Incompetent Cervix - stitch/cerclage - threatened labour

[Carry22]

Priyanka - thanks so much for posting that story for me . It makes me all the more determined to make sure that the hospital treat me right this time!!!

Helengee

- hi and thanks for sharing your story at my first appointment with the midwife she put me under shared care with the consultant I seen in my first pregnancy. However, I got my first appointment through the post and it wasn't until 15th Nov which would put me over 15 wks. I phoned up to say I wasn't happy with this as I had lost the baby by 15 wks the last time. So I now have an appointment on Mon24th when I'll be 12+3 - do you think this is early enough???

I know the consultant is good at his job however I find it hard to talk to him and find him to be very laid back and complacent about things which is not what I want or need. I hate the thought of having to keep on their backs about getting the proper care I need but I'm prepared to do it. I don't care if they think I'm crazy or worrying over nothing! The last time I trusted the NHS I ended up walking around for almost 2 weeks with my poor baby dead inside me and there is no way I am letting that happen again. I am trusting my own instincts!

Can you give me advice on going private?? How do you go about it??

Thanks xxx

 

[HelenGee]

Hi Carry
12 weeks ish sounds about right for a consultant appointment, but I would have them do an internal scan around the same time too. The stats seem to show that stitches placed before any cervical changes occur are more successful than those that "rescue" a changed and shortened cervix. Funnelling is when the end of the cervix nearest the membranes gradually opens under pressure. Imagine that your cervix is 2 Walls that are so tightly pushed together that nothing can get in between them, funnelling is when pressure causes the top of the Walls to separate in a y shape.

So...if you do need a stitch, the sooner the better...but as some docs are wary of placing a preventative stitch without having an actual diagnosis (this is where that awful statute of having had several 2nd trimester losses before acting comes into play in some health authorities - utterly appalling) then monitoring for cervical changes gives the evidence they need (changes tend to
happen around the early 2nd trimester onwards).

I heard about a local private clinic from a friend- there are lots in England which have sonographers, this one is consultant led. However, if you google private pregnancy scans, specifically trans vaginal ultrasound, then you should find something local.

I totally understand the dilemma you are facing, I didn't suffer a loss, but was where you are now, wanting extra care, asking for it, but not getting it. It's a horrible feeling to be fighting docs all the time. Unfortunately you have to keep on shouting to get your concerns addressed in the nhs. Sad but true, once you get the care you need, you will be fine xxx good luck xxx

 

[LaRockera]

Hi LaRockera

I cannot believe you had to go abroad to get the medical treatment you are entitled to in the UK!!!

Can you explain to me what funneling is please and how you knew you had this??? Did you suffer a previous loss due to IC??

I would definitely go private if I had to (we're not mega rich or anything but needs must!!) but not sure how to go about it - do you have any idea??

Sorry for all the questions, its just that I'm almost 11 weeks now and starting to panic.

I'm going to call my community midwife again tomorrow to say i'm very concerned - I wonder if she can do an internal exam just to check the cervix?? Is that even possible??

As you can probably guess I'm totally freaking out xxx

Hey honey.

To be fair, I didn't really go abroad as I'm originally Greek, although a UK resident for the past decade or so. It's funny really, because if you follow the news, you'll know that more or less nothing functions properly in Greece at this point, especially the public sector. But for some amazing reason, we got one of the best medical schools, and also have a much wider choice in private healthcare. In fact most people can afford to go private (I'm not rich by any stretch of the imagination either). Just think. It costs about 1500 euros (cheapest option, three-bed room) to give birth to the best private maternity clinic in Athens, all inclusive apart from doctor's fees.

My cerclage was an elective one and placed at 13w3d. I have not suffered a loss as some of the very brave members of this thread. I went for an HSG and the dye kept leaking out before it had a chance to travel to the tubes. Technician suggested possible IC. Doctor kept that in mind, and at 12 weeks he saw a funneling in my cervix. Basically my cervix looked V-shaped at the internal scan. The doctor said the funneling was small, but didn't want to take any chances. I'm truly grateful. Not that I'm not a bundle of nerves like everyone else, but I know I can trust him.

HelenGee is right, if you can get yourself checked out in a private clinic (after Helen's recommendation I'll be going @ MUMS at Birmingham, I'm sure there'll be private maternity clinics in Scotland too) and have them monitor you.

Please don't get me wrong. I live in the UK by choice. I love it here. I respect the tact, and organisation and order. It's just that the Nhs, well, like so many other posters said... The consultant seemed complacent, patronising and that he wasn't taking me seriously as well. He did try to put my mind at ease, I'll give him that. But his ways, the whole set-up, it just didn't inspire any confidence in me, you know?

While you're investigating things, try to take it easy yourself and stay on pelvic rest as much as you can. Try to avoid intercourse and rest as much as you can. Also drink plenty of fluids, don't bend and try not to do housechores.

You may be absolutely fine hon, and nothing may be wrong. I think it's very important you're taking precautions, and I think you're still early and have some time ahead to act.

Oh by the way. The reason I trust my doctor with his decision is that he has a Phd in cervical abnormalities, and he's been educated in Greece, Switzerland and Australia, and is a member of various committees. I'd be very happy to pass his details for anyone considering options abroad. He's got his own private clinic in Athens.

xx

 

[lizziedripping]

Woah ladies - I miss one night here and there are 4 extra pages!!!! Trying to catch up now and feel like I've missed so much news and so many new members

Firstly - Sham, hun CONGRATULATIONS!!!! Had been wondering about you and I'm so pleased to hear that little Jordan is here safe and well

Welcome Carry Helen and the others have said it all really hun, but just to give you my thoughts (for what they're worth).

IC usually causes a problem between 16 and 24wks in most ladies. That isn't to say you don't have it, BUT since your waters were lost a couple of weeks prior to this, that would mean your cervix gave way as early as 12/13wks. This would be unusual, but not impossible. I have heard of IC affecting pregnancy as early as 14wks, but rarely. IC is purely a mechanical issue. An incompetent cervix is either weak and therefore 'opens effortlessly' i.e. without contractions, OR is too short and so as the pregnancy progresses, and the cervix naturally shortens under pressure, has 'nowhere to go' so to speak.

At 12wks the pregnancy is very small and the pressure absolutely minimal. The baby only begins to affect the cervix with any significance after 14wks atleast and usually around 16-18wks. This is the reason that stitches are usually placed between 12 and 16wks - well before any possible cervical changes can occur. Even when I was pregnant with the twins my cervix was still long and closed at 13wks, tho would likely have begun to open by 16wks because I was carrying two and my uterus was measuring 3/4wks ahead.

All that said, IC is not an exact science, and when you have lost a baby it is worth exploring every avenue hun. It seems unlikely that you will convince medics to place a stitch at 12-14wks in your case, but a TVU can atleast confirm that you aren't experiencing cervical changes as early as 12wks. I would be tempted to ask for a second TVU around 16wks if possible, because as I said above, IC is only likely to show itself from this point on anyway. If it is fine at 12wks then this doesn't rule it out, if that makes sense?

Funneling is secondary to shortening btw, and the first thing they would see before this is a shorter than normal cervix on scan. If your cervix did open due to IC then that is certainly the earliest case of IC I have ever heard of hun, but as I say theoretically it might be possible, especially because you had previous surgery on your cervix.

Keep pressing them sweet, it can't hurt to take every preventative step possible - you lose nothing in proceeding with caution

MA - hope you're doing ok hun. Those early weeks are exhausting and quite a shock to the system. Don't put too much pressure on yourself, and recruit as much help as you can

Jule hun, hope all went well today - another IC beaten!!! Yay xxx

Hope everyone else is still ok, I'll try to check in more often in the next few days, feel like I'm losing track lately xxx

 

[ekt]

Hello!
Recap: I'm 19 weeks tomorrow; had cerclage placed at 12 weeks due to IC/preterm labor/preterm delivery with my second child 16 months ago. Measured 51mm/5.1cm three weeks, measured 33mm/3.3cm last week with minimal funneling. I am on "light duty" and ibuprofen every six hours 24 hours on/24 hours off for contractions. I'm feeling a lot of pressure in my pelvic area and vagina (sorry if that's TMI). I don't remember feeling this pressure with baby #2. I have also come down with a terrible upper respiratory virus and am coughing hard and often, so I'm terribly concerned about what that is doing to my already weak cervix.

Since my IC was not diagnosed until 24 weeks with my previous pregnancy, I did not have a cerclage and was treated w/ bedrest and a pessary as well as meds to control contractions.

I have a few questions and feel like I can't get a straight answer from my OB... maybe you ladies can help!

So... my questions are:
1. Is the pressure I feel in my pelvis and vagina normal (at 18 weeks the baby weighed 8 oz and was head down)?
2. With the amount of cervical shortening and funneling that I currently have, do you feel like my condition is going to be as serious as it was with my previous pregnancy (18mm.1.8cm at 24 weeks; grew with bedrest, a pessary and medications to control preterm labor contractions)
3. What exactly is the purpose of the stitch?
4. If anyone has had conditions similar to mine, what has been the the treatment and outcome?
5. Should I be expecting bed rest and a preterm delivery? I am very hopeful to not have either; both are excruciatingly hard and the thought of either leaves a lump in my throat.

THANK YOU ladies so much! I am so very grateful to have found this blog!!!

 

[vaali]

Priyanka - thanks so much for posting that story for me . It makes me all the more determined to make sure that the hospital treat me right this time!!!

Helengee

- hi and thanks for sharing your story at my first appointment with the midwife she put me under shared care with the consultant I seen in my first pregnancy. However, I got my first appointment through the post and it wasn't until 15th Nov which would put me over 15 wks. I phoned up to say I wasn't happy with this as I had lost the baby by 15 wks the last time. So I now have an appointment on Mon24th when I'll be 12+3 - do you think this is early enough???

I know the consultant is good at his job however I find it hard to talk to him and find him to be very laid back and complacent about things which is not what I want or need. I hate the thought of having to keep on their backs about getting the proper care I need but I'm prepared to do it. I don't care if they think I'm crazy or worrying over nothing! The last time I trusted the NHS I ended up walking around for almost 2 weeks with my poor baby dead inside me and there is no way I am letting that happen again. I am trusting my own instincts!

Can you give me advice on going private?? How do you go about it??

Thanks xxx

Hi Carry22, its me again.. i aint sure of the UK system but i can tell you do whatever you can do to get a TVS/TVU weekly or atleast once in 2 weeks & 12weeks is the right time to start monitoring it. From what i have learnt from my experience, every week of second trim is very important & things can change drastically with in couple of weeks which even the OBGYs might be puzzled at.. (though i found my cervix was over 4cms around 16 weeks this time which i got it done on my own from a diff doc, i had a regular appointment with my current around 18 weeks since 18w was when i had my MC last time. They just did a default physical checkup went through the report i got it from outside & asked me to come by 22w for anomaly scan. I still feel i should have put my foot down & should have made them do a TVU @ 18w coz my cervical changes would have started around that time till it went down to 3mm @ 22w.. had i done that i would have had lil longer cervix by now) Im atleast happy they did their emergency job the right way (i went for consultation around 6.30pm & was out of the theatre by 9.30pm.. thankgod!!). As others had mentioned PPROM @ 12 to 14 weeks is too early to be due to CI. But if its not the infection which is causing it the next best etiology we could think of is CI. So we never know..

My previous OBGY tried to give us all sorts of crappy explanations like " i think the baby has low set ears, placental calcifications & its the nature's way to bring out an unhealthy baby" & all that. Cant believe what all words these docs can use to save their skin & how in the world any genius can figure out low set ears in a 18w foetus!!! (i never was able to make out of any of what she mentioned & my tiny lil stillborn boy was so so perfect). The autopsy reports said "no anomaly.. no infection". Gosh! my hubby hates that doc till date so much for what she said about our baby X-( .

Sorry for all that ranting.. but its always right to follow your instincts esp when it comes to saving the beautiful pregnancy! Good luck to you & keep us informed..

 

[priyanka]

Please Help me ladies....I have serious cough and sneezing since I landed in India, took antibiotics, steriods, asthma inhaler, tried everything &every doctor for 4 months with Little relief. Then got to know that I'm pregnant & doc stopped all medications. Last to last week my sneezing got so much that doc again prescribed me anti-allergy & nasal drops for

 

[priyanka]

For 5 days. Then Little relief for one week but stuffed nose. Now again starting last night I hav had 1000 sneezes & So hard that they hurt my stitch & put so much pressure. I'm so scared of tearing it. Nasal drops bottle says non pregnant dose is max 5-7 days. What should I do?

 

[garrickbaby]

Hi guys, just a quick pass through haven't had a chance to read posts yet! My son Jordan Elijah Cole was born on 11th October at 10.55pm weighing 6pounds 10 ounces. He's absolutely gorgeous and so well behaved. Came home today, will post pics asap. Hope u ladies are all ok? ;-)

Congratulations, enjoy every second with him.

 

[vaali]

Hello!
Recap: I'm 19 weeks tomorrow; had cerclage placed at 12 weeks due to IC/preterm labor/preterm delivery with my second child 16 months ago. Measured 51mm/5.1cm three weeks, measured 33mm/3.3cm last week with minimal funneling. I am on "light duty" and ibuprofen every six hours 24 hours on/24 hours off for contractions. I'm feeling a lot of pressure in my pelvic area and vagina (sorry if that's TMI). I don't remember feeling this pressure with baby #2. I have also come down with a terrible upper respiratory virus and am coughing hard and often, so I'm terribly concerned about what that is doing to my already weak cervix.

Since my IC was not diagnosed until 24 weeks with my previous pregnancy, I did not have a cerclage and was treated w/ bedrest and a pessary as well as meds to control contractions.

I have a few questions and feel like I can't get a straight answer from my OB... maybe you ladies can help!

So... my questions are:
1. Is the pressure I feel in my pelvis and vagina normal (at 18 weeks the baby weighed 8 oz and was head down)?
2. With the amount of cervical shortening and funneling that I currently have, do you feel like my condition is going to be as serious as it was with my previous pregnancy (18mm.1.8cm at 24 weeks; grew with bedrest, a pessary and medications to control preterm labor contractions)
3. What exactly is the purpose of the stitch?
4. If anyone has had conditions similar to mine, what has been the the treatment and outcome?
5. Should I be expecting bed rest and a preterm delivery? I am very hopeful to not have either; both are excruciatingly hard and the thought of either leaves a lump in my throat.

THANK YOU ladies so much! I am so very grateful to have found this blog!!!

Hi ekt.. sorry for not being able to answer your queries im sure others will give you clear views on that. I too feel that pressure kinda thigy you had mentioned when im on my feet.. some heavy feeling which sometimes also is stinging kinda sensation. I keep wondering why! But that head down thingy cant be the reason coz till 30 weeks or so our bubs are free floating inside & their positions are variable. Probably the pressure is more when the head rests on the sutured cervix.. & the purpose of the stitch is definitely to help the otherwise weak cervix hold on to the weight of the growing uterus. Not sure if that was of any help to you

 

[Jule71]

Hi Lizzy,

I had my shirodkar removed earlier today and it was a little difficult. My Dr had to cut a bit of tissue that grew over the stitch. It was done in his office with no spinal or any pain meds but I was tough and got through 5-10 min of pain. lol

Anyways, since he had to cut some of the tissue, I bled a good amount and my Dr had to hold gauze with pressure to stop it. I spotted like a light period for the rest of the evening and now spotting a tiny bit, 8 hrs later. No mucus discharge or cramping or anything else.

My question is, did you have bleeding? Is this normal? My Dr didn't seem concerned at all, but it freaked me out a bit when I saw the gauze with so much blood. I'm still feeling a bit of pain in my cervix area, but not bad. I was told I'm only a finger dilated and fully engaged, but my Dr doesn't think I'll deliver right away.

Thanks in advance for your valuablel insight! J.

 

[Carry22]

Hi Ladies

Thanks so much for all your replies and advice, i'm so glad I ventured over here for Preganacy After Loss its so great to get some answers to the million questions in my head!!

I know it would be quite rare for PPROM to occur because of IC at such an early stage but its not impossible and I just want to do everything in my power to make sure this baby survives. There must have been a reason for the waters breaking the last time, right??

I've found a private clinic that do internal scans in aberdeen (which isn't too far from me) so I'm going to see what the consultant says at my 12 wk appt and if he's not interested at least I know I have another option.

Thanks again and I'll keep you updated. Hope you are all well xxx

 

[LaRockera]

I've found a private clinic that do internal scans in aberdeen (which isn't too far from me) so I'm going to see what the consultant says at my 12 wk appt and if he's not interested at least I know I have another option.

That's BRILLIANT. Good luck to you, and I hope it's all going to be good, and save you from more stress and agony, honey.

Keep us updated.

 

[lizziedripping]

Hi Jule. I had my shirodkar removed immediately after my c-section hun, and I lost several pints of blood due to the boy's size afterwards, so would have no idea how much was due to the stitch I do know that the stitch was significantly embedded and took 30mins to remove, so I had a similar issue to you. Embedding is a common problem especially with the shirodkar, and the bleeding you experienced is probably nothing to worry about. that area is very vascular, and the smallest cut would produce a large but temporary amount of bleeding.

You will likely be left with some scar tissue, but again this is not usually a problem and sometimes actually makes it difficult for the cervix to dilate in labour and in fact strengthens it - so fixing IC for future pregnancies. A 1cm dilated cervix can stay that way for weeks at this late stage, so don't expect labour any time soon hun. Your blood loss probably looked more than it actually was, so please don't worry. You did really really well, and everything is as it should be at this point Jule xxx

 

[lizziedripping]

Carry hun, you are right to get every possibility covered - this is your baby and no stone should be left unturned. Good luck, and you know where we are x

 

[mum2rugrats]

well im still here 11 days after stitch removal! i never thought id actually be trying ways to get little man out now!

 

[truthbtold]

lol how ironic. We worrying about the stitch holding so much and then most people get it out and the baby takes there time coming out.

 

[mum2rugrats]

so true!!! im just so excited to meet him now

 

[truthbtold]

He will be here in no time!

 

[LaRockera]

... it seems I'm developing a thrush or some sort of an infection. I'm wiping greenish chunks (disgusting, I know, sorry).

So called midwife and sent me for some canesten cream.

I'm thinking of calling Triage tomorrow, too, in case this is something far more serious, like BV.

Shall I start panicking?