Incompetent cervix / cervical stitch
Blueroses99 · 15/12/2016 15:03
I had a second trimester pregnancy loss at 21+3 in July and was diagnosed with an incompetent cervix due to the almost painless dilation and ruptured membranes. I went to the hospital because of sudden bleeding (actually it was my waters breaking) and delivered with 3 hours of arriving at hospital. My beautiful baby boy was perfect, genetically and physically, confirmed by the post mortem. There were signs of an infection on the placenta but the consultant was confident that this is not the primary cause of the loss.
The undisputed diagnosis of IC and a solution to manage it during any future pregnancy - an elective cervical stitch at 14 weeks - gave us the confidence to try again. We need IVF to conceive so it wasn't a decision that we made lightly.
So now, amazingly, I am 6 weeks pregnant and had my first scan where all seems well so far, and making plans for my ongoing care. I have been referred to the Pre-Term Clinic at my local hospital and they offered me an appointment at 16 weeks - which is after the 14 weeks that I was recommended for the stitch. They refused to see me before 12 weeks until the nuchal scan is done, but agreed to bring the appointment forward to 13 weeks. They indicated that it is possible to do a stitch the following week if they decided that was the right course of action but indicated that I might not need the stitch if I was properly monitored (my cervix was not measured during my previous pregnancy), that it might not happen again, that it might have been because of the infection. Given that they didn't have access to my medical notes or recommendation letter, it felt very dismissive. I was very distressed after the call and this uncertainty is making me very anxious.
I really wanted to hear from anyone else that has IC or has a stitch for any other reason. When was it put in, when was it taken out, and at how many weeks did you deliver? Did you have any problems with the stitch? If you have IC but didn't have a stitch, how was your care managed? Is there anything else I should consider?
Blossominspring · 15/12/2016 15:34
Hello lovely, so sorry for your loss and congratulations on your new pregnancy. It's great that you're being so proactive and are in the pre-term clinic so they can keep an eye on things and help you if you need it.
I had a cervical stitch in my current pregnancy (weeks 17-36) following a short cervix picked up by monitoring after problems in my first pregnancy. I'm now 39 weeks and still waiting for baby to arrive so a really positive outcome! Here's my thread and please feel free to PM if you'd like to ask anything or to chat as I know it can feel like a really worrying time.
Take care x
Schumann · 15/12/2016 15:46
I lost twins at 23 weeks due to IC. I was told that in any future pregnancy I could have an elective cerclage. However at my first appointment I had a new consultant and he didn't recommend cerclage, but preferred progesterone suppositories. He referred me to a study that supported this (sorry I can't remember the name of it). I was initially thrown by this as I'd been planning on having the cerclage and in my mind that was the route we were going down. However the length of my cervix was good, i read the study and I started on the suppositories (this was prob around week 13 or 14 . They checked the length again a few times and I stayed on the suppositories until week 36 I think. DS arrived 40+1 (I was induced - my choice as it was all too stressful after losing DTs).
Hope that helps a bit.
Blueroses99 · 15/12/2016 17:08
Blossom thanks for sharing your story. Were you restricted in any way after having the stitch or, I see that you were in bed rest for your first pregnancy, did you find yourself less anxious with the stitch in place?
Schumann thanks for sharing your story too. I'm already on progesterone suppositories as it's an IVF pregnancy. I was on them last time too until 14 weeks. (Hard to think that if I'd continued I might have had a different outcome.) I think I'd find myself too nervous to do anything without the stitch, in case the cervix gave way suddenly again. Did you have any worrying moments or anxieties?
Blossominspring · 15/12/2016 17:36
Hi Blueroses, I was probably a bit overly cautious with my stitch but as the advice out there is quite mixed I just wanted to be as careful as possible. I pretty much did bedrest as I'd done it with my first pregnancy and it had worked so well. However, I don't think you need to be so strict if it doesn't feel appropriate. My doctor (who specialises in cervical sutures and is running a study on them at the moment) advised me strict bedrest wasn't needed but to take it as easily as possible - at least two weeks off work, no lifting, long walks, exercise etc. I'm self employed so worked from home, had family round to help look after my toddler and basically only left the house to go to medical appointments. I lay down for most of the day to keep pressure off the cervix but sat up for meals/dressing my little boy/showers etc. It was tough but helped me to feel I was doing all I could to help things along. However, it seems most ladies who have had stitches have just done a more relaxed version of their normal routine and been fine. I was worried about infection too as there is a tiny risk of this with stitches but the consultant's advice about this was to wear cotton underwear and change it regularly, showers rather than baths, no swimming and no sex. Just to reassure you - i had all sorts of twinges, aches and pains throughout and they all came to nothing, thank goodness. I just think that high-risk pregnancies make you hyper attentive and fretful so you notice every little twinge! So don't feel silly for fretting or finding it a tough few months as it's perfectly natural, especially after losing your lovely boy. But stitches have got such a good full term succcess rate - as high as 94% at some clinics - so you've so much to feel hopeful and positive about. The early weeks are the scary ones but as time passes then you'll feel better and better.
Hope that helps. Take care, lovely, and wishing you a safe and uneventful pregnancy.
Blueroses99 · 15/12/2016 18:11
Hi Blossom, I know what you mean, I want to be ultra careful too and I think I'll want to lie down a lot! I have a 1hr+ commute (train/tube) to work so I'll need to figure out if I can manage that. Good luck with your imminent birth xx
Schumann · 15/12/2016 18:11
Yes I found it very stressful but I did have really good care. My bereavement midwife was always there if I neefed her - either to reassure me or get me in for a quick check up!
Best wishes to you for a smooth pregnancy.
FruitCider · 15/12/2016 18:33
I had an emergency stitch put in during my last pregnancy at 17 weeks, after a scan to measure cervical length. I have a bicornuate uterus which is linked to IC. I was on bed rest for 2 weeks and didn't go back to work. I had spd so couldn't really move anyway!
Blueroses99 · 15/12/2016 19:29
Schumann ah yes, I contacted my bereavement midwife today. I was just letting her know, but I didn't realise that she might be able to support too.
FuitCider thanks for sharing your story. I had quite bad backache in my last pregnancy (not SPD, but as I have scoliosis my back is liable to seize up after any stress) so I was trying to relieve it with more exercise by swimming and pregnancy Pilates/yoga.
annlee3817 · 15/12/2016 22:07
I am so sorry for your loss
I had an incompetent cervix which was managed with a high dosage of progesterone pessaries and I was signed off at 31 weeks for the remainder of my pregnancy, I had internal scans weekly from 21 weeks up to 28 then fortnightly until 36 weeks. At which point I was signed back to Midwife led care, and even though my cervix started dilating at 37 weeks and I was 3-4cm on my due date sweep, my DD somehow stayed out until 40+5. I hope that helps somewhat, it has put me off having another, but if I did have another I would push for the same monitoring, and be rather insistent. My cousin was fobbed off on her third pregnancy and went into prem labour at 32 weeks, the consultant actually apologised and said he should have seen her earlier jn the pregnancy, her DS is now 13 months and doing great.
Blueroses99 · 16/12/2016 10:33
Annlee it's great to hear that progesterone pessaries are effective. Do you remember what dose you were on by any chance? I absolutely agree with the need to be insistent.
I saw my GP today and she is going to write to both the consultant that I saw before and the pre-term clinic to convey my anxieties her concerns. It doesn't help that I have a friend who was having her cervix monitored because of twins but lost them the week after monitoring due to IC. Also my auntie lost 3 babies before she was offered a stitch, then lost another baby between my 2 cousins because (in her opinion) the stitch was put in too late.
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