Cerclage questions

takmjs

Hi. I'm not pregnant now, but after a 30-week preemie last year (and now healthy 1 year old), my doctor told me I would definitely have a cerclage put in around 13 weeks for my next pregnancy. I'm a planner (even though I know babies don't follow our plans), so I'm just looking ahead for when we TTC this fall. With my first, I had 5+ weeks of hospital bed rest due to cervical shortening and dilating (I have a bicornuate/split uterus, which often leads to this and preterm labor)....also largely due to me being 90 minutes from the nearest high-risk doctor and NICU. Anyway, here are my questions about cerclages.

1. Is bed rest the norm after a preventive (or any) cerclage? If yes, how long? And if yes, what is the reason for the bedrest after a cerclage? If yes, is it for the remainder of the pregnancy?

2.  Can you still have cervix shortening and/or funneling/dilating with a cerclage in place?

 3. Anything else you can tell me about a cerclage would be appreciated. I'm the type of person who prefers actual experiences rather than just what research says. (My daughter seemed to do the opposite of what the doctor's research said.) 

 Thanks! 

rlajambe

::lurking from TTCAL::

While I have yet to have a cerclage (i'm like you, still waiting), I have been looking into it for quite some time.

1.  Some doctors do bed rest quickly while others prefer to monitor your cervical length closely and place you on bedrest as needed.   It depends on the doctor preference and the woman.  My doctor told me though that he has had some women go through the entire pg without bedrest, although you shouldn't necessarily count on that.  The reason for the bedrest is move the weight off the cervix and hopefully prevent any further shortening.  If you are placed on bed rest it typically is for the rest of the pg.

2,  Unfortunately, there are women that shorten, funnel and dilate with the cerclage.  There are some women who shorten all the way and only have the stitch (and many have succesful pg in the end).  That's why cervical length monitoring is so important. 

3.  Although as I said I don't have personal experience yet, I do know that lifting  more than 10 lbs. is a no-no during pg with IC, so prepare for that. It places too much pressure on the pelvic floor, If you have to do much lifting at work, you may need to confidentially arrange a work accomodation when the time comes.  Also a consideration with your LO. 

chicky1231

I'm in my 2nd pregnancy and I have a cerclage this time....it is a TVCIC which is placed a little higher then a traditional vaginal cerclage.  I had it done by Dr Davis who is one of the top two Dr's in the world for this procedure.

I had it placed at 12 weeks and have not been on bed rest at all and I'm currently a few days shy of 35 weeks.  I took it easy b/c of my own worry until 24 weeks but it gets hard when having a toddler around. I still lifted her in and out of her crib and the car b/c there was no way around it. The further I got in the pregnancy the more I let myself do and I now carry by DD to and from the car, I was ok'd to workout again a few weeks ago and I do all other normal stuff, except have sex

This pregnancy has been a breeze compared to my last!!  My high risk Dr didn't need to monitor me but he said I could be if it made me feel better so I went every two weeks for a cervical check and my cervix has held strong and actually got longer. Yes some people still dilate to the stitch but others have no issues what so ever. My cousin also had a cerclage and continued to work and do normal stuff until delivery.

caden1206

I had a preventative cerclage placed at 13 weeks.  You will see different answers dependent on the timeframe and circumstances women got theirs.

1. Is bed rest the norm after a preventive (or any) cerclage? If yes, how long? And if yes, what is the reason for the bedrest after a cerclage? If yes, is it for the remainder of the pregnancy?  I was on bedrest for a week after my cerclage to allow for healing.  It was more like modified bedrest.  I am currently not on bedrest because my cervix is still measuring long and close and I am not contracting.  If I start to having any funneling or decreases in my cervix beyond 3 cm I will be placed on bedrest.  I don't know how long that will be for, but I will assume it will be until it is safe to deliver my daughter.  I am currently 24 weeks and my cervix is measuring 5 cm.  With my preterm delivery, I was 1.5 cm dilated and 85% effaced by this time.  Are things going better because of my cerclage, I don't know.  But, I am glad I got it. It has helped me feel more confident about this pregnancy from the beginning,

2.  Can you still have cervix shortening and/or funneling/dilating with a cerclage in place?  Yes, you can.  I am getting weekly measurements to watch for that.

 3. Anything else you can tell me about a cerclage would be appreciated. I'm the type of person who prefers actual experiences rather than just what research says. (My daughter seemed to do the opposite of what the doctor's research said.)  I gave some info above.  I did have more than normal bleeding with my cerclage.  That was the only thing that freaked me out.

 

cannolioh

1. I had 2 weeks bedrest after my preventative cerclage, and 1 week around 20 weeks for light bleeding. I think one week bedrest following placement is the norm. 

2. Yes, I was funneled almost to my stitch by 20 weeks, my doctor wasn't worried and it wasn't an issue. I have heard funneling increases the chance of PROM, but like I said it wasn't an issue for me. I was dilated to 2 cm when I had the stitch taken out at 37 weeks, but I'm not sure how long I had been like that. 

3. The surgery itself was not a big deal. I had no pain after, and only light bleeding for about 24 hours. I took prometrium orally for the duration of my pregnancy. Removal of the stitch was painful and I was sore afterwards.

Good luck to you, I hope your next pregnancy is smooth sailing!  

lawgalheel

After DS2 was born at 26 weeks, I skipped getting a preventative transvaginal cerclage and instead had a pre-pregnancy transabdominal cerclage (TAC) placed.  Dr. Davis, who placed an earlier poster's TVCIC, is known for doing these, but I went to Dr. Haney in Chicago to have mine placed.

I have not been on bedrest in this pregnancy, although I have taken it easier than I did in my previous two pregancies.  If you would like to learn more about TACs, please feel free to private message me or google "Abbyloopers" which is a wonderful resource. 

Good luck!

fbf2006

1. I had a preventative cerclage (shidrokar) placed at 16 weeks and have had no bed rest. The research on bed rest is inconclusive. It really depends on your doctor and your personal comfort. Thankfully my job is a desk job, though it's currently our busy season so I do work a good amount right now.

2. Yes you can still have cervix shortening, funneling or dilating with a cerclaege. People do funnel to the stitch and still go full term. Thankfully I'm 28 weeks now and don't have any of these. My cervical length is currently 2.7cm. I guess it did shorten from a high of 4cm when my cerclage was placed. It is normal for it to start shortening though.

 

topchef33

1. I think bedrest varies. I'm not sure if it depends on whether it was placed early on as a preventative measure or later as an emergency cerclage. I had mine placed at 22w6d...so I think mine was more emergency. The dr said my cervix was starting to thin...but he never mentioned funneling or cervical length. He had me take it easy for 2 weeks after...basically just getting up to get food, go to the bathroom, shower...but  mostly keep my feet up. He ended up suggesting that I stay home from work since it was kind of a lot of up and down at the office. I was basically on MBR until my stitch was removed at 36 weeks.

2. Yes I believe you can. Sometimes a cerclage can fail.

3. The procedure wasn't all that bad. I had it placed at night, so I did have to stay the night at the hospital but was home by about 10:30 the next morning. I did have a spinal, so I didn't feel anything. I did have to have help to the bathroom for the first 2 times I needed to go b/c the nurse had to check my urine output. There was a little bleeding afterwards, but really I just needed a small pantiliner for a few days.

There was some back pain and cramping, which is normal. I ended up with an awful spinal headache though which started about a day and a half after my procedure and lasted about 3 days. And there were other restrictions, like no sex, no lifting (small things I lifted but nothing that would cause any strain), no cleaning or cooking. I could make myself lunch, but I don't think the dr wanted me on my feet for long periods of time.

And now I'm 40 weeks and my cervix was still tightly closed at my appt a few days ago. I took it easy shortly after the cerclage was removed b/c I kept thinking that the baby would come soon after and I was hoping to get to at least 38 weeks. I will probably have to have this done again if we have another baby, which will be a challenge if I have to be on MBR again. But, maybe since it will be preventative I will be able to work and take care of a toddler.