Incompetent Cervix - stitch/cerclage - threatened labour

[chistiana]

Faibel... I m not 100% about the protocol but i was due to get my cerclage at between week 12-14... I started bleeding (heavily- not spotting although it later turned to brown spotting) at 12+4 and my doc wouldnt do the stitch before all blood cleared out so i ended up having it at 17+3. I m sure everything will be fine though.. I had heavy bleeding and still made it to a safe stitch... Your baby is not heavy at the moment so even if you have to wait a week or two i think it will be ok.

 

[lch28]

just got back from my follow up.. my cervix looks great and baby does too =]

 

[lizziedripping]

Hey Ich, yeast infections very common and not usually a problem with the stitch, so try not to worry hun. Same goes for any fever you might get in pregnancy - exceptionally high fevers can be an issue (over 39), but moderately high temp not a problem at all. You can always take paracetamol if you do have one Glad all is looking ok for you today xxx

 

[lizziedripping]

Sorry for the long story...my questions are...

I have just started brown spotting, very light, baby fine. I'm not seeing the consultant until Wednesday, will they still go ahead with stitch if i am bleeding/spotting?

I am already feeling some pressure down there, same as last time, will this get worse with the stitch or will the stitch help to improve this?

If I have a short cervix at this point, will it be possible to still place the stitch?

Sorry I'm starting to panic now that it's getting closer, the sudden appearance of spotting is not helping either.

Thank you for any responses x

Hi there hun

I felt enormous pressure and bulging from as early as 8wks with the twins so can understand your anxiety I also began to lose mucusy, brown blood at around 10wks which looked like bits of the plug to me. I was scheduled for the stitch at 12.4, it got postponed to 13.4 and the blood loss wasn't an issue and didn't stop it going ahead.

They'll only query doing the stitch if they think there's a chance you're miscarrying. If baby has been shown on scan to be fine recently despite the blood loss, then the stitch should still go ahead.

The pressure for me didn't go away after stitch, but in subsequent pregnancies is probably mainly due to pelvic prolapse than a weak cervix. It is still quite early, and even if your cervix was 'giving way' this early (which is doubtful) it probably wouldn't be enough to cause symptoms.

My cervix was very atonal and floppy at 13wks (should at that stage be firm), and when I stood up was likely already funneling at the top under pressure. This is because I was carrying two babies however, and my uterus was the size of an 18wk singleton uterus at that early stage. Yours is unlikely to be shortening significantly yet, and even if it were it would have to be virtually non-existent for it to be too late to place a stitch hun.

Hard as it is, try not to worry. Having a stitch at 12wks is in plenty of time to prevent any catastrophic changes to your cervix darlin'. The pressure you feel might indicate an already weakening cervix, BUT it can't be under more pressure than mine was, nor can it be a as weak as mine at that point. I still made it comfortably to 38wks despite this.

Your pressure can be completely normal after previous pregnancies, but even if, worst case scenario, your cervix were already 'giving' slightly under the weight of your expanding uterus, the stitch will help to give it an overall tension, sure everything up and add that much needed support well before it is too late.

The stitch placed early is remarkable and acts almost like a cervical transplant. Be prepared for pressure and added tightenings after the procedure, but for me these were normal post-surgery symptoms which never amounted to anything and certainly didn't indicate any significant changes. Good luck and keep us posted

 

[WTBmyBFP]

Great news for me:

The cerclage lengthened my cervix back up to 2.9(ish) cm and my Fetal fibronectin test came back negative!!! Whooooo hooooo!!

 

[lch28]

awesome news!

 

[angel229]

Morning ladies,

I have my 20 week scan tomorrow which will be 2 Weeks since I had my emergency cerclage. Does anyone know if they will be able to see if stitch has worked from a abdominal scan? Not had my consultants appointment yet and was hoping they week be able to put my kind at rest about the stitch.

 

[LindyB]

Excellent news Ich and WTB! You both must feel a lot better today.

Angel I have had a couple of abdominal scans to check my cervix/stitch since having my stitch. My consultant did them. He could see that my cervix was closed and that the stitch was holding well. He could also show me the position of the stitch which was very high. I could also see that it had resolved all the funnelling and that my memebranes were now well out of the way. It was very reassuring. They won't be able to get a measurement of the cervix length but my consultant didn't want a measurement - and he doesn't want to do an internal scan.
I will have another abdominal scan at 30 weeks.
Good luck!

 

[LindyB]

Angel I just wanted to say that I am seeing the same cosultant as my last stitch pregnancy and I made it to 37 weeks. He never did any internal scans or checked my cervix length then either.

 

[pinkladyangel]

Morning ladies,

I have my 20 week scan tomorrow which will be 2 Weeks since I had my emergency cerclage. Does anyone know if they will be able to see if stitch has worked from a abdominal scan? Not had my consultants appointment yet and was hoping they week be able to put my kind at rest about the stitch.

Hey Angel
When I had my 20 week scan they checked my stitch and they showed me what was what. I could see that my cervix was closed and you could clearly see the tape used. They could also see that I wasn't funneling. They checked the measurement as well but think someone on here said that the measurement taken from an abdominal scan wasn't 100% accurate but it was good enough for me.
Hope all goes ok for you.
XXX

 

[LindyB]

Sorry I am taking up all the space this morning!
I was just thinking about my cervix being short as my consultant said at my last scan. He said it won't get any longer - which I understand. It will be longer than the 1.9 when it had funnelled. Now the funnelling has gone it can only be as long as it was before my cervix started to change which was 2.9cm. Does that sound right?

Anyway, with my two previous pregnancies my waters broke early then I went into labour and it took ages and ages for my cervix to actually open. Do you think my cervix was funnelling at the top and my membranes were bulging down causing them to break?

i am nearly 28 weeks and whilst I don't think that my cervix will start to open now, I think PROM is what I need to be more worried about. Will resting, staying off my feet help to prevent PROM in the same way it can prevent your cervix opening? By reducing funnelling?

I know infections can cause PROM. When I had the stitch they took a swab high up and it was clear. A couple of weeks later a vaginal swab showed 'scant amount' of GBS. I had this in my first pg. I don't think this can cause PROM unless it gets into my uterus? As My cervix is closed I should be ok?

Sorry about the millions of questions!

 

[LindyB]

Hi Pinkladyangel! How many weeks are you now?

 

[lizziedripping]

Hey angel, as the other ladies have said, an abdo scan can definitely see if the cervix is funneled or not and if the stitch is pretty much intact, but it isn't great at establishing length. It can't see the whole cervical length, mainly the top part - but given that it is the top which changes first, then this is probably enough x

Wtb - brilliant news, even more remarkable given that you're carrying trips x

Lindy - Prom happens for a whole host of reasons (many of which are not yet fully understood). On of the major reasons is dilation of a weak cervix, but Doctors are reluctant to say absolutely that this is a cause in many cases because by the time of funneling, infection has commonly set in too and then it's a 'chicken and egg' scenario, most clinicians favouring infection as an explanation as to why dilation and prom has happened.

It is possible that your cervix began to funnel and caused your prom, then hours later labour started. IC can cause this to happen, but your cervix still needs strong, regular contractions to open fully in labour - this would explain why it took an age for your cervix to open. That's the ironic thing about IC - a weak cervix is no more likely to dilate fully than any other 'normal' cervix unless under the influence of contractions.

It's difficult to be definite about your case Hun, but I would say that given your cervix had changed pretty early on it is weak, it had likely funneled in prior pregnancies and it was the cause of your Prom. If this is the case, rest and the stitch will prevent funneling significant enough to cause prom in this pregnancy - unless of course for you there are other unknown factors at play.

Infection is another 'grey area', but with a nicely closed cervix below the stitch it would be extremely unlikely for any lingering gbs to track successfully into your uterus and cause ptl. The cervix when closed is sterile and very efficient at keeping the nasties out. So long as its closed below, any funneling above is not a problem.

Your cervix can lengthen again to its previous pre-pregnancy state now that it is closed, and if it stays that way (which there is no reason why it can't), then there is no reason for prom to be a feature this time for you. Hope that answers your questions chick xxx

 

[LindyB]

I Didn't know you were having triplets WTB? That's amazing! Glad you are being well looked after! xx

 

[pinkladyangel]

Hi Pinkladyangel! How many weeks are you now?

Hi Lindy
I'm 32+2 weeks.
Been a long old journey but only got 5 weeks until stitch comes out. Not looking forward to that bit to be honest. I had an emergency stitch last year and when they removed it (went into labour at 25 weeks)it bloody hurt more than giving birth. Think it could have been cos my cervix had dilated around the stitch but wont forget that in a hurry. The other factor is not knowing if stitch removal will trigger labour.
Sorry for going on lol
XXX

 

[Srrme]

Does it sound like I have an incompetent cervix?

I went into labor with my first at 28.6 weeks. No reason was found, other than spontaneous preterm labor. Once I became pregnant with my second, I was put on weekly progesterone injections, and bi-weekly cervical length scans. My cervix measured fine until around 28 or so weeks, it was "border line" short. The scans were stopped so as not to cause any more shortening. My Doctor wasn't too concerned, and put it off as normal, since the cervix does shorten through out your pregnancy.

TMI. My husband and I didn't have a lot of sex during my second pregnancy because I was afraid to, and when we did have sex, I would have frequent braxton hicks afterwards. No one told me to refrain from having sex, or any other activities that might irritate my cervix.

I went into premature labor at 35 weeks after having sex, and realized I went into premature labor with my first as well after having sex. Coincidence?

When I was admitted into the hospital at 35 weeks, I was checked, and dilated 3 centimetres, within an hour after being checked, I was 9 centimetres.

If we do decide on having another child in the future, should I elect to have a stitch?

 

[LindyB]

Pinkladyangel you've done really well. I can't wait to get past 32 weeks.
My stitch hurt loads when they took it out as my waters had broken and I was having mild contractions. Most people I read about say it doesn't hurt so you will be fine. But I am just as scared as you really! How much resting/walking etc have you been doing. I carried on as normal with my last stitch pregnancy and I got almost to 37 weeks (1 day less!) the stitch was put in early as a precaution. This time the stitch was put in later after my cervix had changed and I've not really left the house for 8 weeks now - I'm too scared this time. x x

 

[pinkladyangel]

You've done really well. I can't wait to get past 32 weeks.
My stitch hurt loads when they took it out as my waters had broken and I was having mild contractions. Most people I read about say it doesn't hurt so you will be fine. But I am just as scared as you really! How much resting/walking etc have you been doing. I carried on as normal with my last stitch pregnancy and I got almost to 37 weeks (1 day less!) the stitch was put in early as a precaution. This time the stitch was put in later after my cervix had changed and I've not really left the house for 8 weeks now - I'm too scared this time. x x

This pregnancy I had the stitch put in at 13 weeks. I bled for that day then nothing. Not even discharge for a start. My consultant signed me off work for 3weeks (I'm a preschool assistant) then I went back to see him. He checked stitch and all was good and closed. I went straightback to normality although was told no lifting and listen to my body basically. Work and family were fab. I worked mon, tues, wed all day and thurs and fri mornings only. I used the thurs and fri afternoons to catch up on sleep or just putting my feet up. At 22 weeks I started getting a bit of discharge and felt pressure down below so went to hospital and they checked stitch. All was fine again and I apologised to doc for wasting time. She told me off and said after what we'd been through it was understanable and to carry on coming in if I was worried about anything. She was really nice and caring. Luckily my job works to school terms so I've got all summer hols off and have been resting but making sure I've been moving about as well. My hips are playing up big time but mainly early hours of morning. Still not long to go now. When I go back to work in sept I have 8 days left until maternity leave starts and stitch removal.
Couldnt be happier really but it has been a very stressful and long journey to get here. Every little twinge and pain make me think and rethink about what happened last year and whether it would happen again. People tell me I'm brave to even try again but it's what we both want so much. Just because you lose a baby doesn't stop the wanting for one to hold. The hardest part was going to hospital pregnant and coming home empty handed.
Sounds like you're having a tough journey too. Stay strong hun.
X

 

[angel229]

hi,
So just had my 20 week scan all well with baby (60% girl). But now I have been sent to wait to speak to a consultant cos they are concerned about my cervical length. My scan showed 3mm open and 7mm closed. Been waiting ages and getting very worried. Dies anyone else have any experience in this?
Cerclage placed 2 Weeks ago on a fully open cervix.
Any reassurance would be nice x x

 

[lizziedripping]

Hey angel, don't panic sweet - if the measurements mean 7mms closed below the stitch, and 3mms open above then although not ideal, these measurements are to be expected since you had a cerclage on a fully open cervix. The important thing is to get some cervical closure below - the stitch usually then prevents it opening any further. It's the reason for having the stitch in the first place. A total of 1cm in length isn't a huge amount, but it is enough and not too ad considering.

Get back to us when you have more detail, good luck xx