Question for anyone who has had IC...

ikrystal · March 2014

Did you have contractions at all? When I went into labor, I had contractions (small, uncomfortable contractions) that led to my PTL at 22 weeks. I didnt have strong contractions until after I was fully dilated (which continued for days until I delivered my sons). My two OBs and MFM say that I am not a candidate for cerclage because they do not believe I had an IC since I contracted and labored to get dilated. But I have heard some stories of people who had a cerclage in subsequent pregnancies, even though they might not have had IC since they also had contractions.

I am trying to do some research as to whether I should fight for cerclage or not if I ever get pregnant again. For those of you who have an IC, did you have contractions leading up to your delivery, or was it a "silent" opening where your cervix just opened and weakened under the pressure without contractions? I hope I am not crossing a line by asking this question. I have gotten some answers from other people in this board, but wanted to reach out and see if anyone else could add their experiences. Thanks ladies.

Mrodriguez898 · March 2014

(Graphic) I only knew I was going into labor after feeling the mucus plug coming out. I did start to have contractions when I arrived at the hospital and when the OB checked I was already dilated. I was induced only to speed up the process as the sac was too far out to be pushed back in. I had contractions from the moment I arrived at the ER until I gave birth to her.
I have been told that since I was dilated and that was the reason for my loss, that I would be getting the cerclage the nex time. I was told to wait a year before TTC.
If I were you and felt that the cerclage was needed, fight for it. But make sure your insurance will cover it as they might not deem it medically necessary.
Sorry it's long and so sorry for your loss.

nuttycoconut · March 2014

***siggy warning***

I also had contractions before I lost my twins @ 22 weeks. I ended up getting a trans-abdominal cerclage and was able to carry my 2nd set of twins successfully with no problems. If you want more info please feel free to PM me or you can check out abbyloopers.com. I am very sorry for your loss.

sparrowmomma24 · March 2014

My daughter was born at 22 weeks in September. I have IC but I still had to labor! I had hourglassing membranes, contractions for 5 days. My water ruptured. Then I finally progressed to 2cm and they progressed my labor process with cytotek. I had awful contractions (til my epidural was put in) but then it went fast. I dilated quickly and she was born 2 hours after taking cytotek. But I was contracting and sat at 1cm for 5 days while we tried to save her. I am required to get a cerclage. I definitely thing you should get a second opinion.

@Mrodriguez898 I had already lost a baby at 13 weeks 1 day due to a short cervix and they REFUSED to give me a cerclage this time. Saying I was perfectly healthy. Of course, I lost my daughter at 22 weeks due to early labor and IC. And the day before I went to the hospital I lost my mucous plug. I called my Dr. and they told me they wouldnt' see me or help me even in the ER because it was perfectly normal to lose it. It grows back. Needless to say, I don't trust doctors much anymore.

Maybe Joleisa · March 2014

I relive this day every Sunday since our loss. In the 21w6d I was pregnant, I felt zero Braxton Hicks or other type of contractions so I guess mine was silent. I didn't feel quite right when I woke up that Sunday morning and felt like I was constipated, so I took a Colace. I got up to pee, wiped pink and then yelled for my DH that I wanted to head to the ER. In the 20 minute drive in the car I started having contractions and found I was fully dilated when I arrived--I could not have been more stunned. I then had horrendous (rolling?) contractions for 2 hours until they could get an anesthesiologist there to give me an epidural + spinal. I didn't deliver until 8+ hours after I arrived at the hospital, because I refused to push. (My water didn't break until I gave my first push.)

@sparrowmomma24: I am so sorry for your losses. That is awful they refused you a cerclage after a previous loss due to your short cervix . I don't trust doctors much anymore either.

@nuttycoconut: Congrats on your double rainbows following your TAC!

jbranden12 · March 2014

No cervical issues my first pregnancy, I went to 31 weeks and even after she died I didn't go into labor. With my rainbow, I lost my mucous plug and had painless dilation at 26w3d. I started funneling and she was breech so I had a c/s. I started feeling contractions on the way to the OR. My OB recs a cerclage and p17 shots for any subsequent pregnancies, but I am considering looking into a TAC since I have to have rc/s anyway due to a classical incision.

Mrodriguez898 · March 2014

@sparrowmomma24‌ I am so sorry to hear that!!! I don't blame you for not trusting doctors anymore. I am lucky enough to have a local ER who rushed me in once they heard I was losing my mucus plug.
If you're not happy with them, look for another OB who will hear you out. Because in the end, they are getting paid by us (even if it's trough the insurance) to help us and put is at ease. I am so sorry for what you went through

sand&starfish · March 2014

I know I responded to your other post, but just wanted to add that typically with IC you will eventually get contractions and have real labor. Your cervix typically dilates silently up until a point, whether it's 2cm or 7cm, but usually at some point contractions will start. If you didn't catch your cervix changing (most don't) the odds are that doctors will call it PTL, or try to find another reason, anything to say it's not IC because they believe it is so uncommon. But it's not.

Abbyloopers.org is a great resource for information about IC. They are for transabdominal cerclage but have a ton of info on IC including FAQs about IC by doctors who commonly see it. Dr. Haney is one of the doctors, his email is on the site and he usually responds quickly. If you're looking for another doctors perspective it may be worth reaching out to him. He was a great help to me when my doctors were back and forth between chorio and IC.

ikrystal · March 2014

Mrodriguez898 I am definitely going to take your advice - called my OB today to discuss it further. Thank you.

nuttycoconut sending you a PM in a few minutes. Thanks

sparrowmomma24 that sounds a bit similar to what I went through. I still labored but I just cannot wrap my head around an infection getting into my uterus without me having IC.

Maybe Joleisa I am so sorry you relive that every week. I do the same thing. I hope one day, we stop torturing ourselves...

jbranden12 I am sorry for your loss. I know my OB is also doing 17p shots for me next time (if there is a next time)

Mrodriguez898 Thank you. I am hoping to talk to my OB more before leaving his practice - I changed OBs three times until I found one that I loved. We actually got a second opinion that was the same as his. I might seek a third.

sand&starfish Thank you for adding that. I think that is interesting that at some point, contractions start. I'm not sure when I started dilating, since I got to the hospital already 2 cm dilated and then quickly got to 10 cm (in less than an hour, relatively painlessly but still with contractions). I think my OB is concerned about the risk of infection with a cerclage, especially since I've had an infection (which three different doctors believe is the culprit to the PTL).

Thank you all for your input. I called my OB and he is calling me later. I hope we can talk about cerclage more seriously. I am planning on seeking a third and maybe fourth opinion if he does not change his mind. My fear is that no doctor will think I need a cerclage when I might need one. I still have no idea if I need one. I labored for awhile, but like I said - relatively painlessly until I was a full 10 cm. I was a bit uncomfortable, but I've had period cramps worse than those contractions. I cannot lose another baby. I've already lost my twins and I do not want to TTC again if I do not have a proper plan in place.

nuttycoconut · March 2014

@jbranden12 please feel free to PM me with TAC questions you have as well. I hope your baby girl is doing great! xo

@ikrystal YGPM back!

nuttycoconut · March 2014

@maybejoliesa Thank you! I'm so sorry about your long fertility journey and devastating loss. It's just not fair

Thinking of you and hoping that the flashbacks occur less frequently. Please PM me if you ever want to chat.

ThereBeDragons · March 2014

Siggy warning- and stuck on my iPad so I can't even give a good blank space here. Sorry.

My loss was at 17 weeks- so by medical definition it could not have been preterm labour (which can only occur after 20 weeks). The details though,point to a combination of factors. I felt crampy for a day and a half. Went in to my doc, was shuffled off to a midwife who told me cramping was normal and gave me a quick internal and declared that I wasn't dilated- go home, rest and take some Tylenol. 8 hours later while I was throwing up my dinner (and not cramping because Tylenol!) my water broke. Then real honest to god "holy mackerel this is labor" contractions started. I delivered about an hour and a half later in a triage room before the nurse could even determine how dilated I was. In retrospect, my MFM believes it was preterm labour, despite being three weeks before that can technically occur. My OB believes it was incompetent cervix which led to preterm labour. They evaluated me for a cerclage with this pregnancy at 17weeks and I had already funneled down to 1.4cm of internal cervix- no dilation. That measurement won the debate and I got my cerclage a few days later. But I was also put on P17 shots starting at 20 weeks to prevent preterm labour. Both of those combined have kept me medically stable. I have virtually no internal cervix left but no dilation and no contractions and assuming nothing changes dramatically, I should make it to 36weeks this time.

My real recommendation is to ask for a cerclage evaluation. If there's no funneling- ask for P17 and regular cervical monitoring until you hit 24weeks (most docs won't place a cerclage after 24). If there is funneling, see if you can get both the cerclage and the shots. Better safe than sorry and an evaluation isn't terribly difficult to do.

ikrystal · March 2014

Hi all,

I talked to my OB last night and we do have a game plan. He said that I was not a candidate for cerclage because when I went into labor with my boys, I was "contracting up a storm." It took 24 hours for me to get to 2 cm, then one additional hour to contract to 10 cm. My water never broke on its own. They broke it for me after three days in the hospital, when the Chorio was so severe that it looked like I would either die or the babies would be stillborn (thankfully, they were not). If he placed a cerclage for any subsequent pregnancy and I do not have IC, my contractions would break through the cerclage anyway, tearing my cervix. Also, cerclage has a risk of infection - which is what my ob, he partner, and my mfm all think if the real culprit to my PTL. They do not want to raise my risk even higher of an infection if they do not need to.

That being said, he does have a plan in place. As soon as I get a BFP, my OB is sending me for another opinion to another MFM for cerclage (this will technically be the fourth opinion I get on this matter). He does not believe the specialist will say I am a candidate, but he said "better safe than sorry." They are putting me on 17p shots no matter what, starting in the 2nd trimester. They are also doing weekly cervical measurements, and if I do start to show signs of funneling/and or weakening cervix, they are doing an emergent cerclage (although he doubts I will need one).

I think that I feel better about this situation. I wanted a cerclage so bad because I have heard of the great success rates, but after talking to my OB further, he is right - I am just not the right candidate, and the risk of infection with cerclage scares me especially after my experience with Chorio. Thank you all for your advice!!!

Maybe Joleisa · March 2014

That sounds like a good game plan and I'm glad you feel comfortable with it, too.

ikrystal · March 2014

@nola78 thank you for sharing your story. That does give me some hope about the weekly cervical checks. I know the emergent cerclages are not as efficient, but that may be the only option I have. I am going to continue to research and possibly seek another opinion on my own, but for now, this plan seems feasible to me.

kz's_girlygirl · March 2014

For those who had weekly cervical checks- was that done through an internal exam or an external ultrasound? My OB and an MFM I saw were both reluctant when I asked if more frequent checks might have discovered either an infection or weakening cervix. They said more frequent internal checks would raise the risk for infection, which makes sense.

I also asked about ways to prevent infection and they both pretty much just shrugged and told me to make sure I wipe from front to back...so frustrating.

FTR, they are both against placing a cerclage for me in a subsequent pregnancy (because there is no clear cut answer as to whether I dilated and infection set in, or infection caused dilation and rupture). but my RE is for it, so I am definitely trying to gather as much info. as possible, like others!

weddedwife · April 2014

I'm late to reply here but my experience is similar to Nola's. I had a full term baby in 2009, no complications. Then I lost my son at 22w4d in 2011. I felt crampy and was having BH contrax that day. I was absolutely laboring by the time I arrived at L&D and was already 4 cm dilated w a bulging bag. He was born less than 2 hours later.

In my rainbow pg, the approach was "wait and see". They gave me p17 shots and put me on strict bed rest at 15w as I was already having small contractions, and my cervix had shortened slightly (but still within normal range). They were not convinced I have IC. I had weekly cervical length checks, and suddenly at 22w (again) my cervix dropped from 2.9 to 8mm and 1 cm dilated in a matter of days. I had an emergent cerclage at 22w5d and it was a very risky procedure. Because my water was funneling, they had to push it up and out of the way to get the stitch in. We are EXTREMELY lucky it worked, I was not given a good prognosis. I spent the rest of my pg on bed rest up til stitch removal at 36w and made it to 38w.

My dr says if I get pg again, I absolutely need a preventative cerclage. Even though she was so sure I was just a "classic" case of PTL, it turned out to be IC after all. The wait and see approach terrifies me now.

Dixon813 · April 2014

~~Siggy Warning & Pregnancy Discussed~~

I'm a little late to respond - but wanted to share my experience if it might help.

I went to the MFM when I was 8 weeks with this pregnancy. I delivered the triplets at exactly 23 weeks after a 2.5 week hospital stay (due to TTTS, pPROM, PRL, etc) She told me that the risks I had with the triplets for PTL labor really didn't exsist since I"m pregnant with one baby, but she and I both agreed that we couldn't rule out IC or any other issues until this baby was born full term. So we decided to do 17p shots from weeks 16-36 and to do U/S from 16-24 weeks to check my cervix and if my cervix got smaller than 24mm, they'd put in a cerclage.

If you're happy/confident with the plan you and your OB made, that's what matters! To me, I knew that one baby technically took me off the "high risk" label, but I was so afraid of those 20-23 weeks that it was important that I saw the MFM and had a plan - it made the first and second trimester much easier to handle.

ikrystal · April 2014

weddedwife Thank you for sharing your story. I am so sorry for the loss of your son. That is what I fear - an emergent cerclage, if I needed one, would be needed too late. I'm glad it worked for you and you got your rainbow baby!

Dixon813 I'm sorry for the loss of your triplets. I love their names. It looks like you are close to bringing your rainbow baby home! Very happy for you.

I do have an update (for anyone who might be reading this) - I saw another MFM at the same practice as my original MFM for another opinion. My OB sent me to see this new MFM because he, like me, wanted to have all of our bases covered. This new MFM said that although she agrees that it is more likely that the Chorio caused my PTL and not IC, that I was still a candidate for preventative cerclage because they cannot rule out IC. So, it is up to me if I want the cerclage or if I want to take the "wait and see" approach. I am leaning towards the cerclage! I have some thinking to do but with the proper team of doctors I think I will make the right one (hopefully).

johnnys june · April 2014

** possible siggy warning **

Hi...first, it's been a very long time since I've posted here so I'm sorry if there's anything in my siggy that isn't acceptable. I'm not sure what this board has morphed to and I would never want to hurt anyone's feelings as I have been there...done that...go the t-shirt in this club.

Second, I would get a 2nd opinion and/or fight for the cerclage. Question, are they going to do weekly injections to prevent pre-term labor?

My OB suggested the dual treatment plan of cerclage and weekly injections (starting at 16-17 weeks) because frankly, there's no 100% way to know if I had IC that caused labor or if labor caused the IC. I had random cramping but no tell tale signs of contractions for nearly 3 days before I went to L&A. By the time I got there (thinking I was only dehydrated) they told my cervix was measuring .7 cm long (2 weeks prior it was well over normal length!). This was my first child and he was born at 25 weeks because of the above. My doctor just didn't have a guarantee and therefore was very cautious. With my rainbow pregnancy I had pre-term labor for 6-8 weeks and was on the weekly injections and alternating meds to keep contractions at a minimum. The doctor agreed that my real issue might just be pre-term labor but with the cerclage in my cervix stayed measuring over 4 cm the entire pregnancy...I think it was shorter during my first pg. It was a win win and really, and something I was willing to pay for if it would help me get my next baby (and any baby after) to full term.

It's totally up to you, but if it were me and there was no way to confirm why you went into labor early, I'd fight for it. It gave me the extra security, and trust me, I needed every ounce of extra security I could get because I was worrying enough during the next pg.

Good luck! And I am so incredibly sorry you're even on this journey to begin with.

johnnys june · April 2014

Oops, just realized you go the 2nd opinion. Good for you!

ikrystal · April 2014

johnnys june Thank you!

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