Incompetent Cervix - stitch/cerclage - threatened labour

[danielita]

hello ladies!

kate, congrats!!! great news!
book.fish, i am so sorry for that lady! i only can say she is in my prayers and in my thoughts.
regarding you, i see you are not in a good mood. you're even pessimistic these days. please let me say, you should not be. your pregnancy situation did not got worse. days go in your favor. babies are achieving more weeks which is great. ok, you still have that discharge, but i do not think you should be worry about it. please believe in yourself and in your babies. this time, it will be ok. :*
lizzie, thanks for asking about me :*. i would say i am quite ok. well, i have some bad days with more contractions, but still braxton hicks. in other days, i have less. very hard to find a pattern about when they are more frequent.
last thursday i had a us scan for the babies and after 40 minutes of measuring the babies, the specialist checked my cervix abdominally (which i know is not very accurate). anyhow, my cervix measured only 1 cm and was funneled inside. the doctor predicted me that within a few days my water will be break. i went home, i called the doctor (who did the cerclage) and 6 hours later we have meet her. she measured the cervix vaginally and it was closed and 2 cm (ok, few weeks ago measured 2.7-2.9, so it was better then). she checked the cervix with the speculum as well and the stitch looked alright.
she said i should start oral t.o.c.o.l.i.t.i.c.s (beside the a.n.t.i.s.p.a.s.t.i.c.s that i already took). we asked her if we should elevated the bed more in the trendelenburg position and she said yes. now the bed is elevated with 20 cm in total. let's hope it will help. on monday i all have another vaginal scan for the cervix length.
anyway, in that day when the us specialist found my cervix funneled and only 1 cm length, i woke up at 5 o'clock in the morning because i had several contraction. maybe those contractions plus the long scan on my uterus (40 minutes) irritated more my uterus and that's why my cervix did not looked too good. else, how to explain 6 hours later, my cervix was closed and 2 cm?
well, i am more convince i have a dynamic cervix. is not a joy, but i have to live with it.
i am 26 wks+1 d and i hope i will be able to bake enough my babies.
2016, in my case, waiting till 16-17 wks was not such a good idea. at 14 wks my cervix measured 3.2 cm and it was closed. without a warning/symptom, at 16 wks+6 days it was 1.3 cm and funneling. got the emergency cerclage but i am thinking if i would have done the cerclage at 14 wks, i would be much better today. somehow i regret i did not put pressure on my doc to do the cerclage as a prevention.
ellie, no, in some cases (i am one of these cases) the cerclage does not prevent the cervix to shortening. but bed rest and maybe some treatment, will keep the baby/babies in uterus.
i am on bed rest from 9 wks already (since wk 17th of pg). i leave the bed only to go to the bathroom. and i have to tell you anytime when i stand up, i am not feeling comfortable - i feel pressure on my cervix (indeed, i have twins, but still i feel the best only when i am in bed).
i would strongly suggest you to have bedrest and to limit as much as you can the time spent outside of the bed, although the doctors did not recommended you in the first place. sometimes we (the future mothers) do know what is better for our pregnancies than our doctors know...
well, maybe is better you are on the hospital now, but even if they let you home, please stay in bed only.

 

[millieboo1111]

Thank you so much lizzie and danelita, I'm staying positive my husband says I have to as baby and body knows if ive given up. Which I never want to do. It's just so frustrating that its my body that is being so un cooperative yesterday was also because my consultant wasn't in clinic and she's so great and decisive but instead I had a registrar, obs and midwife trying to decide what to do with me and then just said there's nothing More we can do for you and your still very early and pulling that face that's when I requested admittance so I can at least see a consultant. I still haunt seen one but I've made my own diagnosis with the help of you ladies and that's total bed rest. I was also shocked to see one of my friends admitted last night as her waters broke at 26+3 I'm stressing to her importance of bed rest too. She was in a right mess pls say a prayer for her too. Every day we get closer to another week and baby gets a little stronger.

I have this thing were I don't want people to think I'm over reacting but i know my body better than anyone and last time I knew something was wrong and no one believed me so this time I'm going to say but if someone asks me am I in pain if i was but not to bad is just say not really and get on with it. I'm so worried I don't think I can go through that again losing eric broke my heart. I'm sorry to go on but there's certain things is rather discuss with you. My husband, mum and all family are wonderful but none of them of have been through anything like this so thank you all in advance.

What is trendlenburg position? Is that bum elevated? Can you do that while lying on left side? Which is best position? Also total bed rest would you shower daily or sponge bath?

 

[danielita]

ellie, i am sorry for your friend who has the water break, i understand your concern, but you have to believe your second pregnancy has its own chances.
i also lost a son (in 2010) at 24 wks of gestation and yes, this will never be fixed. however, day by day i am thinking: ok, we did ivf again, we are pregnant, we have twins, we have a difficult pregnancy but this time it has to be ok. these babies will remain with us and we will make it. you know, last thursday when that us specialist told us my water will break within few days, i did not believed him.
like you, i would definitely know if something would be wrong with my babies/my body. besides, nobody has the right to kill my hopes about this pregnancy as i will fight as much as i can to have these babies.
in general, i am not an optimistic person, but i did know this time i had to set my mind that it will be ok and this attitude will help my body to keep the babies in my uterus. if i start to think negative and to cry, i will have no benefit; for sure i would have more contractions. so no, i will not do so - i will not hurt myself and my babies. i will stay positive.

trendelenburg position is when you have feet higher than your head (or as you said - bum elevated). in this way, your pressure from cervix become lower.
yes, i can stay in this way while i am lying on the left side (lying on the back is not possible for me as it gives me contractions and on the right, as far as i know is not recommended for the babies?). so actually i am lying only on the left side. is not easy, but i guess it helps my cervix.
i take a short shower every 2 days (bath is a big no-no-no for us).

 

[lizziedripping]

Welcome 2016

Definitely query your appt Hun. I am not convinced you have genuine IC because you hung on last time without a stitch until 34wks, but it can't be completely ruled out given your mum's history and the additional Leetz issue. I doubt that your sons delivery would have caused any further problems, but again why wait and see when you could be checked earlier on and a stitch placed if it looks as though your cervix is changing too rapidly.

It is so difficult to convince Doctors of the real threat of IC and that it even exists as a complication in lots of pregnancies. For some reason ptl is often written off as caused by infection ad prom with no link being made to an initial opening of a weak cervix. This is the biggest battle in the fight against IC, and getting them to recognise you might have it is key to having the correct support throughout your pregnancy.

I am horrified to hear ladies say they have been advised against stitching due to the risks of infection! The risks are so minimal as to be negligible, and are certainly no greater than in pregnancy generally anyway. Having a weak and dilating cervix is a far greater risk, and one whose outcome is potentially catastrophic.

One of these days I am resolved to campaign for better awareness of IC as a condition, and to try and 'educate' clinicians as to just how common a problem it really is.

Give your team a call and insist on an earlier check hun. Do not be dismissed. IC may not be your problem, but checking for it atleast eliminates one of your risks. Take care x

Danielita - abdominal scans are totally inaccurate for measuring or checking the cervix. They often give an incorrect view and reading of length, so it is likely that it was just wrong and you weren't short or open. Ignore it and use the tvu as a guide to where things are. You're actually doing pretty well considering you have twins and a stitch. Now that you are 26wks the IC threat is passing, and there is a good chance you will go for several more weeks.

Ihad terrible bh in the twin pregnancy which never amounted to anything. It could be that your cervix and uterus are irritable, but the contractions have to be strong and regular to have a significant effect on your cervix Hun. Xxx

Ellie - trendleburg is when the bed is tilted at the feet end to take the weight completely off your cervix. It isn't really necessary unless you have a dilated cervix with bulging membranes, or if your cervix has shown itself to be extremely weak and dilated very early. You'll be fine with normal horizontal bed rest with a daily shower and occasional toilet breaks. It is good to occasionally stretch your legs, but just make sure not to lift, or be upright for long periods. X

 

[2016]

Thanks Ladies! I am not 100% sure I definitely have IC either but I was contacted by the consultant team while pregnant with DS after I started suffering from severe SPD and they started looking into my history. My mum had no reason for IC – no LLETZ, no trauma, and her hypermobility isn’t even as severe as mine. She was just unlucky.
Anyway, first time round my cervix went from over 4cm at 14 weeks to (now looking at my notes to 2.7cm) at 26 weeks. They said I was “borderline” but would avoid doing the stitch at that stage and just manage preterm labour if it happened.
They said at the time they were slightly less concerned because DS was permanently transverse so there was less pressure on the cervix than had he been head down. My waters went the day he turned.
While delivering my son there was a small tear to the cervix due to an anterior lip that I was pushing against for some time.

I guess we will (hopefully) never find out if I have true IC, but there are certainly warning signs. I would rather they just check regularly like last time and decide I am lucky enough to escape the cerclage again....than the opposite.
Considering 1 in 100 women experience this issue I find it incredible they don’t perform cervical length measurements at the 12 and 20 weeks scans. Such a simple procedure that could potentially save so much heartache.

Anyway, I called my MW and explained my concerns and she said she would speak to the head MW at the antenatal clinic run by the consultant and see what she proposes. She is going to call me back later today. I feel like a bit of a pest because there are women, like yourselves with far worse cases of IC....perhaps I am being a wimp.

 

[2016]

Really impressed by my new MW. She made a few calls and my appointment with the consultant will now be 10th May (my birthday!) when I will be 10+4. Plenty time to get scanned etc, for a baseline if nothing else.

Thanks again for your advice and support.

 

[book.fish2011]

Thank you Danielita for the kind words.

I just learnt that the lovely lady I spoke about here, suffered a uterine rupture just 6 days before her scheduled c-section (at 37 weeks). This left her baby brain dead. She had had a fetal surgery done in Jan 11 because her first baby had spina bfida. She's been asked to not use her uterus again so she's now planning to look for a surrogate

 

[chistiana]

Hi. I just wanted to quickly welcome all the new ladies and wish you all a happy and healthy 9 months! I m really sorry i m not replying to each separately at this point but for some weird reason i am in so much pain i dont have the courage to.

Quick update from me: Had another scan today, baby is fine, approximately 1800gr and still head down! Came back all veeeeerrrryyyy very happy, especially as doc officially now permitted me to cautiously start normal activities again but by the end of the afternoon and since then i ve been having HORRIBLE menstrual like pain but no contractions??? Will give it a good night's rest and see how i am tomorrow before calling doc.

BF- Good luck tomorrow hun.

 

[yellowyamyam]

Hi everyone,

I have been following this thread on/off since my MC on 19 Dec 2011. It was my 1st pregnancy and my son just popped out of me about 30 minutes after my water broke. He was only 16 weeks 5 days. While waiting for the results from placenta and bloodtests, I read up a lot and was quite convinced that I have incompetent cervix. I only just heard his heartbeat that afternoon, about 3 hours before I lost him and MW said "146bps. Happy baby inside"...

So after 3 months of waiting, I finally met with a consultant who told me that the MC was due to bacteria infection which shortened my cervix (?) and infected the placenta which then caused my body to go into labour. Until today, I still question ... if I did not have IC, wouldn't that had prevented bacteria from getting inside? The consultant said it is almost like a chicken/egg situation. He couldn't answer definitively.

Anyway, a week after I met him, I found out that I was pregnant again. I saw him again on Tuesday to discuss my treatment plan. I will have my Nuchal Scan next Saturday and cervical cerglage surgery 3 days after if scan/bloodtest come back clean. I would only be 12 weeks then. He said because I had lost my son at such early stage, he doesn't see the point of waiting around until 16 weeks, which he usually does. I would also be on Progesterone and Antibiotics for bacteria infection.

I am very nervous of the 15 minutes cerclage procedure. I had asked the consultant and he said life goes on as normal after. No pain, No discomfort. How true is this? I understand most of you ladies put yourself on bedrest for a good 2 months. But no pain? no discomfort? I just want to be prepared and to know possibilities of things that might happen.

There are amazing stories in this thread which are inspirational. I just need to train myself to have more faith and believe little by little that this pregnancy might just work.

xx

 

[chistiana]

Yellow, hello and welcome to the thread hun. I am very sorry for your loss, it is always so unfair and so tragic to lose a child at any point. I guess i dont know about weather the IC caused the bacteria to enter or the other way round. But i wanted to tell you that a stitch at 12 weeks is way better and less risky than one at 16weeks (even though it is well worth it at that point too) and unless you have any other complications life should indeed continue normally. For me, i had to stay in bed until very very recently because of my bicornuate uterus. The procedure was pretty straight forward and i was out of the hospital within 3 hours. I had some discomfort after that with some contractions and slight bleeding but nothing more than what is expected. After that i had the normal pregnancy pinching and stretching sensations and i still do till now. Please try not to worry too much, you re being proactive and this is a completely different pregnancy...everything will be fine. A happy and healthy 9 months, stick around, the ladies on this thread are awesome and a wealth of info!

 

[lizziedripping]

Hi yellow You poor thing, what a traumatic experience you had at Christmas - my heart goes out to you darlin'

On a more positive note, it's brilliant news that your consultant is willing to support your suspicions about IC and is not taking any risks with you. It is highly likely that you do have IC and that infection travelled up inside after your cervix had dilated. This is a common finding with IC, but one which many doctors are unwilling to acknowledge.

A stitch at 12wks is no problem at all, and tho it leaves you with some discomfort, this is minimal and feels much like menstrual cramps for afew days. I felt unwell for a few weeks afterwards, and had some tightenings from the stitch onwards, but it was bearable and very reassuring to know that the stitch was in place.

Given that your cervix changed so early in the pregnancy, I'd recommend bed rest hun. No one is certain it makes a difference, but logic tells me that taking the weight off a cervix which is prone to 'giving way' under pressure can never be a bad thing.

Good luck this time sweet, and please join us for your pregnancy journey. You'll need lots of support as the weeks tick by. The loss of a baby due to IC is horrible ad leaves a legacy of fear and uncertainty in pregnancies thereafter.

We've all been there and can help you overcome this

 

[yellowyamyam]

Thanks Christiana & Lizzie for your replies.

*phew* at least now I know not to be paranoid about the horrible pain after a surgery! I've never had surgeries before and though I know this will be a minor one, the word SURGERY turns me into a

I have been resting more horizontally over the last few days after a bleeding scare. I noticed that after standing up doing things around the house for more than an hour, there would be colours in tissue roll when I wipe. I am only 10++ weeks so I am not sure if my theory is right. I just thought - better be safe than sorry. So more bed/sofa rest whenever I can.

Also is it true that average cervix length is 4cm? When I was scanned 2 weeks ago, my cervix length was only 3cm but the OBGYN was not concerned at all. She said that is fine. I hope the sonographer will scan my cervix length next week when I go in for my Nuchal.

 

[chistiana]

Good decision yellow, better to be safe than sorry. I had the same thing with this pg...when i was 12w2d i decided to do a total clean out or whatever you call it of the house and put up the x mas tree and decorate the house blah blah blah and of course i started bleeding 2 days later! So yes, just rest as much as you can hun. Re your question i m not very sure but i think anything from 3-5 is normal, 2. something starts being borderline if you re early on.

 

[heychickie]

Hi ladies! I have been very overwhelmed going back to work, so haven't checked in in quite some time. I hope all is well for you, and that new ladies are feelingthe comfort I myself recieved from such a caring group of ladies that have been there before.

Baby is growing and doing very well, he is 12 weeks tomorrow. He's starting to really play with his toys a bit, and stays very happy.

Monday we have to go to a urologist to see if Jackson's circumcision needs corrected. The hospital left excess skin, and it has already readhered itself once.

If any of you use Facebook, I do have. A favor to ask. We've entered a Mother's day contest with a local photographer, and outing ends Sunday. We're about 40 votes or "likes" behind the leader. I'd really love to win with this being my first "real" Mother's day - Grayson had already died by this time last year. We would get a photo shoot for the family, and prints.

Here's the link if you care to check it out!

https://www.facebook.com/photo.php?...71740080045.838856.238212340044&type=1&ref=nf

 

[LaRockera]

LR. -you can't just make an announcement like that without details!! Omg the suspense is killing me, spill girl spill lol x

Totally agree with lizzie....larockeraaaaaaaa tell us everything!!!!OMG at last!!!yayayayayayay another perfect ending!!!!CONGRATULATIONS KATE!!!!

Sorry, guys. I've kind of disappeared. Truth is, I try to log on daily and do some stalking/lurking but I can never know how much time I'll have before I'm needed. I promise an update soon, and an active, strong comeback.

Just been doing a touch of 'Kate stalking' to see if she'd posted her news elsewhere, and was shocked at how aggressive and confrontational some of the other posts/threads actually get! I never really venture beyond here and twins/trips/multips so wasn't aware of it before - eek, won't be doing that again!

What a lovely bunch of ladies we have here

Hey Lizzie, remember how I almost left BnB a few months ago? At the end of the day, I suspect I just participated too much. Now I'm just updating my journal, stalking others' and coming here. And yeah, this is one thread where dignity, friendship and compassion prevails. Hence, my siggy.

 

[millieboo1111]

Hi Ladies and welcome yellow, Thank you for all your advice!! Sorry i didnt get straight back as Ive been settling into my new home in the antenatal ward !!

Ive been put on 4 weeks total bed rest by my consultant also nerfederpine (spelling?) tablets (to stop any contractions) im not having any so precautionary. antibiotics and blood clot shots every day.

Ive been so inspired by you ladies and now im sharing a room with another lady who has been here since 18 weeks gest, this is her 5th week just lying in bed!! she had a early stitch then her waters started leaking and cervical incompetence shes had 4 previous 2nd tri losses she is so positive and focussed on the goal. This is only my 5th day but we are now 20+6. we are aiming for 24 then 28 then 32 and so on. Baby is really active which is a great sign.

I know this is going to be tough at times but im in this for the long hall and will just keep praying. thank you for your support, you are all in my prayers

 

[chistiana]

hey millie, i really like your positive attitude and those fine milestones you ve set! i used the exact same milestones as you and now my last one is 35 weeks....after that i wont be too bothered but aim for 37 and stitch removal! also so glad your baby is active in there, such a great comfort to be able to feel her/him! well your one week is almost over so yaaayyyyyy for that...only 3 to go...not that bad! all the best hun and just keep positive..it works!

I have a question ladies (especially those who have given birth...Lizzie, LR i think you two are the only ones who might be able to answer as kate, Liven and jimmy are too busy with their little miracles right now..i know i would be)... In the past 3 days i have been having TOO MANY and sometimes regular contractions (well not at regular as every five minutes but like every 15 minutes for an hour or so). They are painful, kind of remind me labor contractions. Plus i ve been feeling my bones down there being pushed to the side...seriously it is like she is popping in and out of there making my bones move. I am wondering..is this something you experienced close in time before you gave birth? I am starting to believe i might not make it to 37 weeks but i m thankful for every day that passes and brings me closer to 34-35 weeks. I m not extremely worried as i ve had the shots and baby is almost 2000kgs now but i still would rather make it to stitch removal day. What do you think?

 

[aegle]

Ladies, I hope not to intrude too much, but I just have a question and figure you would be the ones to know the most about it.

At my 19 week scan, the dr said that my cervical opening is smaller than it should be. Unfortunately, I didn't ask the dimensions, so I really don't know how much smaller it is.
He didn't say anything else and didn't suggest a follow up for that purpose, so I assume I'm not very high risk for IC... BUT

Is there anything I should watch out for? I just want to be cautious and make sure I get the appropriate help incase it does develop into IC.

She's also got an umbilical cord missing an artery (called SUA), which also puts her at risk for preterm labor and low birth weight.

I just want to be informed so that I can watch for signs and take precautionary measures. I will definitely speak to my Dr about it but she's usually rushed and you ladies are the ones that have been through it and have the first hand knowledge.

Thank you!

 

[chistiana]

Aegle hi, i dont think a smaller cervical opening is the same as a shortening cervix so i m not sure it is related to IC. I m sure lizzie, our guru will know more about it thought!!! I
just want to tell you that my son had only a single artery in his ambilical cord too. He was born at 38+4 so definitely not preterm but indeed only 2300gr. He was absolutely healthy, breastfed straight away and didnt have to stay in the nicu not even for 10minutes! My doc back then just told me to make sure i sleep on my left side just to make sure he receives all the nutrient he can!A happy and healthy remaining pg!!

 

[aegle]

chistiana, thanks.. perhaps I should do some more research on the subject

Thank you for the tip.. I've been wondering how I can help make sure that all the nutrients get to her. I woke up this morning with numb hands and feet, which freaked me out until I figured out it probably didn't have anything to do with the cord.