Cervical stitch - thoughts please!

[monkeybumsmum]

First, I have to say that at the moment I'm not pregnant... However, after a check up with a new consultant on Wednesday he has advised me to have a cervical stitch immediately if I do get pregnant again. (We are going to start trying next month.)

Now, I thought that cervical stitches were done later in pregnancy - is this right? Has anyone had one very early?
IMO it seems a bit crazy to put one in, if the pregnancy is possibly going to miscarry, and at 4ish weeks you can't tell that can you. I've had 3 mc's so am very wary... (They were all 12 weeks or before - if they'd been later losses due to IC then I could understand the recommendation for the stitch)

Any advice on cervical stitches would be appreciated, especially from anyone who has been told they'd need one because their cervix is open when not pregnant?? Does this mean I have an IC?

Help please! Am very confused!

[WorzselMummage]

They usually put them in at around 12 weeks. I have never heard of them being put in in early pregnancy but have heard them being put in and then left in for the next pregnancy and the babies beign delivered by section so i am not really sure abut that.

I had a stitch in my last pregnancy due to IC caused by repeat LLETZ but not till 22 weeks and it went in as an emergency as my cervix was found to be shortening on a scan.

Can i ask why they think you will need a stitch ? they are not risk free and i'm not sure if i'd have mine again given the choice.

I dont think there are any reason to have a stitch apart from IC ?

[monkeybumsmum]

Thanks WM for replying! Congratulations on George's birth by the way How's he doing? I hope everything is going well, and he's getting bigger by the day...

I've googled cervical stiches and as you say they seem to usually be done at around 12 weeks. On Wednesday my gynae did an internal scan and said that my cervix is open. Even I could see it on the screen. He said that he would want to do a stitch next time just to be safe. I really don't think that my cervix has had anything to do with my mc's - one was a cp, one at 8 wks, and then a partial molar preg. I have had 2 ERPC's though which could explain it... I just can't understand how he can tell now if I'd need a stitch - the cervix should close up in pregnancy shouldn't it?

Am loathe to have it done because of the risks, but if it is the best course of action then I will.

Can I ask what LLETZ is?

[monkeybumsmum]

Anyone else?

[EldonAve]

your cervix should be closed normally - when you are not pg

[monkeybumsmum]

Even during ovulation?

[EldonAve]

um, dunno
sorry not much help

[monkeybumsmum]

thanks anyway!

[LadyMuck]

I've had cervical stitches in both pgs for a similar reason - my cervix was found to be partly open prior to pg (during fertility treatment). On both occasions my stitch went in just after my nuchal fold test at about 13 weeks.

Whilst I went with the advice of my gyn, the registrar at the birth of my first ds was certain that I did not have an ic. In the end I had an em c/s due to large baby/small pelvis. Ds1 came out with an imprint of my cervix on the top of his head.

I haven't looked at recent research, but much of the research back in 2000 seemed to be ambivalent about the benefits of the stitch. My gyn preferred to be conservative given that these were IVF pgs.

[WorzselMummage]

LLezt is one of the treatment for precancerous cells, they use a hot wire to remove the affected area basicially, i have had 3 and have very little cervix left according to my consultant .

I am not sure about your cervix being open all the time, i know it should be closed in pregnancy but it must open and close a bit during your cycle to let your period out etc.. indeed if you have ever been brave and had a feel you can feel changes fom day to day.

There is a good post about stitches in the high risk pregnancy part of Bounty.... ( eeeek sorry mumsnet ! )

Fwiw i was quoted a sucess rate of 90% for stitches put in at 12 weeks and even a 50% chance of sucess of it working at 22 weeks as mine as. As it happens my stitch did its job but the infected i got having t put in cause a raft of problems as you might have read.

If you do get it done then make sure you get antibiotic cover afterwards, if i had insisted when i was told that they didnt routinly give them then i might still be pregnant.

They can help cervix issusse with progesterone pesseries too i think.

Good Luck

[monkeybumsmum]

LadyMuck that's very interesting, thanks. Stuff I've looked at too seems to question whether it's a good idea or not. I just want to be as prepared as I can be, so I don't just let them go ahead with something I know nothing about...

WM Thanks - I'll definately make sure I ask for antibiotics if I get one done. They've also given me a prescription for progesterone that I have to start taking on day 21 of my cycle. Not sure if they're pessaries, but I'll collect them this week and find out.
Thanks for the Bounty recommendation, I shall scoot over and have a ganders . Poor you with having 3 of the LLETZ's - that must've been horrible.
Re cervix, I am reasonably au fait with the changes and must say that it does generally seem different now than it was before I had ds. Maybe it's because it is more open. I would've thought it was quite normal for it not to go back to exactly how it was before giving birth though, it gets stretched soooo far!

Can I ask you both what the procedure's like when you had the stitch(es), and how did you have them done?

[monkeybumsmum]

WM Did your waters go early because of the infection then?

[WorzselMummage]

They think so but my waters went early with dd too so i may just make rubbish amniotic sacks and it was a coincidence, who knows !

The stitch procedure was pretty grim for me but my surgeon almost failed to get it in atall due to my aformentioned lack of cervix and it took a lot longer than it shoud have ( an hour as opposed to 10 minutes ), i was told at the time that it'd get me to 28 weeks at least, they usually last to the end and have to be taken out at 36 weeks or thereabouts.

Putting it in involves a spinal block and spending some time in theatre with your legs in stirrups, not digniied atall but you can't see whats going on and it's not usually painfull and even immediatly aterwards the pain is easily managed with paracetamol and i didnt bleed much, i was told that was normal.

i was told bedrest or a week aterwards but i think that depends on the surgeon as some people i have spoken to about it have been told to carry on as normal.

I dont think my experience is typical really, i you have read the post on bounty then you will see they work wonders or most people and are nomally a simple short procvedure, infact i have read that its worse having them removed than putting them in but i couldnt tell, i was under epidural when they removed mine

good luck

[LadyMuck]

I had mine done under spinal block at around 13 weeks - can second the undignified in stirrups bit! Did have to stay in hospital for 2 nights on each occasion from memory. With ds1 stitch was removed at 37 weeks (under g&a as was very painful). With ds2 was removed immediately before c/s. Has slight bleeding about a week after insertion on both occasions.

[StripeyKnickersSpottySocks]

I was talking to a consultant today about cervical stitches and he says that he now puts them in for women when they are TTC so there isn't any risk of fiddling with the cervix when pregnant. He says so far he's had good results. Not sure how research based his practice is though.

[monkeybumsmum]

Ooohh it doesn't sound too nice Am not worried about the undignified bit, my dignity went out the window quite a while ago now It's the pain, and mainly the risk to the baby that I would be worried about.

StripeyKnickersSpottySocks Hmmm I shall definately mention that to my consultant next time I see him, thanks. Sounds like it would be better to have it done before, but then would it not make ttc more difficult?

Am presuming a spinal block is an epidural? What's it like having one when you're not in labour? I was so thrilled to be possibly getting some pain relief that I wasn't really aware of having an epidural when in labour with ds. Freaks me out a bit to think of sitting there with a big needle going into your back when there's nothing else (ie contractions) to take your mind off it...

[StripeyKnickersSpottySocks]

He was saying that its never caused any problems with TTC. I'm guessing that putting a stitch in the cervix only keeps it closed to a certain extent, ie; not watertight, so sperm would still be able to get through.

I've had spinals done when not in labor as I've had back problems which have needed steroids through an epidural. Its no worse than having one done in labour, sharp sting when they put the local anasthetic in then it goes a bit numb and some uncomfortable pushing/pressure. Good luck with whatever you do.

[monkeybumsmum]

Thanks x