Incompetent Cervix - stitch/cerclage - threatened labour

hi i posted a while back about my cervix maybe starting to funnel (this is first
pregnancy after vag and uterine sep removal aug 2010) ...well i had my scan
wednesday and my specialist called me 2day after reviewing my results and said
she doesnt think its funneling but my cervix has shortened in a week....not what
i wanted to hear....so i have another scan this tuesday and she said if there is
more change i will be having a stitch fitted im really worried about it all
last wed my length was 3.96cm and this wednesday it was between 2.79/3.09 what
do you ladys think?? .forgot to add im 16 weeks thank you
 
Hi again ladies.

Well, I'm officially 14wks on Sunday. Since coming home from the hospital, Doug decided to bring the tv and everything upstairs to the bedroom. Since I decided to start my own bedrest two weeks from now when I start 17P injections, we thought it best that instead of climbing up and down the stairs to get to the bathroom, that with me recovering from the weakness I'd be better off upstairs where I'll be able to take it easy, have access to internet, tv and books as well as the bathroom.

I too have a question for you, but nothing too intense. I'm wondering for those of you who've been on bedrest for months at a time if you've ever had to get up to exercise your legs or arms. Or if you found you had muscle loss at the end of the bedrest upon delivering baby. I know that with many bed ridden patients your told to turn every so often as to not get bed sores and have also heard of having to do range of motion exercises to not lose muscle.

I'm just wondering if in pregnancy the same rules apply. Are we at risk for blood clots if we dont move around?

Just a few questions I have since honestly I'm not on mandatory bedrest but taking it upon myself with all the information I've heard about bedrest and even those who weren't given the stitch how well bedrest has done for them. Where you encouraged to find some kind of range of motion during your down times??

Kim, I don't have an answer for you since this is all new to me as well, but I just wanted to send you a :hugs: The others in here are a wealth of information and I know they'll have answers to your questions.
 
Hi Kim. Would defo recommend the stitch hun since your cervix has shortened by a cm in a wk. At this stage it should be succesful, since your cervix hasn't begun to funnel or dilate. Good luck and keep us posted x

MA - I'd advise you to ask for some compression stockings for the duration. I had them - they are uncomfortable but worth it to avoid the risk of clotting. i wore them in the daytime only. After delivery it took me 3wks to recover from the initial section, and muscle weakness from bed rest. I was weak and achey, having to sit down frequently but despite having 4 kids to look after, it was manageable. Within 6wks I was drving and bounding up and down the stairs again - it was great to be back to normal tbh. Take care x
 
Hi Kim. Would defo recommend the stitch hun since your cervix has shortened by a cm in a wk. At this stage it should be succesful, since your cervix hasn't begun to funnel or dilate. Good luck and keep us posted x

MA - I'd advise you to ask for some compression stockings for the duration. I had them - they are uncomfortable but worth it to avoid the risk of clotting. i wore them in the daytime only. After delivery it took me 3wks to recover from the initial section, and muscle weakness from bed rest. I was weak and achey, having to sit down frequently but despite having 4 kids to look after, it was manageable. Within 6wks I was drving and bounding up and down the stairs again - it was great to be back to normal tbh. Take care x

thankyou :) i was wondering what happens when the do the stitch 2 are u put to sleep or epidural and how long will i be in hospital for thanks xxxx
 
Hi - standard procedure is to give a spinal aneasthetic, operation taking 20mins for a macdonald, or longer for a shirodkar. Usually they keep you in overnight, but some hospitals send you home the same day. For me recovery took a few weeks, but that was with a shirodkar which is more invasive. I had tightenings and menstrual-like cramps for a fewdays afterwards, and some light bleeding x
 
I am totally freaking out...my cervix is starting to rip (really only slightly) around my stitch because it's opening. I am having massive cramps and bleeding (only light bleeding, frank blood). And the doctor is just saying "oh we have to wait and see...", I know that my cervix can remain stable even with this happening. But man oh man...the thought of ripping or tearing open down there...is freaking me out!
 
Nk hun, only just seen your message - are you ok? Thoughts are with you darlin, let us know xxx
 
Hi NK, so sorry to hear about whats going on. Hoping and praying everything is going well over there. Please keep us posted when you can.


AFM, I just bought some compression hose Lizzie. Goodness I should have waited for a Dr.'s slip. 32.00 for those suckers. :lol: I'll have her write a slip for a couple more so insurance will pay for them and I'll have a couple on hand. Thanks for the tip!!

:hug: to you all. Praying everyone of you is doing better and NK, I really hope this issue subsides somehow. :hugs:
 
On March 29th at 19 weeks I went to hospital for blood in mucus. Come to find out I was dilated to a 1 and membrane was bulging a little. They watched me over night with lots of antibiotic cause of infection & did an ultrasound next morning that showed about the same. A few hours later during surgery I was already fully dilated and membranes bulging bigger than a mans fist and up his wrist the dr said. He sat there for 30 minutes during surgery thinking about what he could do & said "lord its in your hands now" & suddenly membranes went back in enough for him to put in 2 quick stitches (he called it a purse stitch)..dr says we got a miracle and very lucky. I stayed in hospital for a week (got out tuesday) & on strict bed rest...bed and toilet ONLY. He has me on antibiotics & progesterone pills & other meds. I've had lots of cramping since surgery but he says its normal and prescribed me naproxen. Since Thursday I've been having some tiny dots of blood like 1-2 dots a day...(red) not much at all & sometimes a tiny little clot...dr said light spotting can be normal but i'm so worried still. I go tomorrow for my regular 20 week ultrasound & wednesday to dr (the one that did my surgery) for another ultrasound to check stitch. Does the tiny drops of blood sound normal & did anyone else get it? I've also had tons of thick yellow/brownish mucus that he says is normal. Has anyone else had a successful pregnancy after getting an emergency cerclage while membranes bulging and fully dilated? I'm so scared!
 
Hi there

I was so relieved to find this website and read your story-cannot thank you enough!! I feel like a bolt of lightening has just hit me and jolted me into action.....even more so than before.

I so empathise with your situation-I am 15 weeks 4 days of my second pregnancy (lost my first baby in 2003 at 16 wks due to incompetent cervix)
:cry:

At 5 weeks the consultant decided i needed the cerclage stitch and booked me in. I had this last wednesday. I had read up re the op and how it should assist to keep my bubs in this time but on the day of surgery....it was not as easy as they or I had expected.
The consultant told me after the op that my cervix had started to dilate and open and that my cervix is only half a cm where it should be 3cm. They did the stitch and closed the cervix but no guarantees and only time will tell.

I was asked if I had surgery to affect my cervix or my womb. I had lazer treatment for pre cancerous cells several years back but they said this should not have caused the shortened and soft cervix. Consultant was blunt and said I have a 50% chance of miscarrying still. I was and am gutted as I thought this gave me an 80-90% chance of success once it was in.

To top it all this saturday after the op-I thought my waters had broken and spent 7 hours up A&E and seeing my surgeon/drs to clarify my situation.

Am on two weeks bed rest from work. My boss is not impressed but my baby comes first! I really am trying to rest-they said, no sex, no swimming, no ironing, decorating, gardening, jogging and basically the whole pregnancy will be like this. I feel like a freak and so anoid and angry but now realise how common this can be

It is only today that I have really realised I have to REST however hard it is...not go to work and give my bubs the best chance ever. I am scared of losing this baby and the mental affect that would hit me if I did and I am so relieved to hear that although my baby will be prem. it has a good chance of surviving from reading so many stories.


I am on anti biotic cream and pessaries too and didnt realise how vital this treatment was until coming on this website. I cannot thank you enough for your wise words and heartfelt stories. midwifes and doctors are so rushed when you see them I don't feel I understood everything until today!

I am waiting to feel my baby move for the first time.............never got that far before.

My friends and I are praying my bubs arrives in September when its due but me feels that she or he could come way before and I want them to have the best chance so REST REST AND REST IT IS !!

Please take care of yourself and keep in touch.....

Chrissy
x


Hi Everyone,

I know there are several threads on this but just wanted to capture any up to date advice if possible.

I am 24 weeks + 3 days with my first baby. I had a cone biopsy done in 2002 for abnormal cervical cells (cin 3).

As soon as I knew I was pregnant I told everyone who would listen that I had had this invasive op and would potentially require a cervical stitch as my cervix may be weak. But they seemed confident that I would be ok as the op had been several years ago.

However, I started bleeding at 5 weeks. This continued right up until 19 weeks. (Apologies in advance for info but it seems relevant!). Sometimes there was just light pink spotting, other times brown/red blood and sometimes bright red blood. All varying amounts but with maybe only 2 or 3 days respite in between. There was also a considerable amount of mucus/discharge at times. No pain or cramps.

I had several scans in order to check the baby was ok and these were always fine. They could find no reason for the bleed. Eventually at around 17 weeks I was sent to see obs/gyn at John Radcliffe in Oxford. They took an internal scan of my cervix which showed it was within ordinary limits but was slightly short. He suggested because of my history and in view of the bleeding that I have a colposcopy in order to check there was nothing going on. My colposcopy was performed at 19 weeks + 6 days. All went well, no abnormal cells, no bleeding. I had follow up scan the following week and they said my cervix actually looked longer than before so we were really encouraged.

My next internal scan was booked for 3 weeks later. In between I had occasional hard tummy and that pulling sensation, but I just thought this was ordinary pregnancy complaints.

I continued on but just last week at 23 weeks + 3 days, I started to have a pulling/heavy sensation in my tummy when walking (stomach felt like it weighed a ton and moving was slow and laboured) and also some uncomfortable light pains in my vagina/cervix. By nightime, my tummy was rock hard and I found it difficult to sit up, or turn over. I also mentioned to my husband that I felt "strange". Couldn't quite put my finger on it, wasn't unwell but I didn't feel right.

I was extremely restless in bed but eventually went to sleep. The next morning I woke up and felt absolutely fine. Tummy was soft again and all pains gone. Walking was back to normal.

It just so happened that I was scheduled my internal scan the next day. I drove myself to hospital alone thinking all was ok. As I was arriving I began to feel that tightening again in my tummy, a little bit like a stitch on my left side and that downwards pulling sensation too. But it wasn't too bad, just a little uncomfortable. I went in to the scan room and the doctor noted that I seemed to be uncomfortable. First up was my cord scan, to check blood flow to the uterus. This showed that the blood flow was above average i.e. my uterus was up to something! Also my amniotic fluids were less than they had been. We then went through to do the internal scan and my cervix had shortened to 2.1cm. Whilst this is still within limits it was below the 2.4cm they see as minimum. The doctor said I would need to see the consultant and off she went.

The consultant decided that in view of the uterus and shortening cervix that I was in "threatened labour" and that I should stay at the hospital for further monitoring. It was imperative that I have a stitch put in to stop the cervix shortening further but this could not be done whilst I was still having tightenings/contractions.

So I was put in a room and waited for my rather worried husband to arrive from London. The tightenings continued but did stop overnight so they were able to do the stitch the next day.

But by the time the theatre etc was organised it was already 4pm, and by the time they got in there my cervix had dramatically shortened to 1cm at the front and 0cm at the back - they sewed what they could but said it hadn't been ideal. I began medication "Indometacin" to stop contractions and "Progesterone - Cyclogest pessaries" to strengthen the cervix.

When the consultant came round she said that the next day I would be given a steroid injection "Dexamethasone" which would help mature the babys lungs. A second dose would be given 24 hours later. This would give the baby the best chance if its arrival was imminent.

Luckily the stitch and medications have stopped the contractions. I was kept in for two days after the stitch was put in and am now on bed rest at home.

Basically it is imperative to keep the baby in for long enough for her lungs to mature (with the help of the steroids), so if we can get to the end of the week that is great.

However, it is obviously still much much too early for this baby to arrive. If we can just get another 4 weeks even that would increase our chances so much.

Its so scary. I just don't know what to think and there's so little information given to you.

I had some tightenings/contractions yesterday but the pills stopped them again and I have been fine so far today. But I want to know, what signs should I really be looking out for? Afterall my cervix had shortened overnight from 2.1cm to practically nothing and I had hardly any symptoms/pain. What happens if labour starts properly whilst the stitch is in? There have been no signs of "show" or waters breaking but I understand this doesn't always happen or can happen when you go to the loo so you might not realise.

Also the baby has definitely stopped being as active as she was, she used to kick and move all the time but she is only moving lightly and far less active than before.

Whilst I don't want to overeact and be at the hospital every 5 mins in a panic I also don't want to be so brave that I put myself and my unborn baby at risk.

If anybody has been through this any advice would be so greatly welcomed.

Thank you in advance.
M
 
On March 29th at 19 weeks I went to hospital for blood in mucus. Come to find out I was dilated to a 1 and membrane was bulging a little. They watched me over night with lots of antibiotic cause of infection & did an ultrasound next morning that showed about the same. A few hours later during surgery I was already fully dilated and membranes bulging bigger than a mans fist and up his wrist the dr said. He sat there for 30 minutes during surgery thinking about what he could do & said "lord its in your hands now" & suddenly membranes went back in enough for him to put in 2 quick stitches (he called it a purse stitch)..dr says we got a miracle and very lucky. I stayed in hospital for a week (got out tuesday) & on strict bed rest...bed and toilet ONLY. He has me on antibiotics & progesterone pills & other meds. I've had lots of cramping since surgery but he says its normal and prescribed me naproxen. Since Thursday I've been having some tiny dots of blood like 1-2 dots a day...(red) not much at all & sometimes a tiny little clot...dr said light spotting can be normal but i'm so worried still. I go tomorrow for my regular 20 week ultrasound & wednesday to dr (the one that did my surgery) for another ultrasound to check stitch. Does the tiny drops of blood sound normal & did anyone else get it? I've also had tons of thick yellow/brownish mucus that he says is normal. Has anyone else had a successful pregnancy after getting an emergency cerclage while membranes bulging and fully dilated? I'm so scared!

Amy, hi hun :hugs: Spotting totally normal after a cerclage, especially one placed in an emergency. I had light bleeding for a week after my stitch with the twins. Good luck, and keep me posted after your appt :hugs:
 
I am ok. I had another episode of the same thing I posted about before the next night. Cramping/ripping and bleeding. The in home care nurses say as long as it resolves on it's own, I don't cramp for more than an hour and there is less than say about a teaspoon or period amount of blood....to carry on. I am still so scared though.

Baby is a lot less active since this started happening. But there is movement still for sure...

I haven't had any other PTL signs, I mean sure I contract but I have since the stitch went in, on and off.

I keep getting the "hopes of full term this time are fleeting away" comments from every one. Sigh.

Sorry for the mini rant. I am just feeling a bit discouraged lately.
 
I am ok. I had another episode of the same thing I posted about before the next night. Cramping/ripping and bleeding. The in home care nurses say as long as it resolves on it's own, I don't cramp for more than an hour and there is less than say about a teaspoon or period amount of blood....to carry on. I am still so scared though.

Baby is a lot less active since this started happening. But there is movement still for sure...

I haven't had any other PTL signs, I mean sure I contract but I have since the stitch went in, on and off.

I keep getting the "hopes of full term this time are fleeting away" comments from every one. Sigh.

Sorry for the mini rant. I am just feeling a bit discouraged lately.

So sorry dear friend.:hugs: Your emotions are understandable. It is scarey. Sometimes in order to deal with it we have to push those scarey thoughts aside and they're SO hard to do. I wish you weren't going through this and more so, I wish I could be present to do something if only help you around the house.:flower:
 
Nk - your feelings are so understandable, what you are going through is absolutely terrifying, and so unfair :( I have lived with the terror of bleeding/cramping after stitch, longing to go to term but fearing that I may not even make it another day. No one knows what this feels like unless they have actually been there. For me it was the utter feelings of helplessness and lack of control that got to me most.............that and a longing to have a full-term pregnancy.

All I can say is don't assume the worst yet hun. You have a history of cramping and bleeding for several weeks, and so far that is as far as it has gone. You are almost 27wks now, well beyond viability and edging ever closer to your dream of full term. I have seen lots of women with cervixes like yours go on to make it to 36wks and beyond, not quite believing they have left the nightmares of the past behind.

Yes there is a risk of PTL, but no this is not a foregone conclusion. I am willing you and this little cherub to make several more weeks yet, and tho the stress must be crushing you hun, there is a light at the end of the tunnel, and you more than most are deserving of a little happiness now I think. Rest easy hun, hold onto some hope, and here's wishing for the next few weeks to be more settled than the last xxxxx
 
On March 29th at 19 weeks I went to hospital for blood in mucus. Come to find out I was dilated to a 1 and membrane was bulging a little. They watched me over night with lots of antibiotic cause of infection & did an ultrasound next morning that showed about the same. A few hours later during surgery I was already fully dilated and membranes bulging bigger than a mans fist and up his wrist the dr said. He sat there for 30 minutes during surgery thinking about what he could do & said "lord its in your hands now" & suddenly membranes went back in enough for him to put in 2 quick stitches (he called it a purse stitch)..dr says we got a miracle and very lucky. I stayed in hospital for a week (got out tuesday) & on strict bed rest...bed and toilet ONLY. He has me on antibiotics & progesterone pills & other meds. I've had lots of cramping since surgery but he says its normal and prescribed me naproxen. Since Thursday I've been having some tiny dots of blood like 1-2 dots a day...(red) not much at all & sometimes a tiny little clot...dr said light spotting can be normal but i'm so worried still.
I go tomorrow for my regular 20 week ultrasound & wednesday to dr (the one
that did my surgery) for another ultrasound to check stitch. Does the tiny drops of blood sound normal & did anyone else get it? I've also had tons of thick yellow/brownish mucus that he says is normal. Has anyone else had a successful pregnancy after getting an emergency cerclage while membranes bulging and fully dilated? I'm so scared!

Amy, hi hun :hugs: Spotting totally normal after a cerclage, especially one
placed in an emergency. I had light bleeding for a week after my stitch with
the twins. Good luck, and keep me posted after your appt :hugs:


Well the bleeding got heavier & I started having contractions & went to labor & delivery. They stopped my contractions but we found out by blood & ultrasound that infection attacked my membrane & dried up fluid around baby & she also quit growing about 18 weeks even tho she had great heartbeat. Dr had to remove cerclage & deliver my baby girl Emily Alexandria before infection spread to the rest my body & he had to remove whole uterus.
 
Oh Amy, I'm SO sorry :hugs: I know to well how hard this is. My thoughts and prayers are with you as you grieve your loss and walk each new day.
 
On March 29th at 19 weeks I went to hospital for blood in mucus. Come to find out I was dilated to a 1 and membrane was bulging a little. They watched me over night with lots of antibiotic cause of infection & did an ultrasound next morning that showed about the same. A few hours later during surgery I was already fully dilated and membranes bulging bigger than a mans fist and up his wrist the dr said. He sat there for 30 minutes during surgery thinking about what he could do & said "lord its in your hands now" & suddenly membranes went back in enough for him to put in 2 quick stitches (he called it a purse stitch)..dr says we got a miracle and very lucky. I stayed in hospital for a week (got out tuesday) & on strict bed rest...bed and toilet ONLY. He has me on antibiotics & progesterone pills & other meds. I've had lots of cramping since surgery but he says its normal and prescribed me naproxen. Since Thursday I've been having some tiny dots of blood like 1-2 dots a day...(red) not much at all & sometimes a tiny little clot...dr said light spotting can be normal but i'm so worried still.
I go tomorrow for my regular 20 week ultrasound & wednesday to dr (the one
that did my surgery) for another ultrasound to check stitch. Does the tiny drops of blood sound normal & did anyone else get it? I've also had tons of thick yellow/brownish mucus that he says is normal. Has anyone else had a successful pregnancy after getting an emergency cerclage while membranes bulging and fully dilated? I'm so scared!

Amy, hi hun :hugs: Spotting totally normal after a cerclage, especially one
placed in an emergency. I had light bleeding for a week after my stitch with
the twins. Good luck, and keep me posted after your appt :hugs:


Well the bleeding got heavier & I started having contractions & went to labor & delivery. They stopped my contractions but we found out by blood & ultrasound that infection attacked my membrane & dried up fluid around baby & she also quit growing about 18 weeks even tho she had great heartbeat. Dr had to remove cerclage & deliver my baby girl Emily Alexandria before infection spread to the rest my body & he had to remove whole uterus.

:cry:Amy, I am so sorry :nope: You have been through so much already and now this...........there is nothing I can say hun :cry:

WHen I had an emergency stitch placed with my daughter, it bought us another week, but I had increasing amounts of bleeding and cramping until she delivered at 24wks. I didn't want to share that with you at the time because it would have served no purpose except to stress you further sweet.

At the same time, there are women who have the stitch after cervical changes that do go on for several more weeks, sometimes even to term (although the pregnancy is very stressful). There really is no way of knowing for sure who will and who won't, and bleeding is not necessarily indicative of preterm loss.

What I can say for certain is that an elective stitch placed at 12wks before any cervical changes have occured is infinitely more succesful hun. If in time you feel ready to face another pregnancy again, I urge you to press for a planned cerclage. You are clearly a prime candidate, and I only feel sorry that the docs didn't see fit to place one in this pregnancy :nope: That is an issue we have discussed here many times, usually when someone like yourself is faced with a second tragic loss.

At the moment you must feel absolutely heartbroken, and may not even wish to consider your options so soon. If so, please ignore my advice for now, and take some time to heal :hugs: I really hope I haven't spoken out of turn.

I am here if and when you need some support, whether or not you do embark on pregnancy again. In the meantime I am thinking of you, and wish you and your family all the best :hugs:
 

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