over 100 succesful cerclages. He gave me no restrictions but no lifting, stay in bed (just yesterday) and to juts take it easy over all. He has no problem with me working and even told me i can have sex in a week. I wont be doing that.

so i have another question. my pre natals make me constipated. can straining to go affect the cerclage??

 

[ChovieGirl]

the p17 shots are much more expensive. ill talk to my dr. to be honest id love not to have the build up. it really grosses me out =[ i just feel like my dr is crazy lol!! he has done over 100 succesful cerclages. He gave me no restrictions but no lifting, stay in bed (just yesterday) and to juts take it easy over all. He has no problem with me working and even told me i can have sex in a week. I wont be doing that.

so i have another question. my pre natals make me constipated. can straining to go affect the cerclage??

I know what you mean about the Crinone being gross, but I guess I am just used to it now. It has become a routine for me and the more I use it, the less I think about it these days.

I too have been so worried about the constipation thing for a while now, but sometimes straining is almost impossible to avoid, even with meds to help. Tmi, but I have had a couple times where I was stuck on the toilet for almost 45 minutes praying that something would happen. My doctor did not seem to worried about it; although, they did say to be careful with straining just because you don't want the added pressure and hemorrhoids. Also, I noticed that I get heartburn a lot worse when I am constipated...Guess that is because things are not moving out as quickly. I was so worried that I would pop my stitch or something, but was told that was highly unlikely. I am now taking Colace (stool softener) once a night, eating a prune (just one since they are so nasty to me) in the morning and trying to drink lots of water throughout the day. This has really helped a lot! My doctors also said that Miralax works really well, but I have yet to try that. You might also see if you can find a different prenatal that does not have as much iron in it, unless you are anemic. The extra iron can really cause constipation.

 

[lch28]

i am not anemic but i do carry a hemoglobin variant called hemoglobin chicago. couldn't tell you much about it since no doctors know about it. all i know is i carry it and so does my mother (thats why i have it hehe) and its not a problem unless i have a baby with someone who carries it as well (fiancee has been tested) it causes no health issues for me and never would have found out about it had i not gotten pregnant with Sophia. it came up on the 12 panel blood test. however it can lead to anemia somehow ????? so my dr likes me to take the iron. i wish i knew more about it. i even went to a hematologist. she said shes never heard of it in her life and told me all that i already knew about it.. it is kind of like a smaller trait of sicle cell and thallasemia but for Mediterraneans. anyway i am also worried about the constipation. i drink tons of water. i cant even stand the thought of prunes lol! my dr said kiwi could work. i do have colace. its okay to take that once a day then?

 

[ChovieGirl]

i am not anemic but i do carry a hemoglobin variant called hemoglobin chicago. couldn't tell you much about it since no doctors know about it. all i know is i carry it and so does my mother (thats why i have it hehe) and its not a problem unless i have a baby with someone who carries it as well (fiancee has been tested) it causes no health issues for me and never would have found out about it had i not gotten pregnant with Sophia. it came up on the 12 panel blood test. however it can lead to anemia somehow ????? so my dr likes me to take the iron. i wish i knew more about it. i even went to a hematologist. she said shes never heard of it in her life and told me all that i already knew about it.. it is kind of like a smaller trait of sicle cell and thallasemia but for Mediterraneans. anyway i am also worried about the constipation. i drink tons of water. i cant even stand the thought of prunes lol! my dr said kiwi could work. i do have colace. its okay to take that once a day then?

I was told that I can take Colace on a daily basis. I only take one, not two, even though the directions say you can take two. Although, I think that if you get more fiber and eat foods that make you go, then you might not need to take it every day. I had to kind of find a balance.

 

[lizziedripping]

Hi lovely ladies

Ich - back, abdominal, and pelvic pain are all normal after the surgery, as are menstrual like cramps and tightenings so please don't be alarmed. You have had surgery after all and should expect some kick back from it. If the stitch placement were to cause problems, it would be full on ptl with strong, regular cramps and masses of bleeding. I haven't heard of this happening to anyone yet who has had an elective cerclage. Bleeding too is scant and minimal after stitch, and is more mucusy and brown much like the end of a period.

I would opt for the crinone Hun, it does act directly on the cervix and has shown brilliant results - that's if you can tolerate the 'gunk'. Putting clean fingers gently inside won't do much to affect your cervix and should be fine.

As for tvu, I had my first one at 15wks - 2wks after stitch placement. The probe won't hurt baby or stitch at all. I had one every 3wks and it was painless and harmless xx

 

[kimbotrav]

hi ladys i have been on antibiotics and got thrush from it but im worried about putting a pessay up me as when i had my stitch placed i was 1cm dilated do you think it will be ok or should i not do it i have spoke to a midwife and they said should be fine but im not sure xxxx