cerclage?

[spu]

I just got back from my 12w appt, and my dr. doesn't think I'll need a cerclage this time around. I kind of want one... otherwise I'll be petrified the whole 40w that the baby will come early... When I was pg with my twins, my cervix funneled at 18w, and I ended up with an emergency cerclage... but he thinks it was twin related, not "me" related... any thoughts? He said the procedure itself has risks, so if it's not necessary, he'd rather not. But I'm wondering if something happens in my later 2nd trimester, or into the 3rd trimester, could it end up not being possible to do a cerclage? Would you get one anyways as a safety net? or would you wait and see?

thanks!!

[boscopup]

I have heard of a doctor doing an emergency cerclage later in pregnancy, but the woman pretty much had to DEMAND it, as the doctor didn't really want to due to risks (but it was a case of baby was going to come if he didn't... and it'd be way too early).

If you make it to the third trimester, you're pretty much ok. After about 28 weeks, the risks of permanent health issues due to being born early are VERY low, unless baby is really really small (like less than 2 lbs). When my baby was coming at 29 weeks (due to PROM), people came out of the woodwork with stories of preemie babies, and alot of people I knew who were college age had been born at 28 weeks - they had no health problems due to preemieness. I had no clue there were so many preemies around me!

[whateverdidiwants]

I'd ask for a second opinion.

I needed a cerclage because of a LEEP when I was younger, and without it I most likely would've lost the pregnancy, so I know exactly what you must be feeling. I'm going to ttc, and there's no way I would feel safe without another cerclage. I don't know if I would trust waiting for an "emergency" cerclage - I know several women who lost pregnancies between 22-26 weeks because of funneling and there wasn't enough time to put in a cerclage.

[spu]

that's exactly how I feel... I dont want to wait until it's an emergency (if we end up having an emergency), and I don't want to wait until it's too late, or lose the baby. But I don't want to do anything unnecessary either...

[jdlobe]

Are you seeing a regular OB or a perinatologist? A peri can check your cervix periodically starting from 16wks by ultrasound and if they notice changes they can do a cerclage. My last pregnancy my cervix was 2.5cm at 16 weeks and a week later was 1.5cm and starting to funnel. At that point the outcome of a cerclage is still very good. I wouldn't want a cerclage unnecessarily because of risks, etc; however, if you can get frequent cervical ultrasounds between 16-24 weeks, then I would feel reassured that they would catch a potential problem. After 24 weeks most dr's don't put in a cerclage. Apparently outcomes at that time are just as good by prescribing bedrest.

Anyway,
good luck

Julie

[spu]

I just called to see another peri about a 2nd opinion. That's another fear that I'd reach a point when they wouldn't be able to do a cerclage, then end up on bedrest again... and with 3.5 year old twins, my work at home, and moving to a new house this summer, I dread the possibility of bedrest... 4 mos. of bedrest when I was pg. with the twins was bad enough, but I didn't have any other children to tend to, or work that had to be done...

My o.b. is a peri, and said he'd watch my cervix like a hawk every 2-3 weeks, but a lot can happen in that time... when my cervix funneled last time, I had no symptoms whatsoever... it was a complete surprise and shock. I wonder how much time there would have been if I didn't have my appointment on that day... what if it was a week later... would I have lost the pregnancy? can things happen that quickly?

Does anyone know the risks of doing a preventative cerclage? My current o.b. said there were slight risks of losing the pregnancy, but what about the risk of losing the pregnancy from doing nothing? What have your dr.s said?

thanks again!!
susan

[Boxerlove1]

Just lurking and wanted to add myt $.02....

Preventative is always better than emergent. My son was born at 26 weeks and died a day later b/c of possible IC/posible PTL. Now, I'm 11 weeks pregnant and seeing a peri. At first they wanted to take the 'wait and see' approach, but ultimately the decision was mine. It took all of an hour for me to decide on the cerclage, which I will have done on 4/13. I will also start the P17 shots at 16 weeks...

The earlier cerclage is done, the less risk involved. This is my childs life at stake here, and I can't bear the thought of losing another baby when I could have done something to prevent it....

Here is a link to the MSN IC group -

http://groups.msn.com/IncompetentCer...t/welcome.msnw

I encourage you to read their stories and ask questions. There is sop much wisdom and support in there. From women who know what to expect. Some had several losses before having the cerclage and subsequent normal pregnancies.

Just think about your decision. A preventative cerclage is usually done around 12 weeks. You may not have extended bedrest in this case. And youre right - the cervix can change drastically in little or no time... monitoring every 2-3 weeks is not sufficient for many women.

Good luck with your decision. Follow your little inside voice.

[Hazel]

I just had a cerclage done last week. It was done as preventative as I have never had a history of IC. However my cervix suffered much damage from delivering my 2nd child and it is now deformed. I had already chosen to have it done before my appt the day before the procedure was to happen, but when they did the u/s and he saw what I think he called funneling, that sealed my decision. Of course I have been on bedrest the past week. not being up to get up much due to contractions and cannot wait until the u/s tomorrow to make sure my baby is still safe and sound.
The risks are scary to think about, but for me it was worse to think they might not catch it in time with every other week u/s and I might lose the baby.
Good luck.

[jdlobe]

The risks are low for a preventative cerclage, but are there:
preterm labour and infection are the two most prelavent. You may also end up on bedrest even though you have a cerclage (I did during my last pregnancy). Don't get me wrong, I lost my first pregnancy at 18.5 weeks and had a cerclage placed at 17weeks last time. This time I had my cerclage put in at 13 weeks and am grateful that I can have a family. It's just that every medical procedure/surgery has risks and I always like to make sure that the risk is in proportion to the benefit. You can never eliminate risk entirely.

For me, I have an amazing peri and trust her opinion. She has earned that trust and I make sure that I'm well informed and can ask questions. I feel comfortable trusting her advice. If you don't have that kind of relationship; I would not hesitate in asking for a second opinion.


Good luck

Julie