PG after extremely HR pregnancy - cerclage? (sorry, long) — The Bump
High-Risk Pregnancy

PG after extremely HR pregnancy - cerclage? (sorry, long)

Okay, I am totally new to this board, but I need help, especially from those of you who now have or have had cerclages!

History:

Last pregnancy was IVF twins. Water broke on twin B at 17 weeks, and I effaced SLOWLY over the next 5 weeks until I went into labor just past 22 weeks. The PPROM and labor were probably both because of an infection. My miracle doctor did an emergent cerclage after delivering B and kept A in for 3 more weeks. I lost one son but three months later I brought home my other son.

Now:

I'm (surprise) pregnant again with a singleton - now 12.5 weeks along - and while my regular doc seems to think watching and waiting is the thing to do, I happened to see a high risk doc just for my NT scan (not available in time from my regular OB). He seems to think that even though I have a good chance of nothing going wrong at all this pregnancy, I should do the cerclage in two weeks as a preemptive measure, so I don't have the extra risks and bedrest associated with emergent cerclage.

I would just go for it to save the trouble that might come from getting one later, but I am scared to death of the risks. What if doing the cerclage does more harm than skipping it? Or if I don't even need it but I get it and it causes pre-term labor. Who has had them? Any problems? What would you do?

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Re: PG after extremely HR pregnancy - cerclage? (sorry, long)

  • This will be long-- 

    I am sorry for the loss of your LO, but how wonderful that you were able to carry your other LO for a few more weeks! I had a somewhat similar situation with my twins. I lost them at 23 weeks. I had a very short cervix at 20weeks, at which time I also had an infection. My cervix progressively shortened and my water broke at 23 weeks.

    I was so sure I would definitely get a cerclage this pregnancy (a singleton). I had already decided I wanted a cerclage, and even scheduled an abdominal cerclage. I saw three different high risk doctors and they all said I had a 90% shot a full term baby if I did nothing at all. They all suggested checking my cervix every 2 weeks and only doing a cerclage if it shortened. They told me a prophylactic cerclage is not without risk- it can increase the risk of pre-term labor and can get infected. It's a very difficult decision and I am so sorry your are going though this. It was and still is extremely nerve wracking to not have a cerclage, but I am just shy of 24wks and my cervix is still very long and closed, no cerclage or bed rest. 

    Twin pregnancies are sooo different than singletons and the risk of complications is so much lower with a singleton. There is no wrong decision, it is very doctor specific. Regardless, you will be watched very closely, and if there is a problem, it will be recognized early enough that something can be done about it. I would just go with your doctors recommendation. They know your history better than anyone and have lots of experience with these issues. Good luck! Feel free to PM me.

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  • Hi, Sorry to hear about your loss. I lost my son at 22 wks do to incompetent cervix last feb and am now pregnant again, Thank God! I got a cerclage at 14 wks and started p17 shots at 16 wks. I haven't had any problems and my cervix is actually mearsuring super long like 4.9 cm. I see a specialist once a month, my doc every 2 wks and I get a shot every week. I usually get my cervical length checked every 2 wks. I would def. get the cerclage and the shots if possible. I'm not sure how the cerclage can cause problems, they only stitch up your cervix, but I was paranoid at first thinking they might have damaged something, but I was just overreacting. It is a very nerve racking waiting to pass the time where you went into labor the first time. I would say do everything possible to prevent pre term. If a doctor says get a preventative cerclage, do it. Its better to be safe than sorry. I was so devestated with my lost that I wanted everything! It sucks that doctors don't do routine cervical length checks to be on the safe side,it seems like this happens to a lot of women.

    Good luck with everything. Please feel free to contact me with any questions or comments!!!

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  • I am so sorry about the loss of your boy :(  Also, I am amazed you were able to save your baby A! 

    My cervix started to go (and funneling) at 23wks, but was able to make it to 33 1/2 wks with my twins.  I'd been on bedrest from 13wks on. 

    For this pg, I stuck with my Peri and see him regularly, as my OB.  He is a well known Peri who specializes in multiples.  We are keeping a close eye on my cervix.  He has mixed feelings about cerclage, even in singleton pg, and also wants to wait and watch.  I think if I were you I'd find a well respected Peri and get yet another opinion.  I would need another professional opinion to make that decision.

    Also, what about modified bedrest as a preventative measure? 

    My twins were also from IVF, and I am pg with a "suprise!"

    Wishing you the best of luck!! 

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