Incompetent Cervix - stitch/cerclage - threatened labour

[Mommy's Angel]

Sham, yes your very right. I don't know what I would have done without these ladies. Amelia may not have been here because I wouldn't have fought for the stitch so early and though the Dr.'s denied me the preventative at 14wks they wouldn't have given me weekly internal scans to detect the IC in time when I got to 19wks. So this forum and all the ladies in it have been a great deal of help when medical staff weren't.

Well, I was told the stitch itself is colored. So it wasn't the stitch. They also mentioned today that I'd see the wripping, bleeding, etc.

Because I'm having the fluid release though and there was slight burning they want to check me out. They're going to check for amniotic fluid release as well as BV and check the actual stitch to be sure I don't have an infection. I'm NOT a fan of the speculum as they all know because of the issues we've all raised. But they said with either BV, amniotic fluid and/or infection its a case of what's more important at this time. All those issues could be just as detrimental to Amelia.

She's been kicking me up a storm last night and this morning so there's no doubt she's keeping mommy reassured that she is okay. I have an appointment at 1pm today and will keep everyone posted. ((GEE this speculum test puts the fear into me, I don't want to mess with the cerclage OR the length OR the funneling issue ))

 

[rensben]

keep us posted MA. Try not to worry about the speculum. It's better for them to see exactly what's going on than to not do anything at all. If it is BV then at least it will be caught early and dealt with. I get tested every month for infections and the doc does manual checks of my cervix as well as TVUs every 2 weeks. It was every week for a while there. As long as you are on the look out for potential infection then it can be treated as needed. We are slowly but surely getting there. One month from now you will reach a very important milestone of 28 weeks and I will reach my new goal of 36 weeks. I'm looking forward to celebrating that!! good luck

 

[Dash]

Good luck MA!

Rens- do you know if its common practice to be manually checked, or how frequently? My doc wont manually check me, I only get TVU's. He said any touch or force to the cervix is something that could cause irritation. Just wondering if its a difference in docs/protocol/area/etc.

 

[rensben]

Good luck MA!

Rens- do you know if its common practice to be manually checked, or how frequently? My doc wont manually check me, I only get TVU's. He said any touch or force to the cervix is something that could cause irritation. Just wondering if its a difference in docs/protocol/area/etc.

yes, I think it just depends on the doctor. The only time they refused to check me was with my last pregnancy when I was actually in labour. They didn't believe I was having real contractions so they said there was no point in disturbing the cervix. Turns out I had dilated to 3cm with the cerclage in. Then it was a rush to get the stitch out. With this pregnancy, they don't seem to hesitate to check me. I get swabs taken every month with a speculum in because the risk of having an infection is greater than the risk of me getting one from the actual procedure...i hope that makes sense. My doctor did a manual check last week and saw that my cervix was very soft and starting to dilate. This wasn't picked up on the TVU so it was a good thing he checked. I have another apt at the end of the month and he'll be checking again.

 

[lizziedripping]

Hi everyone - MA, don't fret too much about the speculum. Though it isn't ideal, it's a case of weighing up risks against benefits, and the occasional check done for a reason is never a bad thing. They shouldn't be used to routinely check an incompetent cervix, but in your case they are necessary as an occasional one off x

Dash - it isn't wise to push for manual exams. If there is no specific reason to look, then keep all things out and away from your cervix. Every lady is different here with a different set of issues/complications - IC in itself is not a reason to be having more than the fortnightly TVUs. If you have no signs of infection or preterm labour that need further investigation, then it's unwise to introduce any unecessary foreign body into the cervix.

Take care and keep cooking everyone xxx

 

[garrickbaby]

Hi all,

Today I fell when I was at work and had to go to the emergency room to make sure everything was ok. I was cramping but no bleeding which was very good. Needless to say the baby is fine. When the doctor came in and ask me how many pregnancies and how many children I had. So I told him this is my 6th pregnancy and I have one child, his next question was "so, are you planning on keeping this one"? and I was like.... I was trying to keep the other ones, I have incompetent cervix and had loss the other pregnancies. I thought his comment was pretty rude to assume i've aborted the other pregnancies.... but then again maybe it was just the hormones making me take it the wrong way.

How early will they put a cerclage in, I think my doctor said they may put it in around 12weeks this time.

 

[lizziedripping]

What an idiot GB That comment makes me so cross - what business is it of his to make any such comment anyway...............it isn't the hormones, he's an idiot!!!!

Stitch should go in at 12wks sweet - push for that because it catches an incompetent cervix well before any potential changes. Love and hugs, and pay no heed to the mindless comments of thoroughly unpleasant individuals xxx

 

[Mommy's Angel]

Garrick, I agree with Lizzie, what a complete idiot for saying such a thing! I would have taken that to his superior or to the hospital CEO. I've already done it once, I'd have NO PROBLEM doing it again!

Rensben and Lizzie, Thank you SO much for your words of encouragement and experience. I sometimes feel like I'm dealing with a bunch of medical idiots around here. Last night the Dr. on call said it wasn't likely it was the stitch as it was colored. Called this morning and they kept telling me it was mucus (which I KNEW it wasn't) When I finally got into the office, they were STILL skeptical about the white tape like substance. They did the speculum test which I have to say wasn't so rough today. Knowing my stance on speculums and concern about messing with the pelvic floor or anything else for that matter they were gentle and tried not to catch the walls and open too wide. I was grateful for that.

Turns out I wasn't leaking fluid thank God! \o/ No infection with the stitch..AND she said "OOoooooh, I see what your talking about. There's a white thread and a blue one in there". She took samples for BV as well.

She left the room for a half hour to talk with the other nurses about this "white thread and blue thread issue" They were stunned. Went to the Dr. (not mine that did the actual stitch because she wasn't there today) and found out JUST AS YOU BOTH HAD TOLD ME. \o/ They start off with it and then the rest is the blue fishing thread. The white comes out. NOW, why the heck aren't patients told about this little surprise?! Not only that, but how is it the whole medical office doesn't know about it with exceptions to the actual Dr.'s that perform the darn cerclage surgery? Don't they communicate at all?!

End result though is that no amniotic fluid was leaking, the stitch doesn't have infection, I did lose the one that's okay to lose and I have a stinking BV infection AGAIN!

I swear I have only bacteria in my body! I'm on flagyl again and they're putting me on it for a bit longer to try and get rid of it for the rest of the trimester. I'm at least glad we got that. Better to be safe than sorry. That darn BV wreaked havoc when I lost my mucus plug with Jackson and I ended up with a sac bulging and delivering because of everything combined. Won't let it happen this time.

Just goes to show we need to trust our instincts and advocate for ourselves! Pretty odd though that many of you in here know more about IC and issues pertaining to it than Dr.'s with PHD's who are supposed to be practicing medicine. Very frustrating in my opinion to have to fight to be listened to all the time. It honestly gets tiring!

Thank you all for your support. Don't know what I'd do without this thread of dear friends!

 

[garrickbaby]

thanks guys..... I thought it was just me
I tell you, guys don't understand what we have to go through to have a baby. From the cerclage to the antibiotics for BV, and everything in between.

Have a great night ladies....

 

[HelenGee]

Aaaaargh have just lost an epic long post, taken me an hour!

Woody - I was heartbroken for you reading about your devastating loss. I am so so sorry for the trauma you have been through. Please believe it when medics say that there was nothing more you could have done and you have absolutely no way of knowing that ic was an issue. It is cruel and so wrong that this has happened to you. Please also take heart from the fact that your docs will now be proactive and you won't have to fight to have your worries taken seriously. It is cold comfort, I know. I cried when I read your post and you have been in my thoughts and prayers. I was very lucky and my ic was only caught as a coincidence even though I was always at the doctor asking to be checked. Turns out I have a prolapse that went undiagnosed, so seeking a diagnosis for the discomfort I was feeling led to a check on my cervix. The two things are totally unrelated, it was sheer chance that the ic was noticed. Good luck sweetie

Ej's mum- my stitch was removed at 35 weeks, no idea why so early! I had Bella at 38 and 3! Well done Matthew for being a good boy and staying put for so long. Gorgeous name btw xxx

Garrick - I am so sorry for your traumatic losses, but so pleased about your pregnancy. The er doctor acted disgracefully, it is worth a formal complaint if you have the energy hun. Unfortunately the bedside manner of many er docs is shocking, especially when it comes to pregnancy. How dare he be so callous.

MA- I am so sorry I wasn't around to reply about your thread issue. Thank god Rensben was. I had exactly the same thing happen but I knew it was as I was warned about it by my doc. I had a purple knotted string come out about 3 weeks after my stitch, my doc thought it would happen a week after my stitch so I was waiting for it! Oh and I had the leaking fluid fear/feeling probably about 15 times after stitch placement. Every time I went to maternity triage where they did a speculum exam. I would say I had a speculum about every two weeks, and was swabbed at the same time. I only had 1 tvu at 29 weeks. My frequent manual exams were probably not advisable, but I had a watery discharge every now and again that I had to get checked. It seemed to pool and come out with a bowel movement (sorry tmi). BUT, the exams did no harm, I stayed clear of infection and my water didn't break at all until I went into labour at 38 plus weeks. It is a case of balancing the risk, every time they asked if I agreed to the exam, and I did as I was so worried about the discharge. They always saw that my cervix was long and closed and the stitch was in place. Please don't worry, if infection does present it itself they will be straight on the case as they are now with bv. Apparently, the stitch can cause increased discharge, mine had two components, watery and clear, and White and mucousy. Sorry again for the info, but sometimes it's best just to say it!

 

[Mommy's Angel]

Thank you Helen for all your insight. I'm sure you mentioning the discharge will help as I get further along!

I have a few questions again for you ladies:

1. I too was told my cervix was long. Obviously it's the length from the outer part of the stitch right? So what does that mean? Why would the length from the outer part of the stitch matter? Wouldn't the length from the stitch to the baby be more important?! I know I told you last I was 2.4cm's from the stitch to the funneling area I think. So I'm wondering now...does the cervix itself move down? Just wondering as this is all new to me.


Another question I have. Someone with twins has found out her twins are now at the stitch at 26wks. She had the stitch put in at 14wks. I kept warning her about being so active with twins and the good that bed rest could do but she kept bragging about how her length was 4.9 with no funneling totally forgetting that I was 2.0 with funneling just with a singleton. Self-centeredness aside, after finding out Monday she was 4.9cm's cervical length with braxton hicks. She went back in again the other day to find out she was funneled and the babys are at the stitch. ((latest corrections is her Dr. NOW says she's now 3.0cm's and more than me as she cheers ))

She kept telling me HER issue was more serious and she now had to be on bed rest and she could have the babies at any time now and possibly be in the hospital for good until delivery. In trying to give her hope, I mentioned you Lizzie. Who had two boys who also were at the stitch if I believe and you went pretty far with them. SHE got pissed at me! She said everyone is different (which I agree with) and she then mentioned that I was LUCKY because I had an emergent cerclage at 19weeks when I was already funneled. She said at least I have MORE room where the cerclage is...whereas SHE has less room because she in fact had her cerclage put in at 14weeks.

Is that right? I thought having a cerclage done at 14wks is MUCH better than my experience having only 2.0 cervical length and funneling. So I now have more cervical length than she does? I thought the whole issue of getting a cerclage early was to have a better outcome?!

Maybe one of you can shed light on this. Is she right? It didn't sound right to me. I mean I think Lizzie had even less room with the shirdokar stitch and not an actual mcdonald like I have. Please share with me more of your wisdom so I can learn about this. It's SO confusing sometimes. :duh:

 

[jodie083]

Hi

Im new here n hope ye dont mind me joining in. I have been vewing yer posts for the last month I think and have found it very helpful, thank you.

So let me tell ye a bit about my situation.
My name is joanne, Im from Ireland I have two kids girl 8 and boy 7. They are my life.
I had a few problems with pregnancy on both but everything turned out fine n had natural full term births.

After my son I got pregnant shortly after losing the baby at 14 weeks without warning my waters broke n baby was out. Got preg again waters broke 19 weeks didnt have baby till 20 weeks. One more time I got preg and begged doc for stitch n refused about a week later 16 Weeks waters broke baby was born.

I am now currently 13 weeks pregnent and got my stitch placed last Tue. Its been tough. I have no one around me who understands what Im going through.
This site has kept me going tru out it all.

So thank you ladies.

 

[Mommy's Angel]

Hi

Im new here n hope ye dont mind me joining in. I have been vewing yer posts for the last month I think and have found it very helpful, thank you.

So let me tell ye a bit about my situation.
My name is joanne, Im from Ireland I have two kids girl 8 and boy 7. They are my life.
I had a few problems with pregnancy on both but everything turned out fine n had natural full term births.

After my son I got pregnant shortly after losing the baby at 14 weeks without warning my waters broke n baby was out. Got preg again waters broke 19 weeks didnt have baby till 20 weeks. One more time I got preg and begged doc for stitch n refused about a week later 16 Weeks waters broke baby was born.

I am now currently 13 weeks pregnent and got my stitch placed last Tue. Its been tough. I have no one around me who understands what Im going through.
This site has kept me going tru out it all.

So thank you ladies.

Welcome, sorry for what you've been going through but so glad you have a place to chat now!

 

[rensben]

Jodie: Hello and welcome to the thread. You have been through it from the sounds of it and I am very sorry to hear about your losses. I'm happy you have a stitch now and hopefully the outcome will be positive. There are lots of ladies with experience in IC here so feel free to ask as many questions as you need. I think we are all willing and eager to help! good luck to you.

MA hmmm...not sure what to say about your friend. It's always better to have a cerclage placed earlier than later so I'm not sure what she's talking about. 3cm even with funnelling sounds pretty good to me but who knows. Every case is different I guess. Sorry, I can't tell you more..

As for me, I had my 3rd tri ultrasound today. Baby girl is prefect and weighs 2.1 kg (4.6 lbs) !! That is great news because Gabriel weighed 3lbs 5 oz when he was born. The bad news is that I have lost more length. In one week, I lost 10mm so I'm now at 15mm with funnelling, and dilated to 1cm on the outside. I'm going into the hospital for 2 days starting tomorrow morning so they can give me steroid shots for her lungs. I hate being in the hospital but I will feel much better once she has the shots. Will update again when I get back from the hospital! cheers!

 

[Dash]

Good luck Rens! Those steroid shots work wonders. I had mine at 28 weeks and when my son was born at 34 he had NO lung/breathing complications whatsoever. He had other difficulties but the steroids helped his lungs SO much.


I have my first TVU to check cervical length at my appointment tomorrow....hoping for the best.

 

[Mommy's Angel]

Rensben,

already open to 1cm. Well I'm glad the babies weight is up, but praying the weight will go up to 5lbs before you actually deliver. I don't know why that number is in my head. Glad your getting the shots for baby's lungs. Please keep us posted on how your are if you can.

Dash, good luck with your TVU tomorrow. Praying all is well and we here nothing but good news!

 

[lizziedripping]

MA hun - I am TOTALLY confused by your post......sorry

Is your friend trying to say that having a stitch after funneling means there is more CL to play with? Is she saying that because hers was elective, there is opportunity for more funneling and less length?

Right - a cervix starts out at a standard length of between 2.5 and 5 for all women. If a stitch is placed electively, it is placed high up the closed cervix. If it is placed in an emergency, the funneled/dilated cervix is closed during surgery, and the stitch placed in the SAME place regardless. A Shirodkar stitch cannot be done to a dilating/funneling cervix because it is placed higher than a macdonald, and it is not usually possible to get enough closure to place it. A stitch of any kind will not lengthen an already shorter cervix, BUT it can prevent further funneling/shortening.

An elective stitch may not necessarily prevent funneling/dilation, but is more likely to do so because it was placed before any cervical changes. A weak cervix will usually funnel to the stitch but not beyond it - UNLESS contractions happen, in which case it can dilate through it. I had a shirodkar stitch, and I funneled at 25wks. The babies were not out of my uterus or on the stitch - the stitch prevented the membranes from bulging into my cervix.

The CL you have been given is likely its overall length, below and above the stitch. If you funnel, you don't necessarily funnel to the stitch. Funneling can be mild, and the cervix still closed below it to the stitch.

Your friend still has an essentially closed cervix, but it has dilated to the stitch and not beyond. Her stitch can hold the babies in like this potentially to term - if she still has a cl of 3, then her cervix is still closed (albeit below the stitch) and looking good.

Does your firend know this isn't a competition? She doesn't sound like a very good friend MA She is wrong when she says that emergency stitches are better - I didn't really understand her reasoning there.

As for your CL MA, it's looking great. You have funneling (imagine the letter Y with the uterus being at the top, and the funneling being the open bit, the stem of the Y being the closed bit), but a good length of closed cervix too. The stitch is at the top of the stem if that helps. The stitch is doing a great job - for the twin lady too xxx

Rensben - great news hun, lovely weight for baby girl. Another 2wks and you're on the home straight. Again, don't panic at the condition of your cervix - it is misbehaving, but the funny thing about cervixes is that they can do this for weeks, but bubba still sits tight - much love x

 

[Mommy's Angel]

MA hun - I am TOTALLY confused by your post......sorry

Is your friend trying to say that having a stitch after funneling means there is more CL to play with? Is she saying that because hers was elective, there is opportunity for more funneling and less length?

Right - a cervix starts out at a standard length of between 2.5 and 5 for all women. If a stitch is placed electively, it is placed high up the closed cervix. If it is placed in an emergency, the funneled/dilated cervix is closed during surgery, and the stitch placed in the SAME place regardless. A Shirodkar stitch cannot be done to a dilating/funneling cervix because it is placed higher than a macdonald, and it is not usually possible to get enough closure to place it. A stitch of any kind will not lengthen an already shorter cervix, BUT it can prevent further funneling/shortening.

An elective stitch may not necessarily prevent funneling/dilation, but is more likely to do so because it was placed before any cervical changes. A weak cervix will usually funnel to the stitch but not beyond it - UNLESS contractions happen, in which case it can dilate through it. I had a shirodkar stitch, and I funneled at 25wks. The babies were not out of my uterus or on the stitch - the stitch prevented the membranes from bulging into my cervix.

The CL you have been given is likely its overall length, below and above the stitch. If you funnel, you don't necessarily funnel to the stitch. Funneling can be mild, and the cervix still closed below it to the stitch.

Your friend still has an essentially closed cervix, but it has dilated to the stitch and not beyond. Her stitch can hold the babies in like this potentially to term - if she still has a cl of 3, then her cervix is still closed (albeit below the stitch) and looking good.

Does your firend know this isn't a competition? She doesn't sound like a very good friend MA She is wrong when she says that emergency stitches are better - I didn't really understand her reasoning there.

As for your CL MA, it's looking great. You have funneling (imagine the letter Y with the uterus being at the top, and the funneling being the open bit, the stem of the Y being the closed bit), but a good length of closed cervix too. The stitch is at the top of the stem if that helps. The stitch is doing a great job - for the twin lady too xxx

Rensben - great news hun, lovely weight for baby girl. Another 2wks and you're on the home straight. Again, don't panic at the condition of your cervix - it is misbehaving, but the funny thing about cervixes is that they can do this for weeks, but bubba still sits tight - much love x

Thanks Lizzie,

I didn't quite understand her reasoning either but she said that because I had funneled already when the stitch was put in that yes, I actually had more room. I knew that wasn't the case and after telling her that last night she called me an idiot and told me that I have more room than that of an elective stitch. NOT before she threw in my face that her Dr. now said she's at 3cm's of course.

Thinking the same as you...this is NOT a flipping race and besides US there are 3 beautiful children at risk I finally had it and blew up. As you said, this CANNOT be much of a friend! In fact, she pretty much made me look like an idiot in front of others who she fluffs up her feathers in front of to look better and look like "she knows it all". She even had the nerve to tell me that I need to rely on my Dr.'s instead of using my IC thread as my God. The same person, had she been a REAL friend, would have known that those same Dr.'s she speaks of botched my whole pregnancy and are the reason my son is dead. Had God not given me the knowledge to research, let me to this thread and allow me to be MY OWN advocate, I don't believe I'd have Amelia right now. I think around the same time given by my cervix at 19wks, I may have lost her the same time as Jackson at 22wks.

Needless to say, After all that had gone on I have terminated all contact with her and am letting her believe what she wants to. She's shown her true colors and I'm honestly over child-play. I just pray for her sake that she honestly does her research. Up till now I've been warning her that all the walking, going places this summer like she's been doing isn't good for her. She kept telling me that I honestly didn't need bed rest and her Dr. didn't think it fit her either. Guess the scare may have put some fear into her that she needs to take it easy.

At any rate, it's over. I just needed to find out for myself if what she was stating was correct. She had me ALL confused! Either way it doesn't matter because I'm fine thus far, but given the extra caution we've been going through, there was no way that I had a whole lot of space in there compared to someone who had the elective. It just didn't make sense and it was why I was so darn bummed. The good news though is I do still have some room both beyond the stitch and before. I like hearing that. By the grace of God the reason I believe I've made it this far and everything looks fine is because I HAVE done my homework and put myself on more bed rest. Had I not been in here, I wouldn't have known that.

So, thank you. Your post even though you had a hard time understanding mine, made complete sense and explained everything to me clearly and as I origionally understood it.


Hello to everyone else!

 

[Dash]

Reading what you guys have gone through makes me feel so blessed to have the great doctor I do. He never even gave it a chance after my first pregnancy and what happened. Thanks to him I'm lucky enough to never have suffered a loss due to IC.

 

[lizziedripping]

Hi ladies - sad news for me I'm afraid I am pregnant, but had not made an official announcement on Baby and Bump yet until my family knew.

However, we went for a viability scan last night at 7wks 3days and there was no fetal pole - only a yolk sac. The sonographer would not commit to saying it was definitely a failed pregnancy, but I know enough to know it is because there really should be a fetal pole/heartbeat by now. I had begun to feel queasy and fatigued, but that began to fade so I was suspicious, and that was the reason for having a scan.

I will be scanned by my Consultant on July 1st, and she will confirm the news for me, but I suspect I may start to bleed before then. It's funny, but I was panicking about how we were going to manage the pregnancy with the twins to take care of, and I had so many doubts, but now I just feel sad and none of those worries seem important.

I know I will feel better soon, it will just take some time. I am blessed to have 4 healthy kids, and will try to focus on that to get me through. One thing is for certain, I have special respect for ladies who have recurrent miscarriages now - I felt sorry before, but now I'm not sure how they cope This is so much tougher than I had imagined it would be.

Thanks for listening my lovelies, and let's now get some healthy babies delivered this year to cheer us all up xxx