Cerclage?

mle5d

Hi all. I hope it's okay if I post here. I'm 19 weeks pregnant with my second. I had my anatomy scan on Friday, and the dr called today and said my cervix was a little short (2.7 when they want to see 3.5-4). They're sending me for a second opinion tomorrow, but she mentioned putting in a cerclage if the results come back the same. If this happens, what is the process? And am I likely to be on bedrest/restrictions as well, or can I maintain some sort of activity? Thanks so much for any and all information! My first pregnancy had zero complications, so I'm more than a little out of my element here!

aprilmars

Hi, I'm only about 9.5 weeks and will be having a cerclage on May 8th.  I hope someone else answers because I am wondering the same exact thing!

bluebird1109

If you get a cerclage you will go to the hospital and you will get a spinal to numb you. The doctor will do an ultrasound, and place the cerclage. Then you have to go to recovery for the anesthesia to wear off (each hospital has different policies but where I am you need to be able to move around and use the restroom before you can go home). They typically do an ultrasound again before you go home to make sure everything is OK.  This is the procedure for my doctor, I am not sure about yours so that is a good question for them should they suggest the cerclage.

You will be on pelvic rest for about a week after the procedure. As long as things are ok you shouldn't be on full bed rest, but again I would discuss this with your doctor. Most likely you will have restrictions like lifting and such. Each person is different though and each situation is different, all doctors have their own beliefs and practices. 

I would make a list of questions for your next appointment so you understand the process completely before it starts. Good luck!

ThereBeDragons

A cerclage is an outpatient procedure at a local hospital or surgery center. They either give you an epidural or put you under general anesthesia for the procedure and you are discharged same day. 

Restrictions depend on your doctor and the type of cerclage you are getting. A preventative cerclage is placed around 12-15 weeks regardless of current cervical measurement because you have a history of second/third trimester losses (typically two or one and a successful pregnancy featuring an emergent cerclage). Preventative cerclages often come without major restrictions or bed rest unless your cerclage is in danger of failing as the pregnancy progresses. But again, every doctor has a different policy.

Emergent cerclages are placed when a shortened cervical measurement is discovered (typically before 24 weeks). Once you have had significant cervical shortening and a cerclage is placed- you will typically be given some restrictions depending on how severe the shortening/dilation are and your doctor's preferences.

An example of both- I had a second trimester loss due to incompetent cervix in 2012. At 17weeks with my current pregnancy I was referred to a MFM to evaluate me for possible cerclage placement (since I had had only one loss, I wasn't referred for a preventive cerclage). An ultrasound indicated that my cervix had funneled to approx 1.25cm and I received an emergent cerclage 3 days later. I have been on bed rest since a few weeks later- over 3 months now.

Because I now have a history of one second trimester loss due to incompetent cervix and one successful pregnancy treated with an emergent cerclage- (even if something goes terribly wrong between now and delivery- my cerclage functioned properly and got me to 36w3d before being removed- so the cerclage itself is a success) all future pregnancies will qualify for a preventive cerclage. My MFM recommends one placed at 12 weeks. With a preventive cerclage, there's a strong likelihood that I wouldn't need bed rest at all.

mle5d

Thank you ladies for all of the information! I'm hopeful I won't need one, and will just have frequent monitoring, but I'm a little type A, so would rather prepare for all eventualities!