Incompetent Cervix - stitch/cerclage - threatened labour

[Alisa F]

Katece - I'm truly sorry for your loss. I remember how it feels when it's all fresh. If it makes you feel better to search for answers then do it. I found that helped but maybe it was time that helped. It's 20 months since we lost our boy at 25+2 and i think time has healed some of the wounds.

Any uterine anomaly comes with IC risk, but most docs don't remember that from med school unless. Arcuate is the least worst of the anomalies if that helps. I have unicornuate which is the worst apparently.

With regards to your c-section, I think that was the best decision to have one. We weren't given that option at all, I was made to do footling breech delivery. Baby boys heart rate was perfect seconds before he was delivered..... then he was gone. I will always believe it was the delivery that caused his death. I am still angry and still believe he would be with us today toddling around me right now had they done a csect.

The point I'm trying to make is you're not alone, you've every right to feel every emotion out there and give yourself time to heal and time to get answers. Above all, take control, see as many specialists as it takes. You have a uterine anomaly and history of late loss, you must have cerclage in future. I have the details of the most experienced and willing consultants in cerclage in UK and USA so please let me know if it will help you to speak with them and I will give you their details xxx

 

[Alisa F]

MillyBert - I almost feel violent towards the person who told you they dont do stitch on nhs! I think all us UK ladies here were stitched on nhs. That's appalling u were told otherwise.

A good number of ladies on here were stitched at 20+ weeks. If ur appointment is after 20 wks and ur cervix is in a bad state demand an emergent cerclage. Every time I go for my high risk appts I never see the consultant because he is apparently doing emergent cerclages at last minute. That's what they do. You shouldn't have to wait weeks if you need one. Sadly sometimes on nhs u have to make a scene and get a bit hysterical if ur at a bad or busy hospital. I had to do that to get into the high risk clinic, otherwise the midwife saw no need for special care despite the fact I have half a uterus, a stitch and previous late loss! I still want to throttle her when I see her there when we go for our appointments. She avoids me....

Be strong, be firm, don't take no for an answer and don't be afraid to refuse to leave without seeing head consultant until they agree to your stitch xxx

P.s my high risk midwife told me off the record you sometimes need to exaggerate your symptoms to get what you want. But sounds like your pain is bad enough without u having to exaggerate ...

 

[Katece]

Thanks LaRockera.

As a follow-up question, my c-section was the classical vertical incision. Did your gyno say you could try again with that kind, or with a normal horizontal cut, which most women get these days?

 

[baby_maybe]

Milly - all my sutures have been done on the nhs (3 so far) and I'm about to have a fourth. My first one was placed as an emergency at 24 weeks on an open cervix and my consultant was insistent that I have it and he do it himself even though it was very risky at that stage. I managed to get to 32+ weeks and I know it was the suture that saved my little girls life. The second time my consultant (I had moved by then) wouldn't do an elective one and wanted to monitor me, I funnelled at 20 weeks and was told to go home for the weekend and be followed up the next week. I refused to leave the hospital until they agreed to get me admitted to do the procedure. It worked and I had the suture the following morning, I carried to term. Last time round (same area, new consultant) I had an elective placed at 14 weeks, carried to term and never had any issues. This time round with the same consultant it's the same plan, elective suture and hopefully no issues.

Whatever you have been told about sutures on the nhs is just not true. There are plenty of consultants who are willing to place electives sutures and emergency ones if there is evidence to do so. From the symptoms you have described I would definitely say that you need to make a fuss and get one done. Yes it is slightly higher risk to place once cervical changes have already taken place,but personally I'd rather go for that, than take the possible alternative. Please try and get a consultant or midwife to listen to you, if necessary ask for a second opinion from either another consultant at your hospital or from a consultant at another hospital. At this point if it were me I think I'd just turn up at maternity triage and insist you're not leaving until your concern has been dealt with properly.

Keep us posted on what happens

 

[baby_maybe]

Well ladies my morning was interesting. Had some slight discomfort yesterday and just didn't feel quite right, anyway I went to bed to await this mornings feelings. Woke up to some bloody discharge and immediately freaked out thinking something cervix related must be going on. Called maternity and went up to be checked and the midwife tried to listen in but couldn't hear anything (probably just too early). So when the doc came she decided to get the portable scanner and check peanut, who was fine heart beating away and wriggly. She did a speculum and said that she couldn't see any further blood or fluid and that my cervix is long and closed. So sent home, told to take it easy and 'we'll see you next week for your suture'!

I guess it's always better to get checked, my poor hubby though, I had to call him out of work to take me and get m mum over to watch the girls while we went. He honestly thinks I'm the most neurotic person in the world right now, which I suppose is fair, I'd just rather be safe than sorry!

 

[angel229]

Hi katece,

Sorry to hear about everything that has happened you. As everyone else has said we are here for you x x

Can I ask why they gave you a classic c- section instead of the horizontal? I thought they had stopped giving those years ago x x

I have had 2 previous horizontal sections. I was told with my first to wait 1 year but didn't get pregnant again for 6 years. With my 2nd I was given no guide lines, I guess they thought I already knew after already having 1. I got pregnant 7 months after having it. I am currently 23+3 Weeks after having an emergency cerclage at 18+6. My cervix was fully open. Never had any previous problems in previous pregnancies. I am not saying that me getting pregnant so soon after my section is the reason for my problems but it has raised questions in my head that I assume will never be answered x x

 

[Katece]

Alisa, thank you for helping me to feel one degree better about my c-section. Though I am sorry that you had to go through the experience of questioning if things would be different if you had a section. Those "what ifs" are so painful, and they play in my mind constantly.

My biggest "what if" is having a McDonald cerclage instead of a Shirodkar. At 20 weeks, when I was .2 cm and dilated a finger, the doctors said I could have a McDonald right away, or a Shirodkar the next morning when the only doctor qualified to do one returned. My cervix had already changed so much in a few hours, that day, I didn't feel I could wait - though a little voice in my head was saying "the other cerclage is better."

Angel, they said they dud a classical c-section for me because that was the safest for my son, at his early gestational age (24 weeks). I think a lot of moms of micro- preemies get that kind, if they have a section at all.

 

[baby_maybe]

Katece I don't think you should beat yourself up about the type of suture you had. When I was given the emergency one at 24 weeks my consultant said afterwards he could see my waters and my daughters hair floating in it. I had a McDonald suture and it still managed to get me to 32 weeks. What I'm trying to say is that there would be many other things that caused you to labour soon after your suture was placed regardless of the type of suture.

After my first daughter was born at 24+ weeks I thought about what ifs for months after, but at the end of the day I came to the conclusion that no matter what I'd have done differently it probably wouldn't have made any difference to the eventual outcome. There were no indications of anything being amiss at either of the scans I had prior to her delivering and I didn't have any other signs that I can recall which would have led me to think something wasn't right.

 

[lch28]

ladies ive been having random shooting pains in what i think is my cervix. its not awfully painful but annoying. i had it once last night and once right now. is that normal??

 

[Hopeful 4 #1]

Wow I've not been on this thread in aaaaages. How is everybody?! I am getting really exhausted now! No cervix check since placement at 15+6 and i'll be 24 weeks on Thursday... don't know if this is the norm or not. But glad my stitch has carried me almost an extra 2 months so far.. my goal is 28 weeks before I begin to relax.. so another 4 weeks! Hope everyone is ok... been trying to go through the pages and pages of updates but its proving difficult! xx

 

[Alisa F]

Katece - the "what ifs" are th most difficult to deal with, and sometimes no amount of reassurance helps. But I promise you it's will be less painful over time.

 

[Alisa F]

Ich - I've had that whole pregnancy. Docs explanation is ligament pain, had some investigations - urine cultures, scans, even physio yesterday to rule out SPD and it's totally unexplainable except for ligament pain. Would love to know if anyone else has had this and had it diagnosed too ...

 

[lch28]

i also think its more when my bladder is full? its worrying me though.. will let my doc know on Monday at my appointment.

Hopeful 4 #1 - i had a cervical check at 16 weeks and i am having another one at 20. Did you get a anomaly scan around 20 weeks? in the U.S they always check cervical length then even if you have no history of ptl

 

[Alisa F]

Hopeful - glad to hear all is going well. I've had more scans than you cos my high risk docs believe cervical length is key indicator of ptl. So I had stitch at 12+2, scan at 13+5, 17+6 (when they started me on progesterone to help the cervix which was at 29mm), then at 20+6 scan cervix was 30mm. Next scan is at 23+5 and if it's not looking good they will do ffn test.

But I've got the uterine anomaly that makes me at higher risk for the stitch not working, maybe that's why they're watching my stitch. So maybe you don't need the extra prodding down there if you're doing well so far

 

[LaRockera]

Thanks LaRockera.

As a follow-up question, my c-section was the classical vertical incision. Did your gyno say you could try again with that kind, or with a normal horizontal cut, which most women get these days?

Hmm... I've had the horizontal type. Have you gotten a second opinion on this? Perhaps someone private? Someone with expertise on this from another part of the world, that you could fine, through the internet for instance? (not randomly of course, after research).

MillyBert- what a load of crap you've been told. See, it's this kind of criminal negligence that makes me mad. Take comfort in the fact that many ladies had a 20-week cerclage and made it full term- were I you though I'd make a havoc and demand to be stitched up, like, now. In the meantime, put your feet up and stay in bed, honey. x

 

[Alisa F]

Ich and hopeful - in UK you have to ask for them to check your cervix at 20 wk scan otherwise they don't bother. We just had our anomaly scan the other week on top of the transvag cerv measurement at high risk clinic and asked them to check and she did.

My prev preg I had anomaly scan, and they found baby boy had kidney issue, so I had another 2 scans at 22 and 24wks both by a consultant and both just weeks before my ptl and never once did anyone mention any cerv issues when clearly based on what's going on now even with my stitch it's clear to see I have IC issues.

But I think some contentious monographers pick up on issues too but I'd ask them to check just in case they're nit looking there.

 

[Alisa F]

Sonographers, not monographers lol

 

[baby_maybe]

Happy 24 weeks hun you're almost to that 'I can breathe again' part

I've never had cervix checks done once my suture has been placed, not sure if that's the norm all over the uk, but it seems to be in my area. My consultant normally does a ffn test at 24 weeks and then if that comes back + will give steroids, if not will do it again at 28 and then after that he says you don't really need to worry cos that danger from IC has passed by then.

 

[Hopeful 4 #1]

Thanks girlies... I did ask at my anomoly, but the sonographer said she cannot do a tvu unless my consultant says so... which he actually did... but wasn't in and it wasn't doc'd in my notes. I am not overly worried as I am feeling fine and am not symptomatic at the mo, however the general word I have had from other consultants and docs at the hosp, is that they do not routinely do tvu's for cervical length checks once the suture is in place as they would rather nothing go up there... and again stated that unless I am symptomatic in any way they would prefer not to. I see my actual consultant on Monday 10th, so will see what his word is on it. Also.. I am deffo team pink!! Had a 3d scan to confirm a few wks ago xx

 

[DMJ]

I too have had the shooting pains in the cervix area and have been told that they are 'normal' and do not affect your cervix in any way. Although I have just been diagnosed with having spd and have to wear a tubi grip and crutches.
Xx