Incompetent Cervix - stitch/cerclage - threatened labour

[danielita]

book.fish, wow, great news!!!! congrats and all the best for your babies and for you!

dmj, your cervix looks very ok for almost 21 weeks. great!

 

[ooSweetPea]

Hi ladies! I have been a looong time stalker of this thread since the 19 week mark of my 1st pregnancy - almost a year and a half ago! I cannot remember if I ever posted here during that time but I would like to thank each and every one of you for writing down your experiences and sharing... it has been a huge help to me as well as many others I am sure!

DH and I are planning to TTC for #2 this next cycle coming up and I have to admit I am terrified and excited all at the same time. At the end of my last pregnancy I swore NEVER AGAIN but here we are! A brief history of last pg - I had hyperemesis from weeks 6/7 to when he was born and was on home IV therapy and also a Relgan pump for a few weeks at the beginning of second tri. At my 19/20 week scan, my cervix was measured at 1.2 cm, and I was immediatley sent to hospital where I stayed for 2 1/2 weeks. After the first week I ended up getting an emergency cerglage and stayed on bedrest there for the other 1 1/2 weeks until I came home on strict bedrest. No contractions at all until I started contracting at 34 1/2 weeks (fairly painful but spaced apart) and they decided to remove stitch at that time to prevent tearing if I went in active labor. Upon removal I was dilated to a 2 right away. Lost my plug the next day and then 2 or so days later my water broke in the early hours and by the time I got to hospital an hour later I was dilated to 5/6. He came a few hours later exactly 5 weeks early.

I just wanted to ask if anyone has any info about dehydration and IC? I know it can cause uterine irritability and I was wondering if that was maybe the cause (no other known factors, cervical procedures, uterine abnormalities, etc) or maybe it was just 'one of those things'... I am wondering if perhaps I manage to stay better hydrated this time around (if I end up hyperemetic again that is) could that possibly help? I had a preconception visit with my OB and he has already said that he absolutely feels that a preventative mcdonald stitch would be prudent this time around so I am glad I don't have to fight for that.

Love to all

 

[danielita]

Hi Danielita, glad to see all is going well for you Hun

hi lizzie , thanks for your thoughts.
yesterday (33 wks of pg) I had an abdominal us (for afi, measuring the babies, etc - all are ok) and in the end the doctor measured my cervix via tvu and it showed only 1.2 cm but at least it was closed. I was very disappointed, as at 31 wks the cervix measured 2.2 cm.
I would very much like to carry my boys at least 3 more weeks, but realistic thinking, please tell me, do you think do I have any chance? with such a short cervix?
last week I had some BH contractions, more than usually - probably they caused the shortened of the cervix. else, i can not explain: i am still on the bed rest, i still take a.n.t.i.s.p.a.s.t.i.c.s, t.o.c.o.l.i.t.i.c.s and vaginal progesterone, so only the contractions could be "guilty" for this short cervix?
since yesterday, my contractions are back to normal, I mean are not too often.
or could be the fact the cervix was measured in the end of the ultrasound? could provide this late measurement a false result, as my uterus was already irritated because of 20 minutes of abdominal ultrasound?
the doctor did not checked the stitch - she assumed that is ok as long the cervix is closed.
thank you in advance!

 

[lizziedripping]

Woohoo Bf You don't know how relieved, happy, overjoyed and downright ecstatic I am to here that your gorgeous little babies arrived safe and well. Huge congratulations my darlin', you have been in my thoughts for weeks - this is such brilliant news!!

Take awhile to adjust to life with twins. It's tough going to begin with, but gets easier in time. I'm hoping that your parents are able to be with you? If so, how lovely for them to have two little boys to fuss over - and might help the heart to heal in some small way?

Lots of love you wonderful, brave lady. Get back to us when you can, and don't forget to take good care of yourself too

 

[lizziedripping]

A lovely, long, closed cervix for 20wks DMJ, well done you

 

[lizziedripping]

Hi Sweetpea and welcome

I can totally understand your anxiety about another pregnancy - especially since you had suspected IC and hyperemesis - poor you We have all been there, and it took me 4yrs to feel brave enough to take the plunge again after Evie.

The fact that they're agreeing already to a stitch is a huge plus, and you should feel fairly confident that this time you'll make it to term. Last time an emergency stitch worked for you which is reassuring and indicative that your cervix is probably weak, but not hugely incompetent.

I doubt that dehydration contributed to the IC hun. It can cause ptl, but not 'silent' dilation of the cervix under pressure. It might have induced early labour at 34/35wks and is what caused you to deliver early, but it wouldn't have made your cervix weak.

It is possible however that the constant vomiting placed additional strain on your cervix at 20ish wks, but again doubtful that this alone would have affected a strong, closed cervix. It might be that there is weakness there, complicated by the sickness - much like a weak cervix is put an extra strain when supporting two babies, when it otherwise might have held up under the pressure of one just fine.

It's impossible to say for certain what causes IC, or in fact if it will recur, but I personally wouldn't take any chances and if the stitch is offered, go for it. I'd be fairly confident that you can carry to term with a stitch. It sounds as though you did go into early labour in the third tri and that was probably unrelated to your cervical issues. You had already begun to contract before stitch removal, and once removed your cervix was able to dilate fully under the influence of further contractions. This might have just been one of those things which may not complicate any future pregnancies.

Jees I've just waffled - sorry lol. Good luck xxx

 

[lizziedripping]

Hi dani

1.2 at 33wks is brilliant hun, there is nothing to worry about Do you realise that mine was only 1.8mms from 25wks and I was funneled to the stitch!? My boys were huge and I still made it to 38wks with a cervix like that.

It could be now that your cervix is shortening in preparation for labour and delivery, (as it does in all women after 32wks), and this sometimes happens earlier on with twins. It isn't unusual for there to be softening, shortening and dilation weeks before delivery so don't be alarmed by these subtle changes. Your cervix has only shortened slightly, and is still closed - it couldn't look better Hun. Labour for you could be around the corner, but it might not - bh contractions and slight shortening do not mean that you will definitely deliver before 36wks sweetie.

Try not to worry. I had lots of bh throughout the twin pregnancy from as early as 20wks. They never affected my cervix, and didn't cause early labour. Twins are born on average at 34wks, so you are getting close, but there is no reason why these slight changes should mean you can't go way past that gestation

 

[DMJ]

Thankyou for your replies

Just another quick question ...
Saw my midwife this morning and iv got lucocytes (spelling?) in my urine but as there was no protein in my urine she said its probly not an infection and to just drink some cranberry juice.

Having this shouldn't affect my stitch should it?

Xxx

 

[lizziedripping]

No honey, it's basically white cells in your pee which can indicate they you're fighting off an infection. Sometimes tho they're present in small numbers which can just be normal. Usually they give numbers as +1, +2 etc for white cells, glucose, protein. I always showed +2 for protein, but didn't have preeclampsia (which is what it can indicate), that was just normal for me during twin pregnancy.

Even if you had a urine infection, it's unlikely to affect your cervix or stitch unless it was severe and had affected your kidneys. Without symptoms, and with low numbers it probably fine x

 

[lch28]

book.fish congrats honey!!

haven't been on lately.. scan is on Monday and i am scared for some reason.. this low progesterone is really getting to me.. looks like ill be on progesterone my whole pregnancy lol.. taking the suppositories till 12 weeks then again at 15 weeks

my dr said he would prefer me to take the shots though for the IC. should i demand the suppositories (ew even though i hate them)

 

[nhood]

Hi Lizzie,

It's me again....I feel like a walking bomb about to go off. Two days ago I had my cervical scan and the sutures are still in place, no funneling and cervix is still holding steady at 2.5. Well last night, after I had used the bathroom, I noticed this brown something in the toilet. It was no bigger than my thumb nail. I pick it up and it was mucusy, but when I wipe, I had no mucus or brownish discharge at all. Not even clear mucus. My first thought was that its the mucus plug, but now I am wondering if I had a slight mucus discharge from my hemrroid. I also have bad constipation, but this particular time on the toilet I just had to pee, although I was sitting on the toilet for a while. At any rate, nothing since last night. No mucus, no discharge, everything seem normal.

Can you lose your mucus plug this fast, after leaving the doctor the day before? Does it even sound like the mucus plug? If so, did I lose it all with that little bit. I heard that you get less with twins. I was going to call my doctor, but I see them Tuesday anyway, plus I have no bleeding, no mucus, no discharge or cramping.

Nonetheless, today marks 24 weeks. Yahhhh!!!! I hope I can atleast get to 30.

 

[lizziedripping]

Hi nhood - it doesn't sound worrying to me love If there were no other traces of anything when wiping then it was probably just some old blood from the stitch sight, especially if you've been recently prodded and poked up there. A 2.5, closed cervix without funneling is a really positive sign, and doubly reassuring that this was just one of those things.

For the record, the mucus plug is copious and snot-like and if it has come away there would be much more than a thumb nail sized amount. It is clear like jelly and tinged with brown or red blood - unmistakable. Hope that helps xx

 

[lizziedripping]

Hi ich, can understand your nervousness about Monday sweet, but try to remember that your progesterone levels were still within normal range. If you see a healthy embryo on scan, then that's a much better sign than progesterone levels, which are very different for every lady.

As for progesterone shots, they're deemed just as good as suppositories, but go with whatever makes you feel more comfortable xx

 

[nhood]

Hi nhood - it doesn't sound worrying to me love If there were no other traces of anything when wiping then it was probably just some old blood from the stitch sight, especially if you've been recently prodded and poked up there. A 2.5, closed cervix without funneling is a really positive sign, and doubly reassuring that this was just one of those things.

For the record, the mucus plug is copious and snot-like and if it has come away there would be much more than a thumb nail sized amount. It is clear like jelly and tinged with brown or red blood - unmistakable. Hope that helps xx

As always, thanks for your knowledgeable reply. I am going nuts over here. Its even worse now that I am 24 weeks. I know 24-28 weeks I will be a mess since this time is so crucial.

I have my baby shower on July 14th, when I will be 27 weeks and I already don't feel like attending. I feel like staying in bed and letting my husband be the gift receiver. Isn't this ridiculous? I was also thinking about asking the doctor to place me on hospital bedrst, just incase I overlook something. I know that he won't, but atleast I feel I have a better chance in bring my twins into this world and not lose tw
o like I did last year. I know I am being silly though, but last year lost (preterm) was THE WORSE thing I had ever gone through.

Btw, the high amniotic fluid is still high, but its not drastically high. Baby b had a blockage in one of her kidneys. They say it usually works itself out, but if not she may need surgery afterwards.

 

[lch28]

lizziedripping i think i am just so scared because my first u/s showed nothing but my uterine wall thickening, at 4w4d. i know it was early but i am just scared.. i keep going through all the possibility in my mind.. if i see a HB on Monday i will feel much better. you are very knowledgeable indeed =]

 

[nhood]

Lch,

Just want to wish you luck on your journey. Its hard not to be scared, especially when you have had prior losses. We will all get through this together my friend.

 

[lch28]

awww thanks so much nhood you have made my night. it is so great to have such good support on here. this website saved me after my loss and it is so awesome that i have ladies to talk too. i recently moved and don't have many friends in the area and my fiancee works crazy hours.. i am scared so much .. losing Sophia was the worst thing that i have ever been through, i just want my rainbow baby

 

[lizziedripping]

You fears are so totally understandable ladies, to have lost babies is tragic, heartbreaking and something which changes you forever. Dealing with future pregnancies will always be scary, something which most women who haven't faced such loss will never understand.

I don't mind how many times you come here asking questions and seeking reassurance. Pregnancy after IC loss is terrifying - especially from weeks 24 to 30. Reaching viability for me was never enough and in some ways worse. There was the chance of survival, but a long arduous NICU battle to face - that to me was not acceptable and I didn't want my babies to even spend one night in intensive care (which loving Mum does?).

There was no one as scared as me nhood and ich, I am the worlds worst worrier. I am good at reassuring everyone else, rubbish at applying my own advice to me lol. I would have sworn that my boys were coming early in the 20s, I was wrong! Everything was stacked against me, but amazingly I still got to term without any sign they were ready to come. Take heart from that - with a stitch in place it is totally possible to take even twins to 38wks.

Lots of love

 

[pinkladyangel]

Lizzie you are such a bundle of knowledge and I think without yours and a few others advice there would be lots more worried worried women out there, myself included. You seem to know exactly what we need to hear whether it be reassurance or advice good or bad. Since losing our baby girl last year I've been reading this thread from start to finish before plucking up the courage to try again.
I'm 2 days away from 25weeks. The stitch is keeping my cervix closed and my cervical lenghth is 3.2cm. It's around this time last year that things started to go wrong and I'm still a nervous wreck but I feel that with all the help and support given on here there still could be light at the end of the tunnel.
XXX

 

[lch28]

aww lizzie you are great =D thanks so much. i am so glad you carried your twins to 38 weeks =] what type of stitch did you have