PLEASE HELP! Had Cerclage and Water still broke

HawkinsBaby1

Last Monday right at my 21st week, my water broke and my baby was delivered pre-term. Because he wasn't 24 weeks, it did not survive. This is the second time this has happened so this time around my dr. put in a cerclage but my water still broke. My doctor isn't giving up and plans to do a series of test starting in a month but I thought I'd do some research as well to see if anyone else has had this happen and what did your doctor discover? We will try again in 6 months but first we've got to figure out why I'm rupturing so soon. Last time it was at 18 weeks.

Thanks

ThereBeDragons

When did you have the cerclage put in- and how short was your cervix at the time? 

If you had it put in early (before 16weeks) and with a high cervix measurement (above 3cm) then the only guess I can make is that you had a cerclage failure. The doc should still be checking up on your cervical length and to make sure that the cerclage hasn't failed at 21 weeks- my MFM stopped checking length onY at 24weeks. You can ask about a transabdominal cerclage- it is placed before pregnancy and cannot be removed during pregnancy (so you would be required to have a csection) but they are high and very stable/secure.

If it was put in late as an emergency procedure or with a very short measurement- next time it should be placed preventively-early and high. Honestly it should have been placed early and high even with just one second trimester loss... But especially with a history of multiple late losses. 

If the water breaking isn't caused by cerclage failure (and on ultrasound it was still visible and in the proper place after water breaking) it could also be as a result of an infection in the amniotic fluid. That's something that's hard to predict (infection can be introduced with cerclage placement) and can be difficult to prevent if you are prone to infection.

All in all, this is a good question to discuss with your MFM. Hopefully they have more answers.

I am so sorry for your losses.

MissChanandlerBong

I'm so sorry for your losses.

If you don't already have one, definitely see a MFM (maternal fetal medicine) specialist before conceiving another baby - they can walk through different options and the benefits/risks associated with each so you know what your options are.

Do you know if a placental pathology was done after your delivery?  My MFM has said she thinks many cases labeled as cervical incompetence are actually related to placental issues, but not enough research has been done to truly understand all the underlying issues.  I don't know if that's part of the testing that your doctor is doing, but I'm planning to have this done when I deliver to see if that explains some of the issues I've had. 

Were you receiving any other treatments?  Many women also receive weekly progesterone injections or suppositories, are on bed rest and pelvic rest, etc., so those may be a few things you can ask your doctor if you weren't getting those this time.  My MFM also said she may start me on baby aspirin if I ever decide to have another baby.  Good luck with everything. 

angelsnight

ThereBeDragons said:

When did you have the cerclage put in- and how short was your cervix at the time? 

If you had it put in early (before 16weeks) and with a high cervix measurement (above 3cm) then the only guess I can make is that you had a cerclage failure. The doc should still be checking up on your cervical length and to make sure that the cerclage hasn't failed at 21 weeks- my MFM stopped checking length onY at 24weeks. You can ask about a transabdominal cerclage- it is placed before pregnancy and cannot be removed during pregnancy (so you would be required to have a csection) but they are high and very stable/secure.

If it was put in late as an emergency procedure or with a very short measurement- next time it should be placed preventively-early and high. Honestly it should have been placed early and high even with just one second trimester loss... But especially with a history of multiple late losses. 

If the water breaking isn't caused by cerclage failure (and on ultrasound it was still visible and in the proper place after water breaking) it could also be as a result of an infection in the amniotic fluid. That's something that's hard to predict (infection can be introduced with cerclage placement) and can be difficult to prevent if you are prone to infection.

All in all, this is a good question to discuss with your MFM. Hopefully they have more answers.

I am so sorry for your losses.

I have nothing to add, these are all great things to consider and bring up to your doctor.  But I wanted to say I am so sorry for your losses.  If you haven't been already, the loss board is an excellent place for support for those of us who have lost babies later in pregnancy and/or stillbirth.  Big hugs to you.

bcnoelle

I'm very sorry for your loss. You may want to also ask your MFM about a transabdominal cerclage.  I hope that you take time for yourself and have a lot of support during this difficult time.  

thecuddleeffect

I am very sorry for your loss. It happened to me as well. I had a transabdominal cerclage placed and am now almost 31 weeks with a cervical measurement of over 5cm. It was the best decision I have ever made in my life. It's the only way to be sure to carrying a baby to term with IC and will prevent infection from entering and causing your water to break.

Please feel free to PM me with any questions!

bluebird1109

Your water breaking may have nothing to do with your cervix. Mine did not have anything to do with my cervix, I had no contractions, and everything appeared normal. However, I had an infection.

An infection or an underlying medical condition can cause your membranes to rupture prematurely. A pathology report on the placenta is extremely important in determining if you had an infection. Your doctor should (and probably will, since you mentioned it above) run tests for any underlying medical conditions, or clotting disorders that may cause PPROM. 

Unfortunately, there is nothing you can do but wait until the test results come in to get some answers. I am sorry for your losses and I wish you the best.