Incompetent Cervix - stitch/cerclage - threatened labour

[Mommy's Angel]

Garrick- my heart goes put to you, this is the most testing, emotional time, replaying all those emotions, not quite understanding how you've made it, but you did, and knowing that it was a fine line between making it and not. The thoughts troubled me for a while, to the point I obsessed about Bella, I wouldn't sleep in case anything happened, I just sat and watched over her. If I did fall asleep, I wake up with a start and nearly make myself sick with worry. I bought a nappy clip breathing monitor, it made a clicking sound when she breathes, and sounded an alarm if she did kick it off (or stopped breathing). That really helped me, as I knew if it was clicking she was fine. All will be fine, my sweetie, just jeep doing what your doing and be kind to yourself.

You are exactly right.... When she is sleeping soundly I watch her or touch her to make her move... It almost make you feel like you are going crazy and no one understands that. Its like the obsession moved from cervical checks and sonograms to worrying about SIDS. I guess you never stop worrying about your babies no matter what. I'm glad you can relate because I felt like I was the only one.

Oh no, I was like that and am STILL like that. Amelia is coming off her bassinet and will be staying on the pack in play mattress for what I was thinking would be 6 months but since we're on a second floor and the stairwell has me nervous, I may move her crib to the far side of our room until she's 9months. I think having lost our son has really put fear in me. There comes a time when I have to just give it all over to God and let the poor wee one have some room to grow. Your not the only one!

 

[Mommy's Angel]

Jen, as Helen mentioned...your at the prime time to catch it if it is an IC. Both my pregnancies started showing less length at 19wks. The second one I MADE them monitor me with transvaginal ultrasound WEEKLY. Sure enough, wk 19 came and I was right. I went in for the stitch and upon going back to the OB for checkup they agreed with me...FINALLY! Next time I get the stitch at 13wks FINALLY. ((praise emoticon))

Ask that you get your length checked by TVU. Don't have it done on top of your belly because it isn't accurate! It HAS to be TVU. I'd ask it to be done until wk 28 if you can. That way you are monitored just in case. :thumbsup:

 

[Mommy's Angel]

AFM:

Amelia had her 4 month appointment. She's weight 12lbs 10 ounces and is 24 1/4 inches long. She's below 50th percentile for weight but above 50th percentile with height. She's been doing great though and they are happy with all the measurements. She was laughing and talking. Doing everything she should at this stage. She can now start some solids. We're starting with an organic brown rice cereal with DHA and Probiotics. Then we'll move on to organic fruits and veggies. 1 a wk we were told to see how she'll handle it.

Not sure if I mentioned it to anyone but I started working out with my cousin on Sunday night. weight training and cardio. REALLY hard for a level one. By April I'll be at a Gym in something called Project 42. which is similar to Biggest Loser kind of hard. My hope is to lose fat percentage to get off this insulin pump and not only save my life, but prep for another pregnancy in a year or so. It's big bucks but I'm so out of shape that I HAVE to do something. I'm already showing signs of medical issues with the type II diabetes and hypothyroid. The class also deals with nutrician aspect as well. So it's "well rounded".

Here's the class from a few months ago:
https://www.youtube.com/watch?v=75qp7aCdPOk&feature=player_embedded

I'll let you know how it works out. I plan to be back in here with our next little one when we conceive. In the meantime I'm going to work on good health and wellness..Mind, body, and spirit.

 

[JimmyJam]

Hi there,

I'm hoping I can join this thread.

I'm 39 (40 next month!) and 20 weeks pregnant naturally (miracle!) after 5 years trying, 4 failed cycles of IVF (1 ectopic, 1 chemical) & multiple ops to treat polyps & endometriosis - so I think this pregnancy could be the last chance for me after a very bumpy & painful road. I've been stalking the forums for as long as I've been TTC but this is the first time I've been brave enough to post.

At my first antenatal appt I was lucky enough to have a brilliant midwife who took one look at my file and said 'Christ you've been through it'. She noticed I'd had a cone biopsy in 2004 & literally insisted the OB put me through the prem clinic for observation. I feel very lucky that she did my admission because he wouldn't have if she hadn't insisted. Apparently they only took 1cm at my cone, which is 'borderline' for concern - pah!

At my first prem US in mid-December, when I was 13 1/2 weeks pregnant, my cervix measured 3.1cm. But, 4 weeks later, in mid-Jan, it had shortened to 2.6 - but no funneling & the cervix was still closed. I was told to attend clinic a week later & found that my cervix had shortened further to 2.3. I was referred for a cerclage, which was performed on Fri 20 January, at 19 weeks +1 - and my external cervical length was only 1cm so they opted for a shirodkar, higher up inside my uterus, and shifted my bladder out of the way. As I had no dilation or bulging membranes the surgeon said the stitch was still classed as 'preventative' but that they have greater success when they have more cervix to work with. I've since been told an estimated 70% success rate in my case - which doesn't feel that safe.

After a horrific weekend when, the day after surgery, I started having what I think were contractions, and was rushed into hospital and kept in overnight - (and there was a fight on my hospital ward!) I was finally sent home again to take it easy.

Since then I've had no further contractions & really rested up and at my first follow-up scan, five days later, Weds last week, my cervix was still closed & not funnelling & had gone back up to 3.1.

I've been advised not to go on full bed rest due to the psychological impact & the risk of DVT - but I have been told to go on pelvic rest, no lifting & no exercise. I've gradually started pottering about a bit and have been out to dinner once or twice but I live under a perpetual haze of anxiety.

I want to ask if anyone in the thread, particularly Lizzie who seems to be the font of all knowlege, can explain to me what a dynamic cervix is. The fact mine went from 3.1 to 2.6, then 2.3 and back up to 3.1 after the stitch again - does that mean my cervix is dynamic or 'regenerating' from the effect of the stitch? I don't want to go on full bed rest as I'm at particular risk of DVT but am afraid every time I leave the house my cervix will give way! How reliable is the Shirodkar &, as they had only a very short cervix to play with, is there a greater risk of it 'slipping' - and if it did how would I know it had failed?

Also - I can feel the stitch & I'm permanently worried it will give under pressure. It feels like a tampon inserted skew-whiff. Is this a normal sensation?

I'm usually a pretty dynamic, active person but I'm not daft & after everything I've been through I am so desperate to keep this long-awaited baby and to do everything I can to carry it as close as possible to term. But I don't know how much activity is ok. My stitch was preventative but carried out on a short cervix, so what level of 'activity' is appropriate?

Sorry for such a long post but finally, after all these years, I'm just desperate for the support of people who know what I'm going through, and to share my hopes, fears & anxieties.

My baby's due 17 June which seems such a long time away - I just hope I can make it to a stage where he/she is viable. Today is my 20-week scan & I'm just praying I don't get more bad news ...

Would welcome any thoughts, advice. It's good to share.

Thanks.

Ps - my aunt had a stitch almost fifty years ago, having lost three mid-term babies (one at seven months) after a botched illegal termination - she now has three adult children with kids of their own, having had a new stitch put in each time. This gives me major encouragement - but we're all different ...

 

[JimmyJam]

Hi Lizzie, I'm new to the forum & posted a mammoth post today (31 Jan). I know you're away with you family at the moment - hope you're having a great time - but was hoping when you get back you might be able to look @ my post & offer some advice? This is the first time I'e ever joined a forum & I don't know how to send a PM! Thanks

 

[chistiana]

Jimmy welcome and congatulations on your long awaited pg!!we have the exact same due date! I am still very new with the whole cerclage situation (put in as a preventative measure due to previous losses and bicornuate uterus at 17+6) but i just wanted to say hi and that i hope you get to hold your precious little baby in june!ow and that i too have been having all sorts of weird sensations down there since the cerclage but a tvu about a week ago showed everything was fine!good luck with your appointment today!

 

[JimmyJam]

Thanks so much Christiana. How great we have the same due date. Will keep you posted!

 

[book.fish2011]

Thanks to Lizzy who directed me here. Glad to see many familiar faces.

Coming Sunday I will he having a transvaginal cerclage put in because am carrying twins this time around and my last pregnancy ended up in premature rupture of membranes at 30 weeks and I ended up losing my firstborn son in nicu.

Am really glad am getting a cerclage because without that probably I would be just worried. Hoping against hope that everything will be fine this time.

For ladies who have had cerclage, did you experience any spotting after the procedure? What did you do differently after the cerclage? Excessive bedrest? Less activity like showering etc.

At this point my cervix is 2.85 cm. 10 days ago, it was 3 cm. my high risk OB thinks cerclage is really required.
Please pour in your thoughts. I will try to be as prepared as I can for the surgery.

 

[LaRockera]

Hi Jimmy,

I'm not nearly as knowledgeable as Lizzy and Helen and some of the other ladies here, but I'll give you my two cents.

My stitch was elective at 13+3. At 15+2 my cervix measured 3.7cm. At my 20-week ultrasound it had gone up to 49mm and it measured the same at 27 weeks! At 30 weeks, it was 30mm. Last week that I went to check it out, at 33+4, it was still 30mm. So length can fluctuate, and I think taking it easy does help. I'm also on aspirin 60mg (to avoid blood clotting) and never had any problems. I never went on full bedrest, but was advised to go on pelvic rest, stay well off house-chores, not to walk more than 10/15 minutes and overall be careful without putting my life on hold. I think the consensus is, when you can put your feet up, do it really.

Your contractions sounds normal after a stitch. I was put on antibiotics for them. Also, pinching sensations are normal at your gestational age, even without a stitch (although ALWAYS report them to your doctor). Make sure to drink gallons of water as they flush infections out, and eat a pot of yogurt a day/avoid perfumed pantyliners and toilet paper/ keep an eye on thrush down there. No need to panic. Just normal guidelines, really.

I am so very sorry you had to go through all this to get your baby. I conceived via IUI after 13 months of trying, and I felt immensely paranoid- so trying to imagine how someone that went through your experiences must feel, well, you have every right to be nervous. But the stitch is there, and it does work, sweetie. You will take your first breath at 24 weeks, then a big breath at 28, then you'll start living again at 30 weeks. At 20 weeks, I think 3cm is a really encouraging length. There are ladies that managed to go full-term without a stitch and with less than half a cm cervical length (on full bed rest).

Welcome to our family, hon. I've been immensely helped and supported via this thread, it got me through my pregnancy, so we're all here for you when you need it.

 

[kateqpr]

Hello Jimmy!

Welcome to the gang! It sounds like your hospital is being wonderfully proactive. Which one is it (i'm in London too) and that you're in good hands.

A dynamic cervix is simply ( i understand) that the cervix is a part of the human body that is constantly changing, albeit it very slightly. This happens to every women, it's just us IC ladies who worry about it! And also, the measurements we're comparing are often milimeters, so going from, say, 2.8cm up to 3cm is only 2mm change - which given how grainy scans are, isn't always that reliable a figure, and these tiny changes shouldn't be worried about too much, as often simply having someone different measure your cervix on a different day would probably come up with a slightly different measurement.

Your lengths sound good, and your stitch was placed at the right time, so all sounds good to me. I too was told not to go on strict bed rest for the same reasons as you, but i have still been very cautious since about week 20, up until 28 weeks. I got up, showered, lay on the sofa most of the day, but pottered around the house to make cups of tea or food. I also sometimes drove out for a coffee to keep myself sane. Now i've got to 28 weeks, i've started to be a lot more active (not laid down at all today! But now i'm aching...).

If you can get your hospital to give you an FFN test and cervical length scans over the next 8 weeks, you can let it help guide how comfortable you doing, or not doing, bed rest. The FFN test is a simple swab done on high risk women ever fortnight from 20 weeks onwards, which pretty accurately tells you if you're at risk of going into labour in the next two weeks. Many hospitals use it now, and my hospital uses it as a guide as to how to change or adapt my treatment and lifestyle etc. So a negative test, and a stable cervical length, and generally i would be a bit more relaxed about being sat up right or allowing myself a bit of gentle walking.

But generally, as a rule, i think rest as much as you can, feet up, bum raised, as much as you comfortably can, simply to allow yourself to know you're doing all you can. 8 weeks is not too long a time, and just give yourself small goals to reach week by week. As Larockera says, 24 weeks is a big milestone, then 28 weeks feels like the winning line in many ways!

Oh, and i had spotting after my stitch for about a week. It also felt like a tampon for a month or so after. And even now, ten weeks later, it still feels 'odd' some days.

Good luck, and welcome aboard again!

Kate x

 

[JimmyJam]

Hi LaRockera, Kate,

Thank you so much for your replies, you both seem to know so much. it's good to find people with a similar condition to talk to. I'm really grateful. Your tips on rest & what I'm feeling are spot on.

I had my 20-week scan today and, although everything looked okay with the baby, I've now been diagnosed with polyhydramnios - it's where there's too much amniotic fluid, and isn't that common at twenty weeks, usually women get it in the second trimester. It can apparently point to a whole host of nasties including congenital defects, gestational diabetes and (another) increased risk of prem labour; it also complicates an incompetent cervix as the additional fluid puts extra strain on the cervix & stitch.

To be honest I'm in meltdown - I don't know much about the latest condition but I have a consultation with the specialists tomorrow where they'll do a level 2 ultrasound to check again for abnormalities and probably recommend amniocentesis. The two conditions are unrelated - incompetent cervix and excess fluid. It's a total nightmare.

I feel like such a percentage you know? Only 1% of pregnancies are ectopic - me. Only 1-2% of women suffer from an incompetent cervix - me. And now polyhydramnios, which only one in two hundred women get - oh yes, me. I'll have that one too!

I am just so afraid for my little baby - we have such a long way to go ...

Anyone heard of this latest condition? Would love some info & reassurance.

Thanks for your support. I'm being seen at Queen Charlotte's in Hammersmith. They specialise in everything complicated, which is just as well!

I'm not usually a humourless whinge but today is the icing on the cake.

When are you both due?

Jimmy x

 

[HelenGee]

Hi Jimmy and welcome . I'm so sorry for all the heartache you've been through and huge congrats on your pregnancy. I think La Rock and Kate have said it all really, all I wanted to do was to offer some reassurance that you have a great midwife and doctor taking care of you.

I found out at my stitch removal that I had just happened upon the best consultant in the hospital, I chose her as we share the same Christian name, and that she performs shirodkhar stitches. You are in very good hands if you have managed to find a consultant to perform a shirodkhar, as they are more complex, but overall create a greater tension in the cervix, holding together what may be tempted to separate. There are not so many consultants who perform this cerclage, and as the theatre nurses told me, my consultant's stitches had the best success rate, they had only seen a few fail when there were other issues, such as infection.

Your measurements sound very similar to mine, my cervix was 13mm with funnelling at 20 weeks, later, at 29 weeks, the stitch held it to 35mm without funneling. My doctor was equally as stark with the statistics as yours, gradually as I made it through the weeks, I could see the relief on her face, she didn't want to offer unrealistic hope, but technically, given that there were no other issues,it was clear after a couple of weeks to her that we would most likely make it to term.

I truly think that as you are 1 week post stitch, you can breathe a little sigh of relief. If anything were to be stirred up by the stitch, it would have done so by now. You are rightly terrified of every little twinge, I had the sensation of having something stuck in my ladybits, and often felt the stitch pulling a little as the baby started to grow. I did do full bed rest, which has had a psychological impact, but I felt so helpless. You are in a better position than that, so I would stay off your feet as much as possible, but don't be afraid of shuffling around. I was categorically told not to do full bed rest, but I don't think I was thinking very clearly at the time, I just thought it might help to be horizontal.

Sorry for the long post. I hope that helps to allay your fears a little, I know i'm rambling, sorry, tiredness is taking over!

Hi book fish and welcome too I am so sorry for the loss of your precious boy it is good to know that your doctors are taking a proactive approach. Honestly, the procedure will be fine and nothing to worry about. You will have some spotting and feel uncomfortable for a week or so after, but it is so worth it for peace of mind. It's worth asking what the docs plan for you in terms of monitoring post stitch, they are obviously taking good care of you now and checking your cervical length.

 

[HelenGee]

Jimmy- sorry to hear about further complications, we must have posted at the same time. You're not a whinger, it's tough feeling like a margin on "normality." I don't know anything about excess amniotic fluid, it sounds as though your doctors are being extremely thorough though. I wish I could offer more support and advice on this one, usually if there's an odd complication going, I'm the one who gets it, so I totally sympathise. Good luck and please let us know how you get on x

 

[JimmyJam]

Helen thank you so much - honestly this thread is a godsend. Having had my latest dodgy diagnosis least I can feel better about my activity levels & the stitch! I think I'm heading for progesterone supplementation too, Queen Charlotte's are carrying out clinical trials so they're prepared to give it to me.

Re: my last pst about the polyhydroamnios I meant to say it's usually picked up in the third trimester, not second.

Bugger. I sooo want to get there. It just feels like every week I turn the corner & walk straight into a wall of steaming cow dung!

Thank you ladies, your support & advice is invaluable.

Jimmy x

 

[HelenGee]

Jimmy-I had progesterone too, cyclogest pessaries. They are bloody revolting but something worked, and a private consultant I saw was hopeful of their usefulness based on a recent study he had read. It was he who armed me with advice to go back to my local hospital and fight for a stitch and progesterone. You will get through this, you and your baby will get through this. This thread is amazing and saved my sanity when i could find no other hope. Lots of love X

 

[kateqpr]

Hi jimmy,

Sorry to hear you've been given something else to worry about. It seems for some, pregnancy is just sent to be a series of mini tests. Hold strong and try and be positive and I'm sure all will work out in the end.

Queen Charlottes is a brilliant hospital. I nearly had it as my first choice! They really are on the cutting edge of all things high risk and unusual in pregnancy. In fact my lovely consultant works there too half the week ( Miss Girling if you come across her) and I'm sure they'll be able to reassure you tomorrow, whatever the outcome.

Keep us posted and I shall have everything crossed for you tomorrow. I felt similar to you with this pregnancy ( though in my own, small, less significant way!) that anything that could go wrong does go wrong in this pregnancy. Bleeding on and off from 7 weeks to a last bleed at 24 weeks, three UTIs, vaginal infection, friable cervix blah blah blah... I know these aren't the same as your problems in the past, but I know what it's like to feel so dragged down and overwhelmed but the seemingly endless challenges and twists and turns. I spent so many weeks feeling lonely in my pregnancy. I cried a lot, as I just felt frightened and kind of trapped by my own circumstances and fears. But you WILL reach a point where you will feel better and start to believe you're actually going to have a baby.

Take all the support you can, from family and friends and this forum, and be honest with your doctors about your fears and anxieties. So often they can reassure you so much more than a fruitless few hours googling and scaring yourself!

Good luck tomo x

Oh, and hellO everyone else! Helen - how are you doing, lovely?

Larockera - HAPPY BIRTHDAY BEFORE I FORGET!! X

 

[LaRockera]

Jimmy - Did they measure your AFI (amniotic fluid levels)? I'm sure there's one (or several?) threads here in the gestational complications section, have a look. I always worried about the opposite, frankly, my fluids were always between the good and the lower side of normal, putting me closer to the 5th centile, which really augmented my leaking paranoia. I believe I may have read that doctors tell you to cut down on certain types of food, like sugar, when you have excess fluid, I think it's worth checking for a respective thread. I'm so sorry you have to go through this, please stay strong. The stitch does work, and you've already made it half way. You're being monitored closely and I'm sure they'll take all necessary steps for your baby to reach here safe and sound.

bookfish - I'm sorry I didn't see your post before. I'm so sorry about your loss, hon. Congrats on your wonderful twins! I bled for about 4-5 days after the cerclage insertion (it started out as proper bright red blood and gradually subsided to stained cm), had mild cramping/was uncomfortable for about the same period, and was on antibiotics for contractions and infections. No bedrest for me, although I was told to take it easy- no housechores, no lifting, no more than 10/15min walking, on pelvic rest, but I was advised to go on with life as usual. I think moderate rest and caution is what it takes. Also drink plenty of water and eat a pot of yogurt a day/watch out for infections down there. It's quite reassuring that you've got the stitch this time.

 

[LaRockera]

Larockera - HAPPY BIRTHDAY BEFORE I FORGET!! X

I love you.



But you know that already.

 

[HelenGee]

Hey happy birthday LaRock!

I'm fine thanks Kate! Just snuck a cheeky glass of wine before the torture of work tomorrow,only I dropped the glass and it shattered and covered the ENTIRE kitchen. I've just spent 30 mins on my hands and knees trying to sweep it all. I really am the clumsiest person I know You sound very chirpy at the mo....any baby shopping under the belt yet? X

 

[JimmyJam]

Ladies thank you, you are all so kind.

Kate - it sounds like you've been through it too but that you're in a much better place now. O how I want the weeks to slide by ...

LaRockera - my AFI is 32.3 which is waaay high even if I were closer to term - and so it's really scary at 20 weeks. The total opposite spectrum to you. I have a belly stretched taught & big like a beach ball. 97th percentile whatever that means, it's meant to be btw 5 and 25 ... I guess I'll find out tomorrow. And I will check the other threads too for more info. Happy Birthday btw, I hope you've had a great day.

Thanks to all of you for your words of support & advice. My appt with the specialist regarding amniotic fluid tomorrow is followed by my next ultrasound to check on the old shrinking cervix (!) so I'll get online in and give you the update.

Off to bed now for a sleepless night!

Cheers, Jimmy x