Officially joining you ladies

lv2011 · December 2013

At my cervical measurement yesterday, it had gone down from 3.1cm to 2.09cm, so I'm now being referred to an MFM and working to schedule a cerclage hopefully soon. It also looks like I have placenta previa which is being monitored (FX it moves up!). At least we were already used to the pelvic rest from the subchorionic hemorrhage

Can someone walk me through their cerclage experience? Did it hurt? Did you go under or have a spinal/ epidural? How long did you have to be monitored after? Are you on bed rest too? How often are they checking things post-op?

Any and all advice and insight is greatly appreciated!

PerkyErky · December 2013

I had a rescue cerclage placed at 18w6d due to my cervix dropping below 2.5 and having funneling. I also had a loss last pregnancy at 20w4d and was being monitored weekly. I had a cervix check on a Thursday where it had shortened and the MFM sent me to L&D that afternoon and my cerclage was placed the following morning (Friday) and I was kept overnight again for monitoring and discharged Saturday morning. I received IV antibiotics every 8 hrs while in the hospital and for the actual procedure I had a spinal. The procedure took maybe 20 min. It was done in the regular OR because the L&D one was booked. Honestly I don't remember much of the procedure because I was given a sedative due to my anxiety level, but I wasn't asleep.

Afterwards I had some pressure and discomfort. I had spotting the day of and was told it was normal to have a few clots as well. By the time I was discharged I was barely spotting and no real discomfort. The pressure stuck around for maybe a week.

I am now 28w5d and my cervix is staying at 2.1 below the cerclage placement. I'm not on bed rest but modified activity. No exercise, complete pelvic rest, stay off my feet as much as possible (I have a desk job so I am still working), no lifting more than 10-15lbs.

For me the most difficult part was knowing I would be getting a cerclage and all the unknowns that went along with that. Once it was placed and since it has done it's job and my cervix is cooperating, I have had less anxiety. Baby and I were monitored before and after the procedure and my cervix was checked two weeks post op. I still get occasional checks abdominally since my MFM does not want anything near the cervix to potentially irritate it. I get them about every 2-3 weeks. I know some ladies get cervix checks much more frequently and transvaginally than I do.

Kayrock18 · December 2013

Welcome! I had a similar experience to previous poster. I had an emergency cerclage at 19 weeks I'm now 23weeks plus on bed rest and baby and I are still doing ok. My surgery took 10-15 min the most, had an epidural and a (cocktail) meds for anxiety. I was very nervous. I stayed in the hospital for 3 days by the time I left just light spotting and it was gone within the week. I now get cervical u/s weekly along with progesterone shots which sucks because my butt is swollen and very itchy. Upside is I get weekly pic of my lil diva until I'm 35 weeks. Good luck I hope all goes well.

sexyntexy · December 2013

I had a preventative one placed at 14 weeks. My cervix was 2.7 cm and I spent the last 10 weeks of my previous pregnancy on BR. I had a spinal done. The procedure was quick and I went home once the spinal wore off. I had to take Tylenol for a few days after due to cramping. I'm on pelvic rest, taking it as easy as possible and no lifting.

My cervix went from 2.7 pre cerclage to 3.5 a week after and is now over 4cm! I'm so happy! Hoping I can avoid BR this time!

lv2011 · December 2013

Thanks, ladies, for sharing your experiences. I meet with the MFM on Monday, and I'm really hoping that we can schedule the cerclage soon despite the holidays. Wish me luck!

ThereBeDragons · December 2013

I didn't see this yesterday, but I was probably a little too woozy from the anesthesia to give a coherent reply.

To answer specific questions first:

Did it hurt? I was out cold for the procedure, but had some aches and pains afterward. It was Tylenol level pain though, and my MFM told me to go home with 2xTylenol and sleep on it and see if it felt better. It felt just fine upon waking up this morning. No cramping or aches really.

Spinal/General? I was given the option of either. Apparently as few as 2 years ago the Spinal was sufficiently preferred by the doctors as safer that they didn't give the option. General may put baby to sleep, but it has since been proven so safe they now let the patient or doctor choose. The downsides to spinal as told by my doc: Longer recovery time for you (2-3 hours instead of 1)- you have to be able to walk and pee and it takes a while for the spinal to wear off. Downsides to general according to the doc: Some patients get really really queasy when they come up, and vomiting bile can be pretty painful when your tender bits are still feeling tender. I knew from IVF retrievals under general that I tolerate general anesthesia extremely well (no nausea and I wake up feeling like I've had an awesome nap)- so I opted for the option that would let me out of recovery faster. I also knew that baby was really active and kicking and jumping around (and that she has a tendency to shove her foot into the funneling in my cervix) and I thought it might help the doc get a tighter stitch if she took a nap.

Post-procedure monitoring? I woke up in a recovery ward (20+ beds with dividers for privacy but it certainly wasn't my very own room) and they kept me for about an hour and a half. They wanted me 100% lucid and had already had something to drink before they brought my husband back to see me. (This was different than my retrieval- the IF docs let DH come on back while I was still waking up) Then they wanted me to pee, get dressed, and have my IV taken out- then they got me a wheel chair and took me down to the car to go home.

Bedrest, etc? Because mine was considered preventative, my doc said no bed rest. I'm allowed as much time sitting as I like, 6 hours of standing, and 1 hour of walking a day. No lifting over 15lbs and I have a list of stuff to report immediately to my OB (fever, contractions, etc). All of that is for the rest of the pregnancy.

Check-up? I report back to my OB in 1-2 weeks (I already had an appointment for a week so that's fine), and my MFM in 2-4 weeks (I already had an appointment for 3 weeks scheduled so that was fine too).

Now the walk through!

I was informed at my 16w appointment with my OB that I was being referred to an MFM to determine if I needed a cerclage. MFM appointment a week later confirmed that my cervix was really short (1.1-1.5cm) and that I easily qualified for a cerclage if I wanted one. My MFM, however, believes that my loss last year was due to PTL, so he made the cerclage entirely optional despite my super short measurement. I opted to go for it, so he called the hospital to see what the earliest schedule slot was. Hospital said: 2 days.

I had to go in to the hospital immediately after the MFM appointment for pre-operative blood work and registration so that the procedure would be covered by my insurance. That took about 2 hours- they drew my blood, got me registered, ran an EKG, and gave me preparation instructions. Prep instructions: No eating/drinking from 8 hours before the procedure, I was given a special bottle of antiseptic soap and told to do a full body wash minus my head and genitals- twice- to limit any possible exposure to infection. Then arrange a driver to take me home as they wouldn't release me to drive myself. No metal anywhere on my body. Even hair ties had to be metal free.

Day of procedure: Arrived with DH and SIL (a nurse, and an awesome person to take with on medical adventures) and was escorted back to the prep room. I didn't know if it was just a quick intake prep or a long one- It was a long one for me (several hours) and I'm glad I had DH and SIL come on back to keep me company. Changed into the gown, signed a bunch of paperwork, got my IV, vitals taken, another three detailed descriptions of the procedure, and finally was told that I was next up on the schedule. They brought in the anesthesiologist then checked baby's heartbeat (took forever because little miss was hiding). Put a pair of pneumatic stockings on my legs (which sounded pretty cool at the time- but today my legs are really aching from whatever compression they did during the procedure. Ow), let DH give me a kiss and wheeled me off to the OR.

In the OR they had me move beds, get settled with a blood pressure cuff, pulseOx monitor, 3 lead EKG, then I got a nice oxygen mask for a little bit while they did their prep, then the mask had something else in it and they told me to think of a nice vacation place.... and I was out cold. I was intubated and they put in a catheter after I was out- both of which left me with unpleasant aches afterward (my throat is still sore a day later, but peeing went back to normal after a few hours).

I already detailed the recovery earlier.

Doc said I might be able to feel the stitch. Some people say it's painful, some don't. I don't think it's painful at all- just a slight pulling sensation when I shift. And even that should go away after a week or so as the body gets accustomed to it. Doc said I might have a lot of spotting but unless it was soaking a pad that it was fine. I spotted light pink the night of- and nothing at all since. Doc said I might have otherwise increased discharge. I haven't noticed any yet.

Honestly I feel pretty normal the day after. I even went to the grocery store with DH this evening. And it's a huge huge HUGE relief after my loss last year to know that I'm not going to accidentally deliver this baby. I feel like the cerclage really gave me a peace of mind that I'd been lacking for the last few weeks.

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