Incompetent Cervix - stitch/cerclage - threatened labour

[lizziedripping]

Hi Lindy, an embedded stitch is only evident when they look properly and/or begin to remove it. Some docs prepare for this by removal in theatre with a spinal. It's more likely that the shirodkar is embedded and is usually removed in theatre as a result. Macdonald stitches are simpler to put in and remove xx

 

[JJEE]

Hello Ladies,

Welcome to all the new ladies, and welcome back to some returning ladies! Congratulations on your pregnancies!

I am still surprised at how quickly this thread moves! I am also rather excited to see triplets are expected by WTB! Wow..I have read your pregnancy journal and will be following this thread to see how you are getting on!

As for me, I go in on Mon for my stitch removal, I was quite nervous about having it out..but have just been catching up and Lizzie's reply to Pink has made me feel a whole heap better about it! Thanks Lizzie! Just been to see the midwife and she said the babies head is very low, which would explain all of the pressure I am now feeling, I am full term from tomorrow, I am so grateful to have made it this far!

I will update Tues with how the stitch removal went!

xxx

 

[angel229]

Hi,
Been to see the consultant. They told me that I am at high risk of not reaching 24 Weeks but have told me to rest and take each day as it comes. I will be having a scan every 2 Weeks followed by consultant. Fingers crossed I can hold out longer.
Has anyone else been told this but gone longer than 24 Weeks?

 

[lch28]

aww angel i really don't have many answers (i am a first timer with the stitch) but i think if you made it since 18 weeks with the stitch you have a really good chance of making it longer!! but i do have a question i wanted to ask.. with Sophia i was 5cm dilated and they refused to do a stitch because i was over 4cm. are the rules different by you?

 

[angel229]

Hi ich,
Not sure what the rule us to be honest. I hadn't even heard of a cervical cerclage until 2 Weeks ago. But I definitely had a fully open cervix as it is in all of my scan notes. Sorry I couldn't be anymore help x x x

 

[lizziedripping]

Ich, angel might only have been 1cm dilated but fully open at that hun. The general rule of thumb is that they won't stitch if your are 3cms dilated or more - by then the cervix has gone too far and ptl is likely round the corner if not already started.

Angel - did they say exactly how much closed cervix you have remaining? Since you were already dilated at stitch, then a short but closed cervix is to be expected post stitch. A little surprised they aren't hopeful, from my point of view your cervix is behaving as expected xx

 

[angel229]

Hi Lizzie,
I have 7mm of closed cervix. Which I know isn't a great deal. Think that is why they are not hopefully. Just taking each day as it comes and resting x x

 

[lch28]

oooh whats the difference between dilated and open? lol

 

[mpg1502]

Hi,
Been to see the consultant. They told me that I am at high risk of not reaching 24 Weeks but have told me to rest and take each day as it comes. I will be having a scan every 2 Weeks followed by consultant. Fingers crossed I can hold out longer.
Has anyone else been told this but gone longer than 24 Weeks?

Hello Angel229,

Yes, I was high risk and told that I would probably deliver at 24 weeks (and they prepared us both with steroids etc) but my daughter stayed in till 37+6!! In fact when I saw my consultant after she was delivered he said "I'm not a betting man but that day we saw you just before 24 weeks I would have bet that you would have delivered that baby, in fact when we stitched you up we had to tuck a foot back in" !!!!!!! Luckily all my membranes etc were still intact and although my cervix was down to 1mm at front and 0mm at the back they still managed to get a stitch in that held until nearly full term. So there is plenty of hope!

Wishing you lots of luck x

 

[lch28]

wow mpg that is an amazing story. was he serious about tucking a foot in lol? how dilated were u?

 

[angel229]

Thanks mpg,
Similar thing the surgeon said to me after putting in the stitch. Apparently baby kept kicking her out of the way and she had to push the foot and sack back in. in my scan yesterday baby had her foot in the funnelling kicking me in the cervix. Not comfy at all, lol x x thank you for sharing your story with me. Hopefully mine will have a similar outcome x x

 

[lizziedripping]

Ich - dilation is the same as open, what I mean is that angel's cervix was open but only to 1cm (tho she doesn't know exactly how dilated she was). Yours was open but had opened wider to 4cms, thus your cervical dilation had progressed further. Once dilation has gone beyond a certain point, the odds of a stitch working are much reduced. The risks of ptl beginning are also increased.

Angel, there is every hope with 7mms of closed cervix and a stitch. What gives me heart iSt that you are 2/3wks post stitch and nothing has happened (no signs of ptl). This is an extremely good sign despite your lack of length. My cervix was dilated to 3cms when they stitched at 23wks, and within 48hrs of placement I began to experience very strong, regular contractions. Within 10days my waters had gone. Your cervix is behaving very well, and the signs currently are better than I'd have expected.

Keep resting, don't lose hope

 

[lch28]

thanks lizzie. also wanted to ask you to explain funneling to me. i have my first tvu in 2 weeks (gender scan too yippeeee) and want to know what ideally my cevix should be. i always read you ladies talking about funneling and have not a clue what it is!!

 

[WTBmyBFP]

Funneling from what I understand is the side of your cervix where the placenta is (inside) literally funneling open. In the image it is the shape of a funnel/whirlpool. I am not effaced or dialated (vaginal side of the cervix) but my cervix had shortened and even now is funneled.

 

[lizziedripping]

Funneling is when your cervix is open at the top but closed below. It would look on scan like a letter 'Y'. Funneling is the first step in early labour as the cervix thins out, and opens. Funneling is classic in IC as the top part of the cervix 'gives' as the uterus expands.

Stitches tend to prevent funneling in some ladies, in others the cervix funnels to the stitch but cannot open any further because the stitch prevents it. In my case funneling didn't happen until the 25wk scan - I was funneled pretty much to the stitch. At the previous 21wk scan my cervix was long and closed - this surprised everyone given how weak and floppy my cervix was at 13wks -testament to the brilliance of an elective stitch xx

 

[sassy_vixen]

Hello ladies-

I read this thread every day, but don't post very often. I am glad to see you are all still hanging in there.

Had my weekly appointment on Wednesday with the perinatologist. I am shortened back to 1.9cm and am funnelled to the stitch. It is better than the .51cm I started with. First week out was 2.3cm, second week was 3.2cm and then this week was 1.9cm. The doctors didn't seem overly concerned because I haven't shortened past the stitch. Have any of you shortened past the stitch? I didn't know that was possible, since the stitch is IN there - does that really happen!?

I am still on bedrest, and don't expect that to change. My next CL check is next week, and I am getting weekly scans to check amniotic fluid levels since they have me taking ibuprofen every day.

Here is a pic of the ultrasound when they did my first cervical length check at 17+6 - I was sent straight to the hospital after this & got the cerclage the following day. The little tiny measurement on the right is all the cervix I had left. The part to the left of the measurement is the funnelling, for those that wondered what it was, and all that 'stuff' in the funnelled part is what they call debris, which are particles in the amniotic fluid that has accumulated in the funnel.



https://i272.photobucket.com/albums/jj178/BlessedWithBoyz/CLUS157-1.jpg

 

[lch28]

wow thanks for posting that scan pic =]

 

[Jen1802]

Hey girls mind if I join you's? In my second pregnancy I went into hospital at 25 weeks 4 cm dilated and with bulging membranes. Unfortunately a stitch wasn't an option for me as the membranes fully descended over the course of 6 days and broke and my daughter was born via an emergency classical c section on the 18th September 2011. She's done really well but has been left with weak lungs and is extremely prone to respiratory infections. I'm positive she'll outgrow this though, after what was obviously quite a traumatic period we decided to leave having kids until she is 2 but just found out a few weeks ago that I'm pregnant again. Bit of a shock and quite scared of what this pregnancy holds.

When I was discharged from the hospital I was told I'd have to attend a consultant for any subsequent pregnancies and that they were recommending that I get a stitch in between 12 - 16 weeks. I've no idea how far along I am and I'm waiting on my booking in appointment. Hope it comes through quickly so I can find out what the consultant plans on doing this time round. xoxo

 

[Alisa F]

Jen - welcome! elective stitch is the way to go. you will get your booking appointment in no time and they will schedule your stitch and you will be fine. Good luck hon. Sounds like your hospital is a good one cos they did a c-sec at 25+ for you. Keep us updated x

 

[Jen1802]

They had no choice they kept losing her heartbeat and when the waters broke they realised I had an antenatal hemorrhage as the waters were full of blood. I def think an elective stitch is the way to go, roll on the consultants appt! x