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 ...
Hi JJ - at last I've had chance to read your post properly, and hope to put your mind at ease, at least as far as your IC is concerned
Firstly, you have a SHirodkar which is brilliant!! I had one for the twins and it worked a treat in supporting over 16Ibs of baby to 38wks. When mine was placed my cervix was incredibley floppy and atonal (it shouldn't be at 12wks). It was long and closed at that point, but it is likely that on standing it was 'giving way' even at that early stage. Despite this the stitch added an overall tension to my cervix, and by 24wks it had remained long and closed, wasn't funneling at all, despite the weight of two. It did funnel st 25wks, but only to the stitch and remained like that til my scheduled section at 38wks.
I wouldn't describe your cervix as dynamic necessarily. It was shortening prematurely as is expected in IC. You had the stitch, then it gained length afterwards. This is typical in ladies who have a stitch placed after shortening, and a very good sign that the stitch has done its job thus far. A cervix shortens before it begins to dilate. As it thins out it is 'drawn up' and so gets shorter in the process. A shirodkar stitch is placed high up at the top of a cervix and draws it back together again thus regaining lost length.
A dynamic cervix is one which constantly fluctuates in length (sometimes from hour to hour and day to day). With or without a stitch it moves up and down with or without increased pressure. Women can have a dynamic cervix, but stagger on to term regardless - their cervix never fully dilates until they have strong regular contractions at 40wks.
You had contractions immediately after surgery - this isn't abnormal, and in fact is to be expected. Usually women are given an Indomethicin suppository after cerclage placement to stop the expeted uterine contractions caused by cervical surgery. I had two of these within 24hrs and when they wore off had uterine irritability and tightening. I lay there terrified for a full week after the surgery, convinced I was about to deliver the babies
You may or may not have had the suppositories hun, but the contractions are common. It is also the reason you are asked to stay in hospital for 24hrs afterwards so that they can monitor you for such a reaction.
As for the shirodkar, it is incredibley reliable, even in a short cervix (and incidentally it is a stitch which cannot be placed in a cervix which has already shortened catastrophically, so that is reassuring). It is important to note tho that you had it placed after your cervix had already begun to change (albeit just some mild shortening) and for this reason I would advise as much rest as you can tolerate. Whilst you don't need to be horizontal in bed all day long, you could stay on the sofa, feet propped up with regular but gentle walks around the house. Prolonged shopping expeditions or housework is a definite no no hun. The stitch can't 'slip' as such, and is unlikely to fail you, but it is important to give it a helping hand in taking the weight and strain off your cervix as much as you can. I was never told to take bed rest officially, but because of the constant feel of pressure if I did move around for more than 10mins, I took the decision then to put myself on partial bed rest (sofa time with occasional toliet/shower/meal breaks).
The tampon-like sensation you describe is less likely to be the stitch, and related more to the weight of the baby and your bladder being pushed down and protruding into your vaginal walls. I had the exact same sensation from around 20wks, but it vanished after 24wks as the babies moved up and into my abdomen and the pressure on my pelvis was lessened. This is all normal baby/cervix stuff, exaccerbated but not necessarily caused by the presence of the stitch.
All the feelings you are experiencing, both emotional and physical are completely normal and in keeping with the whole IC nightmare sweet. This is a frightening time, and I have lost count of how many ladies have said that their due date seems like an impossible milestone that they'll never reach (me included). I had constant BH contractions, menstrual-like cramps, aches and pains with the twins - all which mimicked perfectly my daughter's preterm arrival. I did make it against the odds tho hun (a dream I never thought possible), and so can you. I can see no reason as things stand at the moment, for you not to make it safely to term
Regarding your excess fluid, I mentioned in a previous post that this will have no bearing on your cervix except to increase the pressure on it. Becasue you now have the stitch, this is nothing to worry about yet. Your levels are at 29 which at the moment is only a little above normal, so for now the threat of PROM is still low and might well remain so. Please remember, I carried two bags of fluid and two babies against the stitch and a crappy cervix, and it held up fine. The medics will always give you worst case scenario hun, it doesn't mean that's where youre headed. There are many more idiopathic reasons behind polyhydramnios than there are sinister ones, so try to hold on to that hope as hard as I know that is.
Take care, and I hope I've answered your original post adequately - get back to me if there's anything else you need - any time
... Least of my worries except now the world & his brother I invited, many of whom didn't even know I was pregnant, all want to know what's going on ...
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!
and its 4 weeks since I had my stitch but am still experiencing mild cramping every other day...Is this normal post cerclage? Or should I visit the maternal assessment unit at my local hospital so i can get it checked out? Am not presenting any discharge or bleeding and the baby's kicks are really low...I really don't know if what am feeling is normal with a stitch. Its just worrying me that this cramping is not going away and it could be my cervix opening up. My next scan is not until 14/2/12.Please share your experiences. Am so scared of sleeping at night as I keep thinking am going to go into preterm labor like i did the last time....Am so worried!
Keep resting treasure 
I'm going back tomorrow so I'm going to question him tightly, but to be fair, he's not the type of doctor to take any chances, on the contrary, I'd say he's overprotective.
Her name will be Xanthe-Eleni (pronounced Zanthee Elenee) from my DH's and my mother respectively. And thank you for your interest in reading my journal, the link's on my siggy. I'd suggest you started one too. You may find it'll help, hon.
