Cerclage -- what to expect?

johnnys june

It seems there are alot of questions/answers for after the cerclage is place, so forgive me if this is a repeat.  I'm 11 weeks tomorrow and I meet with the MFM for the first time this Thursday.  My OB has already discussed several times a cerclage.  I lost my son last year to preterm labor/short cervix at 25 weeks 2 days.  They were originally discussing a cerclage at the initial preterm labor at 24 weeks, but then decided not too because it was too risky.  With this pregnancy we're taking every necessary precaution because I don't technically have an IC, but my cervix shortened drastically last time in just 2-3 weeks, from 2.5 - .7.  I'm really nervous to meet with the MFM just because I don't know what to expect.  If we do the cerclage, what is the down time?  Restrictions?  Pain level? ect.  Any advice/insight is welcome.  I'm just one of those people that likes to know every details up front (product of a medical family).  Thanks in advance!

UsafWifey09

I was initially on bedrest for 2 weeks then the doctor told me I was fine to do things just take it easy, then I wnt back and the doctor has put me on bedrest and I am still on it. The pain wasnt bad after surgery, it felt like period like cramps for a few days and some spotting. I am also going in every 2 weeks to get my length checked. And I am getting weekly progesterone shots. The doctor said no working out, nothing in my vagina (sex, douching, tampons..) and no baths.

tonynamy

I'm sorry, I don't know much about this issue.  I just wanted to say I'm very sorry for your loss.  I delivered my stillborn son 2 months ago (I was almost 20 weeks pregnant) and I know the pain of losing a baby.  You should talk to your high risk doctor about all of your concerns.  I hope that others can give you more advice than I can.  Best of luck to you : )

cbleahy@comcast.net

I had a cerclage placed at 13.5 weeks and just had some cramps for a couple days and some pink the day of.  I did have to take the pain meds that they prescribed me, think it was Lortab but I could be wrong.  I have not had to do bedrest but I have had weekly vaginal u/s to ck length and I pretty much just went to work and then came home from the time I got it placed until about 26 weeks.  I didn't grocery shop, workout, go shopping or stand for long periods.  On the weekends we would just get together with friends and I would lay on their couch instead of mine, haha!  Good luck, it is so anxiety producing going into another pregnancy but with lots of monitoring and your Dr's keeping a close eye on you you will do great!!

gfornkohl

i recently just had my cerclage done..

I also lost my baby due to PROMM & IC 18 weeks of sept 09....So my dr saw my cervix was very bad already so i did a cerclage at 12 weeks...about 2 weeks ago

I also suffer from hyperemesis and was hospital for 2 weeks before finally getting my picc line put in...lost 23 pounds~

SO this pregnancy hasbeen a rough roller coaster .... when doing the cerclage honestly me and my dr were expecting every bad thing LOL not in  a bad way...but already ups and downs and MY LOW tolerance to pain....

Honestly the worst part is the fear....the fear of the spinal for me...right before like literally 2 minutes b4 they finally did it i just started balling...that was the worst part...i had little to no bleeding...no cramping...i actually  felt like nothing had happen...

trust me i was prepared for the worst because i cry when i have to remove the tape from my picc line off my arm....

idk if my dr was great or i was finally  blessed....but i am going to pray if you do get it that it goes the way mine did...

oh and as far as restrictions you will prob b light moderate bedrest for a few weeks and this is so the dr can keep measuring you...if ur cervix continues to go down hil...then flat bedrest

but goodluck and prayers 

easjer05

I haven't read the other responses, so forgive me if I'm being repetitive.  I lost my son at 21 weeks due to cervical damage at the internal os, early dilation from the internal os (the opposite of normal dilation, which is outside in), and bulging membranes breaking precipitating labor - in other words, I'm not classic IC either.

I was also nervous to met the peri, but he immediately said exactly what my OB had said from the beginning - preventative cerclage, 17p and lots of rest.  He placed my cerclage at 12w4d, and the procedure itself was much less painful or worrisome than I'd imagined.  I was in and out of the surgical center in 3 hours total (including the early get there time to complete paperwork and do surgery prep).  Most people get a spinal, but my peri prefers general anesthesia.  I was out for thirty minutes, the procedure took twenty.  Each doctor has their own guidelines for immediately after surgery (and it's different from a preventative cerclage to a rescue cerclage).  Mine said bedrest the remainder of the day and take it easy for another 2-3 days.  I had surgery on Thursday, returned to work Monday.  The most pain was truly from the intubation and napping on the couch.  I bled like a light period that day, spotted the next day, and it was gone entirely (not even tan cm) by the time I returned to work.

As for restrictions, I seem to have a more conservative medical team, but it's possible also because the cerclage isn't a 100% guarantee, given where the damage is located (we're not really concerned with funneling/shortening, and I haven't really experience any yet).  Anyway, I can go up and down one flight of stairs per day (I live in a two-story townhouse, so yeah).  I can't lift/push/pull/carry more than ten pounds.  I am not supposed to exercise at all, and my slow walking is not supposed to exceed thirty minutes at a time, but they prefer under 15 minutes of walking/standing without a break.  No baths/swimming/bodies of water.  No sex, and no sexual stimulation of any kind (no orgasms.  My peri said, only half-joking, that I shouldn't dream of Brad Pitt if I could avoid it).  I was originally told that I'd have cervix checks via transvag u/s every two weeks, but it actually hasn't worked out that way.

I don't have any more pain than a normal pregnancy, I don't feel the stitch at all unless I've pushed too far one day (I walked around Target for an hour, and could feel the stitch by the time I left).  It's no big deal except for the restrictions.  And those are doable, it's just a little frustrating and depressing at times to feel like I can't do anything and that I'm a burden - but it's helping me avoid tighter restrictions like bedrest, so we'll keep going.

There is more discharge, which they warned me about, but it can be disconcerting because somedays there is a lot of it.  It ranges from mucousy to a consistency like watery milk, and I've asked everyone (OB, OB nurse, Peri, home health nurse) to go over with me what I'm looking for in terms of possible amniotic fluid leak, because I'm very paranoid about that.  

My feeling tends towards conservative on this - if they aren't opposed, even if you aren't classic IC, preventative cerclage is so much easier and has such good success rates that I wouldn't hesitate to do it.  It's hard to read about the risks, especially online, because rescue and preventative outcomes aren't always separated, but it was one more thing that gives me peace of mind and confidence, which are rare things this pregnancy.

GL to you, no matter what.

easjer05

Oh, for the record, after the cerclage I wasn't given any pain meds.  I was told I could take extra strength tylenol.  I did once the first day and twice the second day (for neck/shoulder pain).  Very little cramping.

I also spend most of my time away from work resting with my feet up, per their instructions.  I also mentioned 17p - I started weekly injections at 17w4d, and they haven't been too bad.  The new formula I'm on from home health doesn't even give me headaches, which is nice.

johnnys june

Thank you, ladies.  I'm still nervous and carry my own internal conflicting emotions (more to do with my loss and how that relates to how difficult this pregnancy will be), but I feel a bit better "knowing what to expect."

Laxbugg1410

I'm so sorry for your loss.

Because of a LEEP procedure I had years ago, my OB felt I was at risk for IC. He recommended a cerclage when I was pregnant with DS. Not wanting to be on bedrest (or anything worse!), I had the cerclage put in. The procedure itself was easy: 1/2 day in the hospital, knocked out for the procedure, some cramping and spotting that day, and I had to take it easy the next day. I was running again the day after that. I ran throughout my pregnancy, including the day I delivered. My cervix never shortened to less than 3.5cm, but I did dilate to almost 5cm almost immediately after the cerclage was removed (suggesting that it was a good thing I had it!)

For this pregnancy, there was no question about whether I would get a cerclage. Again, the procedure was easy (although I wasn't knocked out and didn't have enough pain meds so I had to work with the anethesiologist to get them upped during the procedure) and my recovery time was similarly short. At my last appointment, my cervix was 3.8cm. I'm a little worried that it has shortened, but I don't go back until January 3.

The only cerclage-related restriction I've heard is no sex. But my doctor said it was actually fine so that was not an issue during my last pregnancy (and hopefully not this one!)

Best of luck. Honestly, IMO it is an easy procedure and well worth it!

Cercamom2011

I'm really sorry for your loss.  My experience is much like the other ladies, except I had to stay in the hospital overnight.  My Dr is ultra-conservative with my care, because I lost a 23 weeker and pretty soon I'll be AMA (I'm 34).  I'm also on the 17p shots (which so far haven't hurt or bothered me).  I'm not a "classic" case of IC, CI or PTL, so I'm being treated as a combination issue patient, which is ok.  GL, and don't stress too much about the cerclage.