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Cerclage?!!? Please give me some advice!


Forum: High Risk Pregnancy

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  #1  
October 5th, 2009, 04:21 PM
fibigrey's Avatar Mega Super Mommy
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I really need some advice... Or just some opinions.. Or even better advice or opinions from people who have been or are in the same situation as me..

I am currently pregnant, with my second child. I will be 13 weeks tomorrow. My first child I had no complications, but he is also 5 1/2, and I did not have anything done to my cervix before he was born.

I had LEEP procedures and then a cone biopsy (also known as cold-knife cone biopsy) in 2007 due to carcinoma in situ of the cervix. My cervix so far, is about normal with where it should be, however, according to my OBGYN and the perinatologist (high-risk specialist) I saw, I am 5 times more likely to have 2nd trimester miscarriage or preterm labor because of the damage done to my cervix. My doctor said that it is hard to tell how the cervix will hold up until after the 16th week, but that by then, it will be too late to get cerclage. I need to make a decision as to what to do by Thursday. I don't know what to do.

For those who aren't familiar with cerclage it is suturing (stitching) of the cervix to prevent it from dilating early.

I feel like I'm ****** if I do, and I'm ****** if I don't. What if I get the cerclage, and I didn't really need it? What if I get it, and because of the cerclage I develop an infection or have a miscarriage or any of the other complications BECAUSE of the cerclage?

What if I don't get it, and I end up losing my baby?!

I don't know what to do.

This scares me. I want my baby to be safe. That is all. I want to enjoy my pregnancy and not constantly be worrying.

Alot of doctors won't do a cerclage unless you've had one 2nd trimester miscarriage or preterm labor, because that is the only way to diagnose an incompetent cervix. I really don't want to find out if it is incompetent through either of those methods My doctor, however is willing to do it, but says studies have shown that it may not make a difference.

Has anyone had cerclage? did you have any problems/complications? Did you deliver your baby full-term? Was it painful?

I'd really appreciate ANY help.

Thank you.
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  #2  
October 5th, 2009, 04:58 PM
rebeccabaltimore and more's Avatar (rebeccabaltimore)
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I would get the cerclage, based on the number of procedures you had done to treat your dysplasia. I have not needed one myself (my dysplasia rather miraculously disappeared despite being quite severe), but my cousin had an emergency cerclage and then 8 weeks of hospital bedrest because her doctor waited too long to give her the cerclage. Despite going into labor 4 times starting at 24 weeks, she made it to term and now has a very healthy 6 month old son. Her only regret is that she didn't get the cerclage sooner, and next time she plans to get it as soon as possible.

Here is a resource page I put together on IC and cerclage: http://www.justmommies.com/forums/f1...-cerclage.html (Incompetent Cervix, Cervical Insufficiency and Cervical Cerclage)
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  #3  
October 5th, 2009, 05:09 PM
fibigrey's Avatar Mega Super Mommy
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I was just about to start looking for a resource page on this. Or tags, or something.. I don't know my way around this website yet..

but thank you for the advice, and thank you for the resource page!
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  #4  
October 5th, 2009, 05:26 PM
prev3xthecharm's Avatar Veteran
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Hi,,

real quick we had a 24 weeker that we lost due to ptl and possibly incomptent cervix.. ( This was 18 years ago)In 1996 we had my daughter I wasn't considered high risk but they watched me really close and at 34 weeks my water broke.

In 1998 they discovered funneling of my cervix and put me on bedrest at 18 weeks (no one even mentioned a cerclage at this point) at about 24 weeks i went into ptl (they stopped it) and this is when i heard the micraculous word cerclage..(but the risk to my baby was the same as if he was born and in the nicu.) My son was born 2 weeks later at 26 weeks weighing 2lbs 2oz we spent 89 days in the nicu..(i would have done anything to not have to do nicu)

in 2003 we became pregnant again and as soon as we went to our first visit we mentioned cerclage and they were like would you do it? im like anything to help my baby..at 14 weeks they did the cerclage it was a same day surgery with an epidural and I was awake..(went home a few hours later a little cramping not a lot of bleeding and i just stayed put most of the weekend) they did cervical checks up till about 24 weeks and thats when things changed a little was put on bedrest at that point..At about 31-33 weeks developed a urinary tract infection brought on ptl..was in the hospital for about 10 days at this point and they found there was a loop in my cerclage and removed it..contractions stopped went home on bedrest carried my daughter till almost 36 weeks..(my first child i got to bring home when I came home) 6lbs 2 oz

In 2006 we were pregnant again and we did the cerclage at 14 weeks..this time at 16 weeks they had these new progesterone shots that i received untill my body started showing signs of a reaction..and my dr beleives in fish oil tablets..I at this point modified my own activity (not necessarily dr induced bedrest but my own)and they removed the cerclage at 36 weeks and my son was born a week later..6lbs 15 oz..(never was in the hospital for ptl or anything )

And just Saturday I found out we are expecting again and i am already figuring out when 14 weeks is so I know about the time I will get my next cerclage.

If your still reading this I think its definitely worth it compared to suffering through nicu.. and i dont remeber there being much pain..

Steph
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  #5  
October 5th, 2009, 06:22 PM
highriskmommy's Avatar Bedrest Mommy
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I had my cerclage placed a few weeks ago at 13w4d.

I was diagnosed with IC when I went into labor with my son. He was born at 21w3d and passed away 3 hours after birth.

They can place emergency cerclages later in pregnancy but the risks are higher. They were going to attempt one with me last time but my water broke 2 hours before surgery.....Which may have been for the best because I had a infection in my bag of water that they didnt know about untill my water broke.

Here's my cerclage placement story: Went in at 8am and the nurses took my vitals and started an IV. Df was able to sit with me once I got dressed into the hospital gown. The anesthesiologist came in and told me that I could choose between a general or a spinal. I chose the spinal because he said he could still put me to sleep if needed. I had to wait in my room for a while because the OR was too busy for me. It was nice because I was a huge ball of nerves and any extra time with DF was great. They finally wheeled me off to the OR and the anesthesiologist started the spinal. It wasnt as bad as I thought it would be but he did have to try a few times before gettting it into the right spot. They laid me down and started my antibiotics and gave me something for my nerves. They also let me listen to music to help keep my mind on something else. Everytime I asked for something to calm me they gave me what I needed. I was awake the whole time but couldnt see anything because they put a sheet over me that I couldnt see over. A nurse came up and said "see that isnt so bad, right?" I asked if they had already started and she said they were almost done. Ill admit I was amazed, I didnt feel anything AT ALL. No pulling or pressure or anything! 5 minutes later I herd the Dr say that everything went perfect and my cervix looked great! They then cleaned my up and wheeled me to recovery. I asked for them to bring DF back but she wouldnt let me see him untill the feeling came back in my legs. I actually feel asleep and woke up an hour able and was able to move my feet and legs. DF came in to see me and they checked the babys heartbeat and when I was able to walk I got to go home.

I was told I could bleed or have funny discharge for 2 weeks. I stoped bleeding that same night. I was a little crampy that night and I had tons of burning but I woke up the next day feeling 100% perfect. I eneded up loosing my mucus plug 2 days after my placement but was told it was normal and my Cervical scans are still looking good with no changes.

Im not allowed to lift anything over 10 pounds, Pelvic rest, no baths or swimming.

I can feel my stitch some. It feels like a tampon inserted wrong or a small ball shoved way up there.

I cant tell you what choice you should make but I feel that a cerclage is best. Ask lots of questions. Find out how many Cerclages your Dr has done. How many of those had complacations. Make sure they will give you antibiotics durring the surgery.

For me its worth the risks to get a cerclage because without one I dont even have a 50-50% chance of carrying to term. I also NEVER want to loose another baby.

Feel free to PM me if you have more questions! I hope everything works out for you!
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  #6  
October 5th, 2009, 06:57 PM
fibigrey's Avatar Mega Super Mommy
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Quote:
Originally Posted by highriskmommy View Post
Ask lots of questions. Find out how many Cerclages your Dr has done. How many of those had complacations. Make sure they will give you antibiotics durring the surgery.
:/ My doctor is new. She has been practicing on her own for a year. she told me today that she has done cerclage, but only in her residency :/ It does make me uncomfortable, but I am also uncomfortable asking for a more experienced physician because I am supposed to trust her.... :/ Plus, she'd recommend probably the perinatologist that I saw for consult, and he is extremely hard to get into, because he is the only high-risk specialist in our area, without driving 2 hours away.... That is a problem
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  #7  
October 5th, 2009, 09:00 PM
rebeccabaltimore and more's Avatar (rebeccabaltimore)
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If you're not comfortable with her doing the cerclage, you should definitely see someone else, her feelings on the matter are not your problem.
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  #8  
October 6th, 2009, 04:54 AM
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I am in your EXACT position!

I carried my son, who is now 5, full term with no complications. I had a cone biopsy done in 2006 to remove Stage 1a1 cancerous tissue from my cervix.

Was told by a fertility specialist back in 06/07 to never attempt to get pregnant on my own because my cervix would never support another pregnancy and that I would need a TAC to keep a baby in place.

Fast forward to March . . . found out about our newest surprise. I was completely freaked out about whether or not this baby would survive without the transabdominal cercglage.

This pregnancy was "fairly" normal up until about 17/18 weeks when we realized that my cervix was, indeed, having some issues supporting the weight of the baby. I had a mcdonald cerclage put in place at the end of June to maintain the pregnancy. The cerclage, along with bed rest and progesterone injections, have helped to get this far. I;m 37 days away from my scheduled c-section and am over the moon about having a new little man in my life.

My advice is . . . it's better to be safe than sorry. If your doctor is willing to do it, then by all means, go ahead. I think that when doctors see women in or position, they are definitely willing to consider the placement of a cerclage over the alternative.

I was nervous about the cerclage at first but it was the best decision that we made.
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Last edited by mlgteach; October 6th, 2009 at 04:59 AM.
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  #9  
October 6th, 2009, 10:29 AM
highriskmommy's Avatar Bedrest Mommy
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Quote:
Originally Posted by rebeccabaltimore View Post
If you're not comfortable with her doing the cerclage, you should definitely see someone else, her feelings on the matter are not your problem.
I agree 100%.

Experence is a must have! The Dr can actually pop the bag of water durring the surgery so you need to find one that has tons of experence. Can you maybe travel just for the surgery and then see your nomal Dr for all the rest of the check ups? I also chat on a different site then JM, its just for ladies with IC and I know lots of them have done just that.
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  #10  
October 6th, 2009, 02:54 PM
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There are also options for how active you want to remain too. I had a McDonald put in as a rescue with baby #2 at 18 weeks and carried to 37 weeks on complete bedrest. With #3 I opted for a Shirodkar at 13 weeks and never needed bedrest. I maintained 3.5 cm of cervix (4 cm is average, 2 cm is cause for concern) untill it was removed at 35 weeks due to irritation causing contractions. I delivered at 36 weeks 6 days, we were only 23 hours shy of full term. The Shirodkar is a more invasive stitch and needs a practiced hand so you would be looking for another Dr to put it in. It also needs to come out in the OR not the office. The stitch is completely burried under the surface of the cervix and it is placed higher than a McDonald. The down sides are more painful to place (I was down for almost a week instead of a couple days) and needing the OR to get it out. But the upsides far outweighed that for me. I am a full time student and have a 10 and 9 year old so continuing to be on my feet was very important to me. I was also never put on pelvic rest, because the stitch is completely covered there is a much lower risk of infection so I could still have sex. I also couldn't feel the stitch as much as the McDonald. For me there was never a question as to whether or not to get the stitch, is was what kind and when is the OR open.
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