Incompetent Cervix - stitch/cerclage - threatened labour

[lizziedripping]

Happy Easter to all!

I've been coming to this board and reading every once in awhile recently and reading a lot of inspiring stories!

My own story begins with having to have two LEEP procedures in the past year - both for severe dysplasia. The first time, the doctor took as little as she thought she possibly could, but unfortunately, it wasn't enough; the dysplasia was either much worse than we knew, or it just completely took off after my first surgery. But I ended up going to a new doctor in a new practice after I found out that the dysplasia was still severe and had a second LEEP in October which was successful and I had a normal follow-up Pap right after I became pregnant!

Of course, now that I am pregnant, my cervical length is being monitored and I have a follow-up plan of every two weeks. My doctor told me that she had to remove a lot of my cervix when she did the LEEP, but that there's an outer os and an inner os and the inner os is the one that we need to be worried about so she tried very hard not to take anything out of the inner os.

Still, when I went for my first cervical length measurement at the beginning of this week, my cervix was only measuring a little over 3cm. I've read that I'm supposed to have at least 3cm of cervix in order to maintain my pregnancy although I've also read that I could have as little as 2.5cm. Either way, the perinatologist said that my cervix is looking good and is an excellent length right now. But I'm worried anyway. My cervix was only 3cm at 16 weeks, so is it likely to become even shorter? Or does that not always happen?

Hi KC and welcome

Given that you had a quite extensive leep procedure done, 3cms is actually pretty good at 16wks. There are some women in your position who have short but strong cervixes and go to term with ease. Your cervix will naturally shorten as the pregnancy progresses, but if it is strong might not necessarily shorten significantly as a genuinely weak and incompetent cervix tends to.

I'm assuming your doctor is 'waiting and seeing' for now? Is there a plan to stitch if your cervix has shortened further at your next appointment?

For now I'd say yours is not catastrophically short and it is theoretically possible to carry a baby with a cervix of much less than 3cms so don't assume the worst. Keep us posted and let us know what things are looking like at your nxt appt. take care xxx

 

[lizziedripping]

Hi everyone.

Well i don't know where to start! so I've been sat reading a lot of the posts on here and i'm amazed how supportive all the ladies are towards each other which is just what you need when finding out you have complications its a very lonely and frightening feeling no matter how much support you have from partners/family or friends.

Not sure if i totally belong in this thread but i cant find any that are specially about uterus didelphys with possible shortening of the cervix,

I basically had no idea i had this uterus malformation till i fell pregnant and had a accident at my horses stables which ended with a trip to hospital for an emergency scan due to pain and bleeding at 6 weeks, during the scan i was told had a didelphic uterus with possibly two cervix and a double vagina and its pretty rare? and also why it had taken me and my husband over two years to conceive.

since then i'm now 18 weeks and I've seen a specialist which to his and my relief has confirmed after in internal investigation that i don't have two cervix and a double vagina which makes what were dealing with a little less complicated
but I've been told I'm highly likely to have shortening of my cervix and spontaneous premature labour think the statistics are that about 86% premature births due to uterus didelphys.

So far I've been told that they don't want to put a stitch in as they want to wait and see what happens due it it being my first pregnancy which frightens me being told that they are just going to wait and see and let nature take its course

I have an appointment this Thursday for another internal to measure my cervix to see where to go from there so fingers crossed it hasn't shortened as I'm pretty frightened about the whole situation

Hi Smile - as the other ladies have said, you're very welcome to join us here. So sorry to read about the surprise discovery that you have ud - must have been a tremendous shock hun.

I would urge that you push for a stitch but understand how difficult it can be to persuade medics it is necessary. You imply your cervix is looking ok at the moment? If so then there is of course a chance it will be fine, but as you know your condition does put you at greater risk of cervical issues.

If at your appt tomorrow it is looking short, then there is still plenty of time to act, so for the moment don't assume the worst and wait and see what the scan brings. I am hopeful that all will be looking ok on tomorrow's scan, but if there is shortening then the is a good chance your doctor will take preventative measures with plenty of time to spare. Good luck with the appt xxx

 

[lizziedripping]

Hi Everybody,

Just wondered if anybody can help? I am now 18weeks, yesterday and all of today i have been experiencing groin pain, mainly on the right side..has anybody else had this? Could it be in any way connected to the stitch? I would of thought 18weeks is too early to be a symptom from the weight of the baby??

xx

Hi JJE - this sounds like normal pregnancy-related aches hun. It's common to have groin pain in the second trimester and is stretching, round ligament pain and not in the least bit sinister

 

[lizziedripping]

hello ladies,

i am new here. i find this thread being great.
i am 23 wks pregnant with twins and in wk 17th i was diagnosed with ic: my cervix became 1.3 cm and with funneling (at wk 14th was 3.2 cm and was closed). after cerclage, the doctor did not recommended strict bed rest, but i decided myself i should do it. so, i only go to the toilet. in wk 22th, my cervix has 2.9 cm and it showed no funneling. but since one wk, i had some pain in my lower abdomen and i am afraid for my cervix. for a few days, i stopped the vaginally progesterone due to a candidosis and i stared temporary some shots of progesterone. anyway, i associated my pains from the lower abdomene with my lack of vaginally progesterone. i really think the vaginally route of progesterone helps me more than shots.
i ended yesterday my candidosis treatment, but i still feel some itches. so perhaps i should wait few more days before i restart the vaginally progesterone.
my pregnancy was get via an ivf treatment and i have one son borned with angel wings at 24 wks of gestation, in 2010 . 1st pregnancy was conceived via ivf as well, as me and my husband have fertility problems.
i really hope this time my pregnancy will be ok and i will have 2 healthy sons.

Hi Hun and welcome to the thread. So sorry to hear about your previous loss, that is so sad

Please take heart from the fact that I managed to carry twins to term with a stitch, despite the fact that at 23wks my cervix wasn't looking as good as yours. There is every chance that you will make it this time sweet, and that stitches placed at the right time do work well even with twins.

The abdominal pain you describe is much more likely to be related to the extra stretching caused by two babies than anything to do with your cervix or stitch. Twin pregnancy brings with it all kinds of additional aches and pains which mimic early labour, but which are normal considering how much more strain your body is under than when carrying one baby.

At 23wks your uterus is probably the size of a 30wk singleton uterus so it is understandable then that you are beginning to 'feel' it. I also had contractions on a daily basis which were occasionally painful, they happened over a few hours and were sometimes 15mins apart! Very scary because They started as early as 20wks but never had an effect on my cervix. I was told time and time again that twins are notorious for causing bh. I never believed it and was convinced that I was in prem labour - of course my healthy boys are living proof that I was wrong and that the 'contractions' were indeed harmless.

Pelvic pain and lower abdo pressure was a constant feature and I could barely walk at all at your stage. (it felt as though the babies would fall out). It was however all normal for a twin pregnancy, but was probably made worse by the presence of the stitch. I do hope that knowing how I felt, but that I made it to 38wks despite this helps to reassures you hun.

Take care, keep resting and get in touch any time if you need anything

 

[lizziedripping]

Hi to everyone else, and hope you all had a good Easter?

JJ - loving Soren as a name Will always think of lo as Wriggles first and foremost tho lol. Thinking of you honey

Olga, very worried still hoping all is ok x

Bf - you're very quiet sweetie. Is everything ok? Don't suffer alone, you have been through so much it's a heavy burden to shoulder without support from friends

Lovely MA - where are you? Are you ok? Always in my thoughts, and its been soooo uncharacteristically long since you came by - missing you xxx

Kate (keep thinking I'll log on and little miss will have arrived lol - she is way too happy on the inside ), Liven, Helen, Christiana (wow you sound so much more relaxed and happy chicken, great to see ) Sunkiss and Selina - sending hugs your way ladies xxxxxx

 

[blav]

Hi ladies! I should have asked this earlier, but I just thought of it now! I have my first appointment and ultrasound tomorrow morning and am wondering what questions I should ask. I know I'm going to ask when I can get the cerclage placement scheduled but is there anything else? My mind is a blur...

 

[book.fish2011]

Dear lovely ladies

Am still here. Alive. More importantly, still pregnant. Am reading through the thread everyday, but just don't have anything special to update. All I have is my regular woes

A hearty welcome to all the new ladies. I promise you'll draw a lot of comfort from this thread. People like Lizzie, Kate, Christiana, Helen, LR are not just knowledgeable but very kind. If I were in the UK, I'd have surely met them all and made friendship in real life.

JJ - love your son's name. Hang in there. He will be in your arms soon and you'll take him home to feed him and cuddle him all the time. Liven, hru?

Danielle, am sorry for your baby's loss. My story is quite similar to yours. After losing my son born at 30 weeks, am pg with twins through IUI. I have a cerclage and it's helped me, so far, I believe. I have had BH since 20 weeks. Initially, they were less and not painful. But since past few weeks, they have increased in frequency and sometimes are painful even. Like Lizzie said, I thought its ptl. I met my OB two days ago, she did the abdominal scan and saw that cervix is holding fine. So she's asked me to not worry about the little twinges. If there is more pain or any colored discharge, she's Asked me to go to ER.

Although am about 26 weeks, am still scared of having babies at this point of time. Am scared about baby's health + nicu costs. Lately, my insurance co. Is behaving strangely. They refused to cover my cyclogest pessaries and I had to pay myself. They are non-committal on covering preterm babies. They don't tell me what will the premium be, will they really cover etc etc. everything is based on their whim and fancy. There's no written rule.

It's a scary situation.

I hope everyone had a happy Easter

 

[lizziedripping]

Hi Blav, so sorry darlin' when I went back To catch up on what I had missed over the weekend I obviously didn't go back far enough and missed your post. Just looked again and saw it. Welcome to the thread honey

Congratulations on your new pregnancy - with a preventative cerclage and plenty of rest you should reach term this time around and I'm keeping everything crossed for a happy healthy 9mths for you.

As for your scan tomorrow, there isn't anything you need to ask except to ensure they book you in for the stitch at no later than 14wks. Good luck and keep us posted xxx

Bf - lovely to hear from you. Your having to pay for medical care sounds like a complete nightmare and an added strain when you just don't need it sweetie I have a feeling you will go to near term, but even so it must be a worry that we in the UK don't even have to consider. Glad all is progressing ok, take care lovely xxxx

So sorry if I've missed anyone else out, this thread moves shockingly fast and it appears so rude of me when I do overlook a post. Not intentional and I am sorry if occasionally it happens xxxxx

 

[chistiana]

"So sorry if I've missed anyone else out, this thread moves shockingly fast and it appears so rude of me when I do overlook a post. Not intentional and I am sorry if occasionally it happens xxxxx"

Seriously lizzie, you have 4 kids... And you re the most knowledgeable here!!!

 

[nhood]

Lizzie,
Did you say that you started having contractions at 20weeks? Btw, my OB and my high risk appt on Friday, my doctors said my cervix looked great, however last night, I started cramping and still have the cramping today. I am not sure if these are contractions, normal pregnancy cramping or bowels, I ve also had severe constipation. I don't know if and when I should call my doctor.

Lizzie and others, what are your thoughts on this?

 

[JJEE]

Hello lovely ladies,

Welcome to all of the fellow newbies, this site is full of lovely people sharing a wealth of knowledge that has been an absolute godsend to me!!

I had my 2week follow up at the hospital today and am happy to report that all looked good, the stitch looked fine, and my CL had actually gone up 6mm to 2.9cm..although she was quick to say that this is not anything to get excited about as it can just as quickly drop again..hmmmm I also had my hopes of returning to work dashed, i have to remain ''at rest'' until week 28/29..it's a daunting prospect thinking of another 10 weeks like this!!

Oh i did ask about my groin pain, and was reassured it is just a 'normal' pregnancy symptom..so thanks ladies, your knowledge shines through again!!
I am now being reviewed in 4 weeks..is this normal?? i had been weekly prior to my stitch, i am taking this as a positive sign that she no longer thinks i am a huge risk of having this little baba imminently...your thoughts would be much appreciated!

Lots of love to you all xxx

 

[blav]

Had my first ultrasound today and saw the gestation sac and not much else! It's still so early, the nurse practitioner said they saw what they needed to, which gives me a little relief. My next ultrasound is on May 3 and at that time they will schedule cerclage placement for around 12 weeks!

 

[lizziedripping]

Hey JJE - great news today Your doctor is being Understandabley cautious about your cl, but now that it has lengthened by so much the signs are good that it will remain this way for a while yet.

4wks sounds about right considering I had scans every 3wks only because I was carrying twins plus the stitch. I would have preferred a tvu every week, but in the UK it would be unusual to have them more frequently than fortnightly. The stitch should now do its job anyway, so unless you feel any unusual pressure or pains try to trust it will work. Take care xxx

 

[lizziedripping]

Lizzie,
Did you say that you started having contractions at 20weeks? Btw, my OB and my high risk appt on Friday, my doctors said my cervix looked great, however last night, I started cramping and still have the cramping today. I am not sure if these are contractions, normal pregnancy cramping or bowels, I ve also had severe constipation. I don't know if and when I should call my doctor.

Lizzie and others, what are your thoughts on this?

Hi nh - I had cramps and tightenings from as early as 10wks, and they were especially bad the few weeks after stitch placement. They eased off but then returned from 20wks on.

They were like mild menstrual aches and were accompanied by a weird tightening and 'balling up' sensation in my uterus. Sometimes I could actually see the outline of baby when they happened!!! From 26wks they left me with a back ache and were sometime painful and burning. They were very similar to early ptl for me and frightened me constantly. My consultant never seemed worried because they lasted only a few hours each day and never built in intensity.

Its probably fine, but I'd recommend getting checked anyway if nothing other than to reassure you hun. I know that Bf (our other twin lady) has been plagued by similar aches and pains but they have never amounted to anything

 

[nhood]

Thanks Lizzie!!! I don't see how I am going to keep my sanity the next few months. Being pregnant alone can be scary, but add twins and IC and I think I just might of chewed all my nails off. On the bright side, the cramping has stopped and Iam feeling much better now. My next cervical check is next week. I'm getting there, I'll be 15 weeks.

Btw, everyone, my name is Natalie. I chose the awful screen name when I was extremely nausea and tired in my last pregnancy that I miscarried.

 

[chistiana]

Btw, everyone, my name is Natalie. I chose the awful screen name when I was extremely nausea and tired in my last pregnancy that I miscarried.

Love the name! (that s the name chosen for bubs in there!!)

 

[danielita]

hello all!

lizzie, book.fish, for me sometimes is very scarring to have twins in my belly, because of the extra-risks (not to mention the ic). book.fish, i am sorry for your first son . must be terrible to loose a son at 30 wks.
today i had a us scan for the cervix and in the beginning, i was really scared! my cervix was really short and with internal funneling (similar with what it was 6 wks ago, before the emergency cerclage). the doctor had a look again and noticed i had a contraction in that very moment. she waited few seconds and when the uterus was relaxed, she had again a look over it and noticed the cervix looks ok, closed (so no funneling) and the measurement showed 2.7-2.9 cm. then we noticed one of the babies is still in that area and he push with one hand in the cervix direction . please tell me: do you think if i put a pillow below my bottom and my legs, it could help to release the pressure from my cervix?

anyway, the doctor says is not good the internal part of the cervix gets so easily open under contractions and it might jeopardize the cerclage and it might broken it . ok, but excepting staying only in bed, taking some anti-******* medicines, drink a plenty of water, how else could i prevent the contractions?
please ladies, help me if you have any answer for me. thanks a lot!

 

[danielita]

i meant anti-s.p.a.s.t.i.c.s

 

[book.fish2011]

Danielta: what you mentioned is scary (I have this constant worry too - of cerclage giving away due to contractions).

Lizzie would be the best person to guide both of us in this direction.

How many weeks are you now?

 

[danielita]

book.fish, I only have 23wks+2days. in my country, the fetuses could be saved only starting with 30wks...
the fact that the cervix get funneled during the contraction i guess could mean is a weak cervix and will not resist to the pressure.