Preventative vs emergency cerclage

christylala · January 2014

I had an emergency cerclage at 20 wks with my last pregnancy but am about to get a preventative cerclage done at 14 wks. Those with experience with preventative or both, how successful was it and did you end up getting put on bed rest anyway? What sort of restrictions were you on? I was hoping to avoid getting another one since it didn't work so well last time and ended up on bed rest for 4 months. Also wondering how long the recovery time is. For those whose cerclages didn't work so well, did your Dr. suggest a different treatment for subsequent pregnancies? I was just prescribed progesterone suppositories also, so if anyone has any experience with that too, it'd be nice to know what that's like as well.

Thanks!

tracint · January 2014

I had a preventative cerclage placed at 13 weeks and started progesterone injections at 16 weeks. At 19 weeks the MFM found the fetal membranes were funneling down to the stitch... that and I was already having some contractions so I was put on bedrest. I'm 26weeks today so the cerclage is holding but unfortunately I couldn't avoid BR.

As far as recovery after the procedure, I took it easy for 3 days afterwards but there wasnt much pain and the bleeding/discharge was done by the next evening.

sexyntexy · January 2014

My dr told me preventative was better because they have more cervix to work with and can sometimes put in 2 stitches. Also w/ more cervix it decreases the risk of complications.

I had mine at 14w and my cervix has started shrinking (2.64). It was 2.7 before cerclage and then 3.5-4 after. I've put myself on as little activity as possible and I go back next week to see how it's doing. But after the procedure I was put on pelvic rest but that's it.

ajsweeton · January 2014

I had a preventative cerclage placed at 14w. I'm now 24.5w with twins I've had no shortening at this point. I have a restriction of only lifting <20 lbs and nothing in the vagina (orgasms are ok though), but that's really it. I've been taking it really easy when I'm home though. I still work, but I have a desk job so it's not strenuous at all. My MFM is very hopeful that the cerclage is working and I'll make it to removal at 36w as everything looks really good right now.

JackieP1023 · January 2014

Last pregnancy, they tried an emergency cerclage at 19 weeks, but it wasn't successful-my water broke during the procedure.

This pregnancy, i had a preventative cerclage placed at 13+2. I was put on pelvic rest, and told to take it easy. No official word for rest, though. At 15w, my OB recommended I work from home, since I had the flexibility to do so. I sort of put myself on modified rest, doing as little as possible.

In addition to the cerclage, I took procardia 4x/day from week 15-35. I also got the p17 shots from week 20-35. Also as a precaution, I had the steroid shots at 25 weeks.

As far as recovery time after cerclage, mine was placed on a Friday. I had more issues from the spinal-horrible back pain (could barely walk) for a couple days after. I was back at work Monday, but was taking things as easy as possible, and it took about a week to get 'used' to the pinching feeling of the cerclage being in there.

I had my cerclage taken out at 36+5, and just hit 38weeks today. My OB says it could be anytime-but will induce next Friday if nothing happens before then (because of gestational diabetes). I have had no 'official' restrictions all pregnancy.

rlajambe · January 2014

My first pg, I suffered a lost due to IC at 21 weeks. I was 2.5 cm with bulging membranes and was not a good candidate for emergent cerclage.

My last pg, I had a preventative cerclage placed at 11.5 weeks. It was a double McDonald stitch. One set of stitches with #5 surgical wire and one set of stitches #2 silk. I had several restrictions: no sex, no lifting over 10 lbs., no running, no jumping, no physical exertions, no swimming or bathing.

I had some spotting due to irritation on the stitch through the pg, but was able to avoid BR. I was also able to work until 36 weeks (2 days before my removal). I delivered at 38w4d.

ThereBeDragons · January 2014

My cerclage is technically considered preventative (no dilation), but was put in so late that I already had significant funneling indicating the need for it. My MFM has me on restricted activity- lifting restrictions/1 hour of walking a day. My OB told me to go ahead and put myself on bedrest though- she doesn't like to see anyone with a cervix as short as mine (13mm) wandering around.

So far so good though. And I really believe that the stitch has kept this baby cooking. My cervix is just terrible at keeping everything in. In my mind, a few months of bed rest is a small price to pay for a child we can bring home- but I also know that this baby is our last shot at children and bed rest isn't a financial burden on our family.

MissChanandlerBong · January 2014

I had an emergency cerclage with DD and I have a preventative cerclage with this pregnancy. I was very advanced with DD (2 cm dilated and bulging membranes) when the emergency cerclage was placed at 21w. It held for 2 weeks while I was on strict hospital bedrest and I gave birth to her at 23w4d. I know 2 weeks seems like a short amount of time, but given how far advanced I was when it was done, it was really a miracle and got us to viability. So they do consider it successful, even though she was still born really early.

For this pregnancy, I had a preventative cerclage placed at 14w. I spotted/cramped for a few days, and then it took a week or two before I really felt back to "normal". I am on modified bed rest and pelvic rest, so I do as little as possible and no heavy lifting. I have been going for weekly cervical length checks and see both my OB and a MFM. I started weekly p17 shots at 16w I think. The last couple weeks I've had some funneling/shortening, although I'm holding strong around 2.7cm. As a precaution, I am getting the steroid shots (first round yesterday, second round today). I am 29w today, so I can't tell you how far I will go, but I am hopeful. I am sure if things start to worsen, my doctor will put me on hospital bed rest again, but we're not there yet. Good luck with everything!

angelsnight · January 2014

I had a preventative one placed at 14 weeks. Recovery was very minimal, I had a pretty prominent ache in my pelvic area when leaving the OR but by the time I wasin recovery for a little bit it had lessened a lot. By the time I went home and for the rest of the day (and part of the next) I just had some dull menstrual like cramps. I don't even think I took Tylenol for them.

I bled the rest of that day though not very much....in total my light pink spotting lasted about 5 days but there wasn't very much of it at all. I took it easy the day of and the next day, and then that weekend we took a short road trip, so not a ton of activity but I wasn't laying around or in pain.

I haven't needed any bed rest, I am currently 32 weeks and haven't had any shortening. I will definitely get another prevantative next time. I've been on pelvic rest the whole time, and I can't really do much more exercise than walking, but that's fine because I really don't even have the energy or desire to do that.

bcnoelle · January 2014

I had an emergency cerclage at 19 weeks. I was down to 1.7 mm, 1 cmm dilated, and funneling. If I had know this could be an issue I would had definitely gotten the preventative cerclage earlier where they can get more of the cervix involved, as past people said. I'm 22 weeks now and luckily my cervix is over 3.5 mm. So an emergency cerclage can work too, although I'm still very early in my pregnancy and I never know when it will keep shortening. I would have greater peace of mind if the cerclage was able to actually tie up more of the cervix.

christylala · January 2014

Hi ladies,

Firstly, I'd like to say how very sorry I am for your losses. Rooting for all of your rainbow babies! I know how stressful and scary it is to try again, especially being high-risk.

Thank you for all the great info. My cervix was measuring 3.1 so they should have more to work with this time. Makes me feel a bit better. Spoke with one of the nurses and they said I could go back to work after three days but needed to get checked again after ten days and they'd decide if I could continue working. I'm really hoping I can avoid strict bed rest since I've got a crazy toddler to chase after! And I'm not looking forward to these prometrium suppositories or pelvic rest or transvaginal ultrasounds every two weeks, but whatever gets baby here safe and sound!!!

Hoping for the best for all of you ladies!

takmjs · January 2014

@christylala, just something to ask your MFM about. Two MFMs have told me that the suppositories are for first pregnancies, but once you have had an incompetent cervix, that the p17 (progesterone) injections are better. That's what the research says, at least. Wishing you the best!

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