Multiples

Cerclage with multiples??

Hello everyone!

I am about 21 weeks with twins! I saw a specialist 2 weeks ago (at 19 wks), who did an internal US and let me know that my cervix was measuring 1.7cm. I suggested a Cerclage and he told me that it does not work with women having twins. I've seen on a few posts about women with twins/triplets and getting the cerclage. Is it possible to do with twins? Will it work? Are there many risks involved? Does anyone think I should get a second opinion? 

Any advice would be helpful Tongue Tied

Lilypie Angel and Memorial tickers Lilypie Premature Baby tickers

Re: Cerclage with multiples??

  • You are too far along to have a cerclage put in. Please tell me you are on hospital bed rest if you are at a 1.7?
    image Our 25 week miracles! Lilypie Pregnancy tickers
  • At this stage it's considered an emergency cerclage.  Unfortunately, they are not as successful as getting women to term as preventative cerclages are.  1.7 is very short.  Anything below 2.5cm warrants immediate action.  Mine was 2.5cm at 15w and unfortunately I lost my first set of twins at 17w4d and 18w2d. 

    It's important to note that your cervical length can change dramatically very quickly, EITHER way.  Even more important is the strength of that 1.7cm.  It could be iron tight or it could be made of mush.  Unfortunately it's hard to know until someone pokes and prods in there or you wait it out and see what happens.

    I would absolutely 100% PUSH for an emergency cerclage and strict bedrest (perhaps hospital) to keep these babies cooking as long as possible.

    Keep us posted!

    ETA: He's an IDIOT.   MANY women who have cerclage put in are carrying multiples.  A cervix that needs extra reinforcement needs it, regardless of how many babies are in there!!!!!  Find another doc.

    image
    Twin boys born too early at 17w4d and 18w2d in February 2010
    Transabdominal cerclage placed September 2010
    DS born at 35w1d in February 2011
    Twin girls born at exactly 36w in February 2013
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    Lilypie First Birthday tickers
  • image Courtneyw04:
    You are too far along to have a cerclage put in. Please tell me you are on hospital bed rest if you are at a 1.7?

    She's too far to put in a preventative cerclage.  They can do an emergent cerclage with the remaining small amount of cervix she has left.  My OB said she can work with anything more than .7mm.  All OB's are differently skilled, though.  Bed rest and contraction preventatives are also needed.

    image
    Twin boys born too early at 17w4d and 18w2d in February 2010
    Transabdominal cerclage placed September 2010
    DS born at 35w1d in February 2011
    Twin girls born at exactly 36w in February 2013
    Lilypie Third Birthday tickers
    Lilypie First Birthday tickers
  • I agree you need a second opinion.  A cervix is a cervix whether or not you are carrying multiples.  I would personally want to do anything possible to prevent an extremely premature birth and/or loss.  I have heard of women getting emergent cerclages up through the 23rd week.  I would insist on a definite plan in place by my doc with possible hospital monitoring.  Many places will give a round of steroid injections for fetal lung development at as early as 23-24 weeks if there is a risk of delivery. Keeping you in my thoughts.
  • With a cervix that short I would insist on an emergent cerclage, hospital bed rest, and a fetal fibronectin test to see if you are going into labor anytime soon. My doctor didn't offer a cerclage and wanted to "wait and see" before going on bed rest and I went into preterm labor and lost both babies at 22 weeks 3 days. Please take care of those babies and keep us posted! 
    Lilypie Angel and Memorial tickers
    IVF #1 BFP b/g twins!; loss at 23 weeks due to I.C. and PTL. IVF #2 BFP 5/26/12; due date 2/6/13; TAC surgery 7/20/12, blessed with another girl & boy! 

    Lilypie Second Birthday tickers
  • image Courtneyw04:
    You are too far along to have a cerclage put in. Please tell me you are on hospital bed rest if you are at a 1.7?
    Nope, home bed rest since 19 weeks.. I have another appointment tomorrow to see if anything has changed..praying for SOME good news..
    Lilypie Angel and Memorial tickers Lilypie Premature Baby tickers
  • I am trying my hardest to stay as unactive as possible.. The doc also told me they will not know too much until they check me again (tomorrow) and see if anything has changed. My cervix could be short and strong and always been that way, or it cold have shortened. They have no way to tell yet because they hae never checked the length before measuring it at 1.7.. With all of everyone's information on here I think I am going to talk to the doc about the emergency cerclage tomorrow, and see what happens with that. If anything has changed i'm sure they will put me on HBR.. I was actually surprised that they didn't do that two weeks ago.

    Trying my best to keep these boys cookin' as LONG as possible!!!

    Lilypie Angel and Memorial tickers Lilypie Premature Baby tickers
  • My cervix measured 1.5 at 18.6w.  I was also told a cerclage was not a good idea...not because it wouldn't work or hasn't worked for others, but because there is no research that it works for a multiples pregnancy.  And my OB thought that the risks (infection and putting my body through surgery), were too much for the possible benefit. I was put on modified home bedrest with progesterone supps. 

    When I was admitted for hospital bedrest 3 weeks later, a cerclage was completely out of the question because I was already dilated and Baby A's sac was visible.  I was given a pessary, which is far less invasive than a cerclage.  If your doctor is still against a cerclage, I would at least push for a pessary.

    After 5 TI Clomid cycles, 5 IUIs, and 2 IVFs we finally got our BFP!
    Beta#1 (12dp3dt)= 353, Beta#2 (15dp3dt)= 1466, Beta#3 (22dp3dt)= 14,139, First u/s: TWINS!!
    After 10 weeks of bedrest, our two little ladies joined us at 28w6d
    Lilypie Premature Baby tickers
  • Fight for it. get a second opinion. i just delivered a twin mom at 36 6/7 who i put in a cerclage at 13 weeks who delivered her first set of twins at 28 weeks after an emergent cerclage at 18 wks. It worked for her. data shows that twins do not always benefit but some of us believe in them.

    are you contracting though??? Big difference between effacement and effacement caused by cobtractions.

    i had a length of 1.6 at 23 weeks and i was contracting. strict bedrest at home got me go 36 weeks.

    good luck and keep us posted.
    Three losses in 2009; Boy/Girl twins born in 2010 image
  • image Courtneyw04:
    You are too far along to have a cerclage put in. Please tell me you are on hospital bed rest if you are at a 1.7?

    I had an emergency cerclage at 20 weeks, 5 days. I was put on strict bed rest at home. I had a few hospitalizations, but was able to deliver healthy babies at 35 weeks, 5 days.

    Are you now on bedrest? My cervix measured about what your's is measuring. Are you at home? In the hospital? 

    Mom to Big Sister (2008) , and boy/girl twins (2010) Life is busy!
  • Are there really doctors out there that are saying "don't bother with a cerclage, it doesn't work with multiples"? That scares me.

    My doctor was very clear. He told me about the risks, etc. I also knew I had no choice. The cerclage was worth the risk. Without it, I would have lost the babies. 

    Mom to Big Sister (2008) , and boy/girl twins (2010) Life is busy!
  • I had an emergency cerclage put in at 21 weeks due to PTL along with strict bed rest. It held beautifully until 33 weeks when my water broke on its own. the number of babies doesnt matter, as PP said, a cervix is a cervix. Definitely insist on one being put in immediately and most importantly- get off your feet immediately.
    Fraternal twin boys born at 33 weeks 4 days Baby Birthday Ticker Ticker
  • I had a rescue cerclage at 21 weeks and it punctured my amniotic sac and landed me in the hospital on bedrest for a month. It was very dangerous, but likely the only reason my babies are here now. 

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  • I dont know if anyone is still following this thread but i am currently in the hospital after having an emergency cerclage put in yesterday at 21w4d. I went to my scheduled anatomy scan and they noticed my cervix was only 1cm. I was referred to another mfm and by the time i got there same day it was around .7cm. I had the procedure done yesterday and after today's follow up i'm up to 4cm! Im on restricted activity now. While i have no idea when ill deliver at least i cant beat myself for not trying everything to save these babies. Good luck! Its a scary situation. Be positive and REST!
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    It's a BOY and a GIRL!!
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  • You are NOT too far along to get a cerclage, I was 22 weeks when I got one and though it is NOT known to help as well in twin pregnancies, it was MY only option the docs said and I am now at 26 weeks, so it couldve saved my babies lives. I am also on modified bedrest and I wish you good luck:)
  • fFN test are not accurate until 24 weeks earliest....but she should be offered them every two weeks after that....I am doing that now.
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