I need to have a cervix stitch, can anyone share experiences?

[namos14]

I am 9+w pg and I will need to have a stitch done on w 12. I was considering going private but have no idea who to turn to?

Can anyone share their experiences and/or recommend a private consultant in London?

Thanks!

[CrispyFB]

Honestly, NHS will be just as good as private and probably whoever you see privately will be an NHS consultant too. You do have a choice over who you see on the NHS so you can make sure you see a decent one.

I would really recommend Nick Wales at Chelsea and Westminster for what it's worth - a total expert. He put in my transabdominal stitch which is a permanent one but he does regular transvaginal ones too. I asked my GP for a referral to him despite living in SE London, and there were no issues.

Good luck!

[time2deal]

I need one too, but I'm struggling to get anyone to look at the issue properly. How did you find out you needed one, and how soon are they putting it in?

I had one in last year, but it was removed as it was causing problems with conception, but now I'm pregnant I need to get it put back in. Today I had a booking in appointment but I won't see a consultant until the end of March, and the premature clinic until 7 April (who look after cerclage operations). That would have me at about week 15, and I was told I needed the cerclage put in around week 9-11 by my oncologist. I had cervical cancer last year, which is why I need it.

I'm a bit stressed about it to be honest. The midwife was lovely, but they didn't really take any details of my history, just said to come back in 6 weeks. Anyone got advice on how to get in to see a consultant! I'm happy to pay privately for an appointment to talk, but I need the operations done on the NHS as I know it quickly becomes thousands. My cancer treatment was private, so there is no continuity of care, but the maternity teams seem somewhat uninterested...

[eurochick]

time () I think you really need to push given your circs. Could your GP help with a consultant referral?

[time2deal]

Do you think that would speed things up? I will see if I can get a booking tomorrow. Problem is it takes a while to get a GP appointment too! Then the referral. I'm really not used to the red tape of the NHS.

I'll call the consultant tomorrow. He actually has my private referral from my oncologist, so maybe that would just be the quickest way. I would like to get an idea of how the pregnancy will be managed. I have been told I could go on bedrest, ranging from week 16 (!) to week 30, but I just don't know.

Trying to not get stressed. I have my last appointment with my IVF clinic tomorrow, so maybe they can provide extra guidance.

Sorry OP for hijacking your thread!

[212smj]

Hiya, I have a Shrodkar suture. I had it put in electively at 17 weeks due to a previous loss, I have an incompetent cervix. I had it done through the NHS. At 24 weeks my cervix had opened up to the suture, but as I'm now 32 weeks it's clearly holding everything together beautifully. I believe most NHS consultants also do private work, so it's likely that NHS will be as good as private.

I'm not saying it's always easy, I get very nervous and anxious at times but my care on the NHS has been fantastic (although I'm based in Gloucestershire so not much use to you!)

Good luck with it!

[CrispyFB]

(hijack) - Glad to hear you're still pregnant 212smj - I was wondering how things were going with you!

[212smj]

Ah yes Crispy I'm still going strong thanks! 2 more weeks until stitch removal. Yikes! Thanks for asking x

[namos14]

Wow, thank you so much for all your comments!

CrispyFB thanks also for recommending a consultant. I have been cared for at UCHL and I have been very happy with NHS. However, I would like to ensure I have an expert doing the job. All the doctors I heard of are from Chelsea or St Mary's Hospitals. But good to know I can be referred to any hospital.

time2deal, I had a laser surgery back in 2005 (which I found out caused the shortening of my cervix). At my first midwife appointment, she referred me to the pre term clinic to check my cervix, but when I got my first appointment at week 16 they said it was already too late to put the stitch. I know, each hospital seems to follow a different procedure. I kept being monitored every three weeks, but unfortunately my waters broke on week 26. I ended up having a c section and unfortunately after two days my baby girl passed away.

I don't want to make you more worried, and as 212smj said, she had her stitch on week 17. So each case is different. The only thing I say is, if you are not comfortable and safe, call them as ask to see someone soon.

UCHL are now being super precautions with me and I am seeing a consultant there next week. It is likely that they will put the stitch on straight after my 12w scan prove baby is growing well.

Please keep in touch and let me know how you get on.

[time2deal]

Thanks for the information. You've given me the push I needed to push things today. I'll call as soon as I get a bit of privacy. 8 week scan today and all is well, so I want to keep him safe in there!

212smj great to hear of the stitch really holding. Hope things continue to go well.

[time2deal]

212smj, can you tell me what the stitch involves? Does it need to be done under a general, and do you have to stay in hospital for long. Also have you been put on partial, or complete, bedrest, or any other restrictions?

Was there any reason you went for the Shrodkar stitch instead of any others?

I was at my IVF clinic today, and they may be able to refer me directly to get it done. I'm at C&W where I believe there are some good consultants, so I will wait to hear from them today before pushing for a private appointment.

[212smj]

I was advised to go for the Shirodkar suture by my consultant as he believes it is the most effective and the best for avoiding infections. When I went in they gave me the choice of either a spinal or general anesthetic but I chose spinal as I wanted to be awake. They showed me the material they use it's very strong and plastic, looks a bit like a cable tie. I stayed in hospital overnight and then was advised not to have baths, not to lift anything heavier than a half filled kettle etc. I took a week off work after wards to let everything settle, bleeding stopped the evening I had it done and it felt a bit crampy for about a day. You do get increased discharge which can be a bit odd but you get used to it, and it's normal. I also occasionally feel like I can sense it inside of me, which I'm assured is normal as everything downstairs swells a little in pregnancy. I continued to have my cervix scanned every two weeks and unfortunately at 24 weeks my cervix had opened up to the stitch so my consultant put me on bed rest for the rest of the pregnancy. The stitch has held and is still in place, no doubt at all that without it I would be looking at a very sad outcome. I am having the stitch taken out at 34+3 which is 2 weeks today.

I hope this helps. Good luck with it.

[eurochick]

time I'm glad the scan showed that all is well and that your clinic might be able to refer you.

[time2deal]

Thanks so much for the detail.

Namos I've been referred to consultant on Monday, which is a great relief. Your story really worried me! I went to a final scan at my ivf clinic and they have a little more history and so understood that the referral was urgent. It will be 8+5 then, so perhaps a few more weeks before they do the cerclage.

My husband is away for 2 weeks from 9-11, but if that's the right time for it then so be it.

[MyShinyRedCoat]

Hi, I had a prem baby 10 years ago due to premature rupture of membranes at 27 weeks (he is absolutely fine now, a miracle). So, 4 years ago when I was pregnant again they checked my cervix routinely at my 20 week scan and it was starting to open.

I had an emergency Shirodkar suture put in at 20+2 and it held until I had it taken out at 36+2!! I had my son at 39+4.

They are not usually so successful at a later stage on pregnancy I believe so I was lucky. I was on bed rest from having the stitch until about 28 weeks (once I got past 27 weeks I relaxed more) and left work immediately after my 20 week scan.

It was ok having it put in under a spinal anaesthetic but having it out on nothing really hurt!!

Any questions please PM me, good luck x

[thewalrus]

Namos14, I had a stitch done at UCLH in 2008 when I was 22 weeks pregnant with twins. The consultant who did it was Patrick O'Brien. Twins were born by planned section at 38 weeks, so obviously I was pleased with him!
I thought the specialist care I got at UCLH was really good (post-natal ward/routine midwife care was another story, but hey!) though obviously several years out of date.
Good luck with it, whatever you decide.

[time2deal]

I met with a consultant today at Chelsea and Westminster (on nhs). He said I needed at trans abdominal cerclage, which is now booked at 12 weeks. He was a bit worried about their not being sufficient cervix, and said he would have preferred to do it before pregnancy, but no one told me that!! I've hardly gone a month without seeing some kind of gynae... You'd think they would have mentioned it. But can't change it now.

He said I need to take a month off work! 3-4 days in hospital then 3-4 weeks recovery. And terribly timed for work, but not like I can change it. I told my boss once I realised how bad it was and he was very accepting. It means both of us (senior managers) will be out for a month. I guess the business will realise they need us!! Hopefully anyway. :)

I'm so glad they saw me. He said it was good I came so early, and the big problem occurs when women show up at 14 weeks, which is exactly when my other appointment was going to be. Glad I pushed it.

[CrispyFB]

time2deal - Was that Nick Wales? I had a TAC placed at 13 weeks by him back in 2010 - it saved the life of DS and I still have it in place for this one, and I'm almost 37 weeks. Amazing thing it is.

The surgery was fine, extremely routine general anaesthetic which seems scary in pregnancy but is actually fine. Someone on a due date forum with me had 8 hour surgery at 22 weeks for cancer a few months back with no issue! Baby goes to sleep just like the mother does. They scan immediately post op to check all is okay.

Anyway, he told me he'd only ever had one loss as a direct result (this was back in 2011) and that was a woman who refused to take the antibiotics and got an infection. It seems like an incredibly commonplace procedure at C&W which amuses me as it is so so so rare everywhere else in the country. Every medical professional I've seen has either never seen a TAC before or hasn't for many years, and many are fascinated!

The surgery was very similar to a c-section - I was out after two nights in hospital, and although I wasn't working, it was a good two weeks before I started feeling mostly okay again just with a bit of discomfort. I felt quite normal by four weeks, just taking it a bit easier than usual. Depending on how well you recover you may not need the full 3-4 weeks but it also depends on the nature of your job.

Best thing is with my pregnancy with DC4 (this one) I haven't had to to anything. It's just been like a normal pregnancy with that stitch in place. No bedrest, nothing. It was the same with the last one too - I was wandering around (in so much as SPD let me) just like I was a normal pregnant lady. An amazing stitch, it really is!

[time2deal]

Yes it is Nick Wales! He was very nice and reassuring. It will be my first proper abdominal surgery, the last ones I had were laproscopic and I found the recovery from them quite painful. The pain was controlled with a mix of panadol, codeine and tramadol, but I suspect that won't be allowed!
But it's great that it is possible, and the success rates seem excellent.

He said no need for bedrest afterwards, but I suppose they will keep an eye on me as time goes on.

Work will cope without me, I have a habit of rushing things, but since I have stewardship of another little being I'll take the extra time to make sure it is ok. My work is desk based, but I have a crammed tube trip each way to manage which can be hard.

[CrispyFB]

Ohhh.. you'd be surprised at what they DO give you! I had IV morphine, and I did take codeine home with me and possibly had some other stuff in the hospital too. Second trimester is a good time for drugs - the foetus is developed, but it's not so near the birth that you have to worry about addiction and so on. In fact I had a fab old time with all the drugs, woozily updating Facebook repeating myself over and over in a generally chilled state (note: not wise) to everyone's amusement! Codeine is actually fine in pregnancy right up until near the end, so long as you avoid the usual addiction-related levels which applies whether pregnant or not.

The worst part for me were the prophylactic antibiotics I had to take every six weeks for the rest of the pregnancy (no idea if he still does this). They were strong enough to drop a horse and even at more normal levels would be horrid (erythromycin and metronidazole). I had some horrendous side effects from them.

He is very reassuring and he's right to be. I don't have a lot of faith in doctors I am sad to say, because if I'd listened to half of them without doing my own research, I wouldn't have two of my children right now. But Mr Wales was great - he talks the talk AND has the excellent statistics and skill to back it up unlike so many of them. There's not many doctors I respect but he is one of them and I'm very grateful to him! And he did very neat stitches as well that healed well, I was very impressed.

I have also had two laparoscopic surgeries (investigative, with HSGs) And two c-sections plus the TAC. I can tell you that the c-sections/TAC aren't actually an awful lot worse. It takes a little longer to get back to normal, and of course you have to be more careful over the incision than you would with a lap, but in terms of pain they were fairly comparable to me at least. Both feel like you've been hit by a sack of potatoes. Staying on top of the pain medication is always the best way of course.

Yes, no bedrest - I almost feel like I'm cheating because of that, as people with regular transvaginal stitches have to have much more monitoring and can often end up on bedrest. I do have a few cervical length checks, I think I had two last pregnancy and two this pregnancy, but compared to the fortnightly ones I had with the rescue TVC stitch I had with DD2 (that tore through at 34 weeks, hence the TAC) it's a hugely different story.

I found the post-op experience at C&W to be one of the better NHS experiences I've had by quite some margin, but then I have been in some pretty crap hospitals too. I'd certainly recommend the place. I delivered at C&W as well - the postnatal ward was fine as NHS postnatal wards go - far better than the other two London hospitals I used for my previous two DC.

Much sympathy on the tube journey though - yes, I would want to be feeling pretty good before attempting a tube commute every day! I found it hard enough with a regular pregnancy with my first.

Very glad you pushed it. Advocating for baby doesn't always bring success but it can hugely improves the outcome in some cases. My family would look very different right now if I hadn't done the same.

[time2deal]

Sounds promising. I had a cerclage that broke during a later surgery but I think that was just vaginal, so maybe a good thing to have this new one.

Thanks for info on c&w generally. My last surgeries were all private so I'm a bit nervous about being on a ward and all the noise. I'll have to focus on ensuring I get enough drugs! I distinctly remember explaining to my sister exactly what the elves were doing when I closed my eyes last time I was on a nice painkilling drip. Good times. :)

[CrispyFB]

The TAC doesn't break That's the beauty of it! It's a small piece of tape tied around the bottom of the uterus, effectively creating a whole new cervix, and it's not a part that tries to dilate. Your "old" cervix can do whatever it wants, it doesn't matter with the TAC in place! The success rates are huge compared to a TVC - 99% versus 80% I think.

I've had a bunch of private surgeries too over the years - ERPC, lap/HSG etc. I won't lie, of course it is nicer (in terms of aftercare!) to go private. Nicer sandwiches, more peace and quiet, Molton Brown in the private bathroom etc. But as NHS hospitals go, C&W seems to be one of the better ones. You can't avoid the other people on the ward but it seems to attract patients who are (and I hate to say this but it is my own personal observation) a bit more considerate in general than many of the other NHS hospitals I've spent time in. The nurses etc didn't feel as pressured/rushed either so were able to meet my needs better. The food wasn't as appalling as some either, heh.

With a TAC there's no harm in getting earplugs - it's not like when you have a c-section and have a new baby to listen out for after all.

[MoominsYonisAreScary]

I had a cervical stitch with my last dc at 14 weeks, I had the mcdonalds suture. Ive had the same consultant with ds2,3,4 and 5 and had every confidence in him.

The stitch was taken out at 35 weeks and ds5 was born by elcs at 38 weeks.

I also had progesterone suppositories from 18-32 weeks

[CrispyFB]

Ah yep, I have the suppositories as well!

[MoominsYonisAreScary]

I did stop them at 29-30 weeks as they started to make me itch terribly.


I should probably add a little history,
Ds1 was born at 43+ weeks weighing 11lb 2.
Ds2 35 weeks due to prom
Ds3 32 weeks also prom
Ds4 my cervix started to fail at 18 weeks and he was born at 20 after a rescue stitch failed. This is when they diagnosed ic
Ds5 38 weeks by elcs.

Ive had quite a few procefures inbetween which probably caused the weekness with my cervix

[time2deal]

Good to hear C&W is ok. Silly question, but do you know if they have wi-fi? I can pretty much cope with anything if I can switch off and surf the web.

My last major surgeries were for cervical cancer, done privately at the Marsden. It was like being in a hotel! Private room with ensuite, a TV on the wall and another up close if I wanted. I was there a week for one operation, and 2 days for another, so I am sort of curious what it's like in the NHS. I did spend on night on a ward though, and I found the noise of the other patients machines very annoying. I can't see why they need to BEEEEEEEEP when each drip finishes! Just as you have drifted off...

Thanks for all the advice. I'm sort of excited about it now. I have not allowed myself to bond too much to this pregnancy as I know the risks, but I'm starting to feel more positive.