Cervical Suture??

[hgirs]

Hi, has anyone one had a cervical suture/cerclage before? Just wanting to know your experiences and what I could expect. Sadly we lost our DS in April at 23wks+5days, the autopsy said it was most likely from infection, but they can't rule out IC. I have spoken with another OB and have decided that I will have the suture put in. I am hoping I am doing the right thing as a suture carries risk of infection, which could increase my risk. Anyone?

[Visitor9]

Hgirs,
I had a suture done after losing 2 babies in the second trimester. The first one was unpredictable , the second one after I was diagnosed was closely monitored and after having a u-s done on a Tuesday and all being fine (closed cervix) my waters broke within 48 hrs and I went into labour and I stayed in labour for 2 weeks. I delievered her at 22 weeks and swore never again would I go thru a pregnancy without a suture.
When I fell pregnant the 3rd time I was recomended a stitch a 13 weeks. He was a high risk specialist and dealt with alot of multiple pregnancys that have alot of stress on the cervix.
The day of the surgery I had a scan to confirm viabilty and then was taken to day surgery. I chose to have a general rather than a epidural and had a week in bed with a little bleeding. I had a follow up scan to confirm the stitch was in a favourable position which it was. I gave up work at 13 weeks and spent as little time on my feet. Then had routine scans every fortnight during the mid and early 3rd.
After I reached 30 weeks I had monthly scans as the cervix never shortened. I made it to 36 weeks and chose to have DD then as she was a gest diabetes baby and came out 8'8.
If I was ever to have another baby my obst told me that I would have another stitch, and it wouldnt bother the infection aspect as losing another baby doing nothing where if I was to get an infection atleast I knew I did everything I could possible do.
Good luck
All I can say is find a great doctor who does these alot...as mine said there is a suture and there is a suture.
B

[hgirs]

Thanks Minky, did you have a natural birth after you had the stitch out? Or did they do a c-section and take it out then?
Helen

[Visitor9]

I had a choice, either natural which I would of gone into immediate labour (so they told me after). My specialist was over an hour away and my prev labour I had no labour pain , no delievery pain and I was so over paranoid that I would have the baby had they sent me home at home. I chose a c-sect, they had to do a spinal to take the stitch out, I had post traumatic stress from the prev births with complications that usually put me in surgery afterwards (retained placenta) (snapped ambilical cords). So that was the "best" birth I could chosen at the time. Now I think I probably could of done it and one day I might get the opportunity to see how a happy vaginal birth turns out.
I think most doctors are happy either way they tell you to pack for a birth at the time of removal but then I have spoken to women that go full term + .
Its frightening to think what they have to do but the peace of mind I had afterwards knowing that if my membranes were to bulge they was something to stop them even if it was enough time to get to the hospital
B
I have my suture to this day lol it is in with all of E's baby stuff it is part of her history

[AngelLukesmum]

Hi Helen

Sorry I missed this post earlier. I just wrote you an enormous response but the system lost it. Aargh, not happy!

I had my stitch placed just over 2 weeks ago due to my loss last year that my ob thinks was due to IC. I couldn't risk going down the just monitoring road as things happened so quickly last time that I wasn't prepared to risk it and luckily my ob agreed.

The operation was fairly easy. It was done under GA (no choice for me as my ob only does it this way) and I was admitted as a day patient but put in Maternity before and after the procedure. The op itself took about 40 mins, maybe a bit less and when I woke I was in quite a lot of bad pain, mainly cramping and strong pressure pain in my backside area. I was given morphine which didn?t really help with the pain, it just sent me to sleep so they gave me panadol back in Maternity which worked a treat. I was released later that same evening after the usual eating, drinking etc although they were happy for me to stay the night if I wanted to.

Recovery took about 4-5 days until I was completely back to normal. The first 2 days I was pretty much lounge-bound with panadol every now and again, and a hot water bottle pressed to my tummy. I found that the worst thing about the pain was that it was not centralised to just the uterus or cervix but was in the whole area - bladder, uterus and bowel/back passage area. One would play off the other while the area worked out what was going on I think! But my ob had warned me that due to my very sensitive cervix (I cramp when I have a normal pap smear) I might suffer more than usual.

Bleeding was minimal for me and was a bit like browny discharge rather than red blood. My ob had warned me though not to panic if I did have bright red blood as apparently the cervix can swell with pg and bleed easier. But luckily mine spared me that. My CM has been back to normal for about a week now so it didn't take too long.

I saw my ob a week after surgery and he did a quick scan to check on bubs. I have another scan this week at a proper clinic where they will measure my cervix and check the stitch position. 2 weeks later during my morphology scan they will do another check on measurements and my ob has warned me that if they have changed or shortened he will want me on bedrest in hospital. Hoping that doesn't happen! I will then see him again at 20 weeks and have another proper scan at our nervous time at 21w. We haven't gotten past that timeframe yet in terms of scan discussions.

When it comes time for removal, if all has gone well, my ob plans to take the stitch out at 38w. If he has done too good a job I will apparently need an epidural for removal and he said he might induce me at the same time. Something we will discuss further though as we get closer.

As for infection - well, it hasn't been that long for me so I don't have anything personal to contribute except that my ob has never seen a patient get an infection from a stitch and especially when you have it placed early as the cervix should still be nice and long and closed, making it harder for anything to get up where it shouldn't and also less chance of your waters breaking etc. Try not to google, but having said that I have read more good stories than bad so that can't be too bad a thing can it?
Oh and not sure if you know what type of stitch you will be having but mine is apparently a modified shridovkar (or something like that!) which means it is right up near the top of the cervix and is more under the skin. According to some research that can help prevent infection but I don't think they really have too clear a study either way on that.

I hope that all helps and sorry for the long post. I am truly sorry to hear of the loss of your DS too and congratulations on your new pg.

Minky - I am so sorry to hear of both of your losses and thanks for sharing your story. I am so happy you got a happy ending

Jo

[Visitor9]

Just wanted to add that sutures done in the 12-13 week opposed to an emergency suture have higher sucess rates and minimal infection as the waters arnt bulging or compromised.

[hgirs]

Thanks guys you have been a great help, if I think of anymore questions I might just have to drill you some more!

[hgirs]

Hi ladies just a quick update, I am having my suture placed on Wed, I will be 13 +5 weeks. I feel relieved the decision is made but still apprehensive about having it done. Did you guys get U/S monitoring after the suture? My OB has said there would be no need unless something shows up on the 20 week scan, he also said we didn't 'have' to refrain from sex, but indicated some people like to wait until they are at least 30 weeks. Did your Dr's give you any restrictions??

[NaeNae]

Just popping in to wish you the best of luck for Wed, I have only just stumbled across this post. This will be something I may need to do with my next pregnancy so will be watching closely to see how you do.

We didn't have infection but my Ob feels it was contractions that started the ball rolling for me rather than IC. I still think I may have an IC but we won't know for sure until we get preggers again.

Wishing you all the very best and sending "full term" sticky vibes

Nae x x x

[hgirs]

Hi Nae, it is so hard isn't it? They don't know for sure wether I have it either, but I feel there is some issue there. Originally they just wanted to do the fortnightly scans, but my fear with that which the OB confirmed is that they could still miss it, or find out too late for the stich to then be of any help. I am concerned about increasing my infection risk by doing so, but he is going to do a double stitch (one up high where it is meant to be, one lower) this apparently has some promising research for keeping the bugs out. I am so sorry about your Nikita, to have had such a short time with our angels is so very hard, wishing you all the best for the future. Feel free to join us girls in the TTC after late loss thread, if you ever need some extra support.

[AngelLukesmum]

Hi Helen
That's great news about your stitch being scheduled - it must be a bit of a relief knowing your concerns are being taken seriously by your ob.

My stitch was put in at 14+1 and I think I saw my ob the following week (15+2) just for a quick checkup. He didn't really check the stitch as such, just asked how I had been after the surgery and did a quick scan so we could see bubs was okay after the op. I had a proper scan the following week at 16+4 where they did an internal u/s and measured my cervix. My ob wanted a base measurement for us to work off so we know if things are changing for the worse as time goes on. That came in at 3.3cm; well within the normal range. My normal morphology scan is tomorrow and apparently they will do another internal u/s to check my cervix again. I then have another cervix checkup at 21 weeks but that is mainly because I asked for it as that is our nervous week and I need the reassurance (even if my ob doesn't!). Not sure after that as we haven't discussed that far yet. My ob is very confident in the stitch & probably thinks I am a fool for needing the reassurance of checkups but I figure that (a) we are paying him enough, and (b) I NEVER want to go through another loss so he will just have to put up with me

As for restrictions, this seems to vary from ob to ob - mine basically said no really heavy lifting but no other restrictions. Sex okay too but he acknowledged that we probably wouldn't be game enough anyway. And that is very true! I know some others with a stitch and they have been told things like no sex, no swimming, no baths, no orgasms, rest when you can etc so opinion really does seem to vary. I think though that preventative stitches are a bit more restriction-free than the emergency ones which might be why our ob's are pretty carefree about it all.

Sorry, not much help there but just take it a day/week at a time and see how you feel. I am just trying to take it easy and listen to my body - if it says "lie down on the lounge and watch TV instead of doing housework", who am I to disagree?

Good luck on Wednesday - please let me know how you go. And a piece of advice I am not sure if I told you before - have some Benefibre or Metamucil on hand for the days after the op. The last thing you want to be doing is worrying about straining when all you can think about is that foreign object that has just been sewn into your insides!

[NaeNae]

They don't know for sure wether I have it either, but I feel there is some issue there. Originally they just wanted to do the fortnightly scans, but my fear with that which the OB confirmed is that they could still miss it, or find out too late for the stich to then be of any help.

Yep thats the scariest part of it isn't it - finding out a little too late. I was 2 cm dialated with bulging membranes when I wen tinto hospital.
My Ob has discussed weekly check up and ultrasounds with a sonographer who was once a Gyn and who is specialised in cases such as ours. We have discussed a suture but Ob feels very strongly that it was contractions and is against using them unless necessary. I am willing to trust him at this stage but I may feel different when we start our TTc journey and fall in again.

Thanks for the understanding. I am so sorry about the loss of your son. Its a heart wrenching thing to go through and thank goodness for BB and finding others who have been through the same or similar things its such a comfort to have when most (around me anyway) cannot possibly fathom what its like.

I will be joining the TTC group once we get to that stage

again best wishes hun x x

[Visitor9]

I was told not to have any sexual experiences..lol not even anything that may be slightly nice..I had bleeding at 30 weeks and the first thing my obst said "I told you not to do anything!" I told him we hadnt since the IVF transfer. They are all different, Good luck for Wed, I'm sure it will go fine. As for all the checkups to be honest after 30 weeks I was so relaxed thinking that any change would of had to of been picked up by now and dreaded the hr to the obst office.

[hgirs]

Thanks for being so helpful ladies, I will let you know how it all goes.

[NaeNae]

Hey hgirs,

hope it all went well yesterday and that your recovery is quick and the stitch is not causing you any probs.

Thinking of you

Nae x

[hgirs]

Hi ladies
Well everything seemed to go well on Wed, apart from the fact that they put me under a GA and I was quite sick! I had a fair amount of cramping Wed/Thurs but has settled down now, still have a little spotting but otherwise wouldn't know much has changed. They told me I wasn't to lift anything heavier than a newborn so it is going to be a difficult 6 months ahead with a toddler, but if it keeps this munchkin safe it is all well worth it! I am still a bit apprehensive about getting an infection, but at least I feel like we have done our best. I am taking pro-biotics and cranberry juice everyday to try and keep any bacteria away (whether that helps or not who knows).Thanks again for your support!

[NaeNae]

Glad to hear it went well - all in all.

I am surprised they didn't give you any antibiotics though to help the prevention of infection? will you have weekly or fortnightly monitoring, swabs etc?

Nae x

[hgirs]

Oh they did give me antibiotics in theatre but not on a regular basis, and they have decided against the swabs as apparently they are not overly accurate, so it is more if I feel anything different to come straight in. I will go over it all again when I go back on Tues for a checkup. My next scan will be at 18 weeks and if there is no problem indicated he seems to think I don't need constant monitoring. That being said, I will be pushing for at least another scan around 22/23 weeks as that is when things started to go wrong last time, and maybe another a month later.