Please tell me what you would do in my situation...

crazyanimals

You may have seen my post a while back about my cervical length, if not, I had an appt on the 5th with maternal fetal medicine to have my cervical length checked.  The previous appt to that was 3.5cm.  On the 5th it was 2.9cm.  This terrified to crap out of me since I'm only 19 weeks and that is a big change over 2 weeks time.

MFM told me they don't place cerclages until 1.5cm or less....I talked to my OB yesterday and she said that there really isn't anything that they can do other than wait and see.  I have 3 weeks until the cerclage option is out.  Should I request one if my cervix is thinner at my appt. on the 19th??  Should I request one regardless?  I know the risks involved (which are terrifying to me also), but with such a high success rate I can't help but think it's the right thing to do.  It seems like Dr.'s have done them for much less than my situation (LO #1 born at 30wks 1 day due to pPROM and I had a LEEP done this past August).  Being on bedrest for the next 17 weeks will be almost impossible for us since I have an 18 month old....

Any ideas/advice are great appreciated....prayers too!  I'm an emotional wreck right now.  I can't even fathom the thought of losing this baby....

fanofanne

Hello! I absolutely would. My drs only noticed that I started funneling only after I insisted on a vag exam and then a preventative cerclage was put in. I was definitely more than 1.5. Btw this was when I was 20/21 weeks. Good luck!

Tapioca

You should follow your gut, however, my doctor would not feel that a change between 3.5 and 2.9 in two weeks is a big jump. I have jumped more than that in a week.  Honestly, a lot of women on this board would be happy with a cervix of 2.9 (I know I would be!). But, given your history of preterm birth and a LEEP, you certainly have the right to worry. Did they ever speculate as to why you had a preterm baby? Infection? IC? PTL?

Also, don't think that getting a cerclage will eliminate bedrest. I ended up receiving an emergent cerclage when my cervix was 1.9 at 21 weeks.  I am on bedrest with bathroom privelages and will be until delivery or, God willing, I make it to term.

Only you and your doctor know what is best for you, your baby and your family. Good luck!

crazyanimals

Tapioca:

You should follow your gut, however, my doctor would not feel that a change between 3.5 and 2.9 in two weeks is a big jump. I have jumped more than that in a week.  Honestly, a lot of women on this board would be happy with a cervix of 2.9 (I know I would be!). But, given your history of preterm birth and a LEEP, you certainly have the right to worry. Did they ever speculate as to why you had a preterm baby? Infection? IC? PTL?

Also, don't think that getting a cerclage will eliminate bedrest. I ended up receiving an emergent cerclage when my cervix was 1.9 at 21 weeks.  I am on bedrest with bathroom privelages and will be until delivery or, God willing, I make it to term.

Only you and your doctor know what is best for you, your baby and your family. Good luck!

 

I had PTL starting at 27 weeks and my water broke at 29 weeks.  At 28 weeks I had gone from a 2.4 at 27 to a 1.8 at 29.  After my water broke (same day I was measured at 29wks), I dilated to 1cm.  

Everything happened so quickly.  I don't want to be in a situation where I hit 24 weeks and get put on hospital bedrest.

camillaandcarson

In your situation I would get a cerclage placed ASAP.  Cerclages have a higher success rate when placed preventively vs when there is a problem, like a rescue cerclage.  

irylyn

My suggestion is talk to either your or another doctor.  I was 19 weeks along, had a sinus infection, went into the hospital to get antibiotics, and through a series of flukes (IE: routine check on baby and the monitors and stuff wasn't working right, so they got an ultrasound tech in there), found out I was 2cm dialated, and length was 2.6.  Turns out, I had a low-grade bacterial infection in the uterus and my body was trying to fight it.  I was admitted into the hospital, put through a series of antibiotics, 2 days later, cerclage was placed.  

I don't know how much information you have on them, but a cerclage WILL make you thin to pretty much nothing.  It's just what they do.  They're strong buggers though.  And like all procedures, it does have a small percentage of risk.  Make sure you trust the doctor performing it.  They can be little miracle strings.  My doctor and I are just hoping to get to week 28 (TOMORROW!!!!!) because that's when the best chances of infant survival with minimal complications from preterm birth start, although I think my son's going to go longer than that, if not be a little stubborn bug and go full term just to show us he can. If it wasn't for the cerclage, I wouldn't still be carrying him, though.

Also:  I was on bed rest for 2 weeks after the cerclage was placed.  After that, the rules for me were pretty simple.  Take it easy.  Don't over do it.  And trust me, you will know if you do.  And you're not supposed to lift over 10lbs, they get pretty strict about that, but in your case with an 18mo old, they might see it as a necessity and go a little gentle on you. But I'm not your doctor, they might have different ideas of what's best for you.

Good luck, congratulations, and don't stress.  You always have options!   

T+Schultz4

If you decrease more by your next appointment I would demand a cercalge. You have already been there and done that with a premie, why risk it again. Your body is already showing signs of pre-term labor by your cervix decreasing so early.

I don't want to scare you but I had 2 friends who's doctors (diff doctors) told them not to get the cerclage because their cervix wasn't below 2. One of my friends lost her baby and the other delivered her twins at 25 weeks (they have been in the nicu for 4 months now). Based on their experiences I was well aware of short cervix's and cerclages. At my second appt with my doctor when I saw that my cervix had shrunk more, I demanded a cercalge.

I am now almost 33 weeks and doing good. The baby's head is right against my stitches and has been for a month now. My cervix is at a .8. If I didn't get the cerclage, I would have definitely had a permie.

All I cared about was having a healthy baby and I was going to do whatever it took.

Best of luck. Follow your heart and your gut; this is your child, not your doctors.