Does anyone have experience of a cervical stitch...?

[blueberry69]

I am having a cervical stitch put in on Saturday due to a slightly shortened cervix (19mm) which is linked to 2 cone biopsies in the past.

I don't really know what to expect in terms of the procedure or recovery. If you have any experience I would be grateful to hear from you.

Hi Blueberry
I had a cervical stitch about a month ago because variously:
My cervix was just 2cms at 16 weeks, have had cone biopsy, early miscarriage and pregnancy is IVF so pretty high risk for miscarriage/premature delivery.

I had a general aneasthetic (as I am a wimp and was assured no risk to baby)and was back out of the hospital a couple of hours later. Discomfort not pain was managed with a couple of paracetamol. Minimal bleeding which stopped after a couple of days.

I have had no pain since just increased normal discharge (sorry if TMI).

The only real downside is no penetrative sex or much in the way of exercise.

I was worried about the possible risks but they were outweighed by the potential benefits and on balance, I'm glad I had it done. 20 week scan today with lovely healthy looking baby.

Good luck

Thank you Ipod. I have all the same factors and risks (incl ivf pregnancy) so good to hear from you. Great to hear all is well for you at 20 weeks.

I am having mine under an epidural and have no idea what to expect. I think I, like you, would rather be knocked out by a general.

Were you told not to exercise much for the remainder of your pregnancy or just for a few days/weeks after stitch..?

Well I was told to take it really easy for a week not quite bedrest but close and then very easy for another 4-5 weeks then life should go back to normal with a few caveats - mainly no sex, flying or proper exercise.

I was told that exercise-wise swimming or walking were OK but nothing else however, subsequently my consultant has been a bit sniffy about the idea of me getting back to swimming being worried about the "hygiene of public pools" and the possibility of infection. My normal self would say FGS and go to my local pool but my paranoid pregnant self will probably just try and walk everywhere instead!

Can't think of anything else useful to tell you except it was a fairly uneventful experience and you shouldn't worry about it too much. Do ask if you have any other q's tho.

Sorry didn't make myself clear - swimming and walking were only permitted exercise for the duration of the pregnancy not just the recovery period.

Thanks Ipod - what a blow about not being able to do much exercise, have sex or fly! However probably a small price to pay for the benefits of keeping the baby safe!

Hope all goes really smoothly for you for the remainder of your pregnancy and thanks for the info.

Hope the op went OK and best of luck for an easy and uneventful pregnancy!

I cant answer this question but i just wanted to say, i give to a charity for cervical stitch...its called tommy's.

I no people that have had really sad experiences in pregnancy. i feel very strongly about pregnancy's.

good luck, and all the best for the future!

Hi,

I'm on my second stitch pregnancy. First was a mcdonald, I've now got a shirodkar. I've got a 2cm cervix.

Do you know what type of stitch you had? If you had a mcdonald, you do need to be watchful for infection and I would definitely stay out of public pools. If you had a shirodkar, infection is not such a risk but I would avoid anyway.

My shirodkar went in at 16 weeks and I was told normal activities "within reason" but no sex. I think it's wise to be extremely careful for the first few weeks, my advice would be:

First week - off work and feet up as much as possible.
Second week - back to work but no walking around, still feet up/sitting as much as possible.
Third week - ditto.

From then on I would gradually build up your activities. I went back to my daily yoga practise at about 24 weeks (viability!) but have not been walking much, mostly because I've also had SPD.

If you've had a mcdonald, I would be cautious about resuming any kind of exercise post stitch, whatever the doctors say. Take it easy.

Have you been offered supplementary progesterone? If not, I would talk to your consultant about it as studies have shown that it helps prevent premature labour. I took it from 16 - 34 weeks.

I'm now 36 weeks and going strong. My shirodkar is out next week.

Hi,
I've been told that I'll need one of these for a second pregnancy (if I ever manage it!)as I'm also 'challenged' in the cervix department!

Just wondering, i've heard that the progesterone can be used as an alternate to the stitch, is this true and is it just as effective I wonder?

Did you get a say in what type of stitch you had? I've also read about the transabdominal and wondered if they are more secure/sucessful?

As its taking us so long to conceive, I sure as hell don't want to be running the risk of miscarrying due to IC.

Thank you Ipod and Illuminasmam.

Sounds as though both your pregnancies are going swimmingly which is great to hear and given me much positive inspiration. . I had a shirodkar stitch put in on Saturday and am also on progesterone to relax the uterus.

The obstetrician did say to take things very easy (my cervix is super short due to cone biopsies - 19mm and 10mm at the back) but I wanted him to be much more prescriptive as his idea of taking it easy may not be mine. So it is great to know what you have/haven't been doing. He said yoga was OK if gentle but that I am not to walk for more than 15 minutes or do any other form of exercise. Also no travelling on public transport due to the vibrations of tubes, trains and buses which he says could irritate the cervix. I live in London so without that and without much walking I am somewhat restricted! Not quite house arrest but I will have to radically rethink how i spend my time over the next 4-5 months! I can work from home and should that become tricky there are endless seated jobs that I have been meaning to do for years - sorting all the photos out for one!

Earplugs - I had a cervical length assessment at 15 weeks (last week) and was told by the obstetrician that there are 2 schools of thought on stitches. The old approach was to put a stitch in preventatively and the new one is to wait and see what happens by regular assessments and if the cervix starts to shorten then put one in. (He did say doctors are equally divided over this so speaking to 2 different people may result in 2 different opinions). Progesterone can be used in either case to relax the uterus and prevent early labour and has been shown to be highly effective in doing this. We were advised to go for the stitch due to the fact that i had had 2 cone biopsies and chances are the cervix is weak and would more likely than not shorten further - a preventative stitch is more effective than an emergency one. Like you it took us ages to conceive and we decided we wanted to do everything we could to protect the pregnancy. There are risks to a stitch but the benefits to us seemed to significantly outweigh the risks. Why have you been advised to have a stitch...?

Oops - sorry Illuminasam - nothing worse than people getting your name wrong!! Great to hear you are at doing so well at 36 weeks. Hope everything goes very smoothly for you over the coming weeks.

Hi Earplugs - re. choice of stitch: Basically, my mcdonald was put in at a different hospital in a different town to the one I'm in now. I would never go for a mcdonald again - I ended up losing the baby - I would insist on a shirodkar.

I have heard great things about Transabdominals (TACs) and I was told I was a candidate for one so could have requested one pre-pregnancy or gone for one once pregnant but I decided to try the "wait and see" approach. I had this choice because I had a previous failed stitch. If you're interested in TAC there's a yahoo group called abbyloopers who will fill you in.

As blueberry describes above, wait and see is now the preferred route for women like us as so many stitches fail and may have been unnecessary in the first place. My cervix is very short due to previous cone biopsy. I started TVUs (ultrasounds) at 14 weeks and my cervix was stable for 3 weeks at 2cm. It then dropped to 1cm within a week and the stitch went in the next day. After the stitch went in, my cervix went back up to 2cm at the 22 week scan. It is doubtful I would have made it this far without a stitch.

A friend of mine had a cervix that dropped below 2.5cm at around 25 weeks but they just kept monitoring her closely and so far she's holding at around 1.5cm without stitch or progesterone. She's had a previous baby so her cervix might just be a bit more dynamic now. She will probably get to 0cm sometime in the 35 week range and this is considered fine. Basically, latest thought on this is to keep a close eye on you and only to treat if absolutely necessary.

Blueberry - I also live in London and commiserate on the travelling thing. Basically, I was very cautious at first but became more and more confident as time went on. I wouldn't think twice now about doing a long walk and have done several recently due to being stranded by snow! The way to approach it is to not do something if you're unsure but to go ahead if you feel confident. For me this meant I was quite immobile during the danger zone (15 - 24 weeks approx) but have built up to being a normal pregnant woman with normal activities now. I started doing one ante natal yoga class a week but within 3 weeks was back to my daily ashtanga practise. I drive to work so didn't have the daily walk or public transport issue but now I'm on maternity leave I go on trains, tubes and buses. It's great that you can work from home. Shirodkar + progesterone is a very good treatment and I'm sure that like me, you will feel more and more stable as time goes on. The thing is to give the the stitch and cervix lots of time to settle and heal completely and then gradually add things, stopping as you feel necessary. If I had a period of activity I had a feet up rest afterwards.

Good luck ladies!

Thank you very much for the information ladies, it is much appreciated.

Blueberry,I've also got a history of cone biopsies and LLETZ and had a cervical tear during the delivery of DS probably caused by scar tissue. Whilst that pregnancy was OK, I've since had more LLETZ which has left me with a cervix of 2.2cm before I've even conceived.The report even says that my cervix is almost 'flush' with the vagina so pretty much all external cervix has been removed, gulp!

The doctor was quite relaxed and just said 'oh well we'd just monitor you and give you progesterone' but if it could be a problem, I'd rather go for a stitch early then wait until it was an emergency and possibly less likely to work?

I'm liking the idea of the TAC (well as much as you can IYSWIM) because it could be done before conception, carries less chance of infection (I suffered horrible infections after both courses of treatment for CIN) and could be taken out during a CS, which I would request anyway after the complications with DS.

Mmmm lots to think about, thanks for the info about the yahoo group as well illuminasam. What a relief to find that yours has gone back to 2cm, wishing you the best for the rest of your pregnancy.

My cervix is also "nearly flush with vaginal wall" - it's not a diagnosis that fills you full of confidence for sure!

It's worth bearing in mind that some short cervixes are actually fine in pregnancy - it's whether the cervix shortens that is the issue, not how short it is to start with, if you see what I mean. They stitched me because it went from 2cm to 1cm, if it hadn't, I might not have had the stitch.

Having had problems that resulted in the loss of my baby with my first stitch I was keen to only have one if necessary this time. At the end of my last pregnancy, they weren't sure whether my cervix would be OK without a stitch as it was infection that caused the loss.

Unfortunately there are risks with a stitch and it is important to have a balanced view that whatever treatment option can sometimes, as I know only too well, mean problems for the pregnancy. I can understand that going for a stitch might seem like the safe option but actually studies and figures show that it may not be. You must make the choice that feels right to you but please do make the choice with full knowledge of all the factors involved.

If you are just monitored, try and insist on weekly TVUs from 16 weeks to at least 24. That will catch any shortening. You will be fine for a stitch in this period.

What actually shortens the cervix is contractions of the uterus and pressure from the growing baby. This is why progesterone is so effective as it keeps the uterus calm. My cervix probably shortened due to the amount of sex I'd had in the previous week (orgasm causing uterine contractions) - whoops!

Once you are 26 weeks or so, the pressure on the cervix from the baby is considerably reduced which means the problems from IC are less likely to rear their ugly heads.

One other point - if you're not comfortable with the approach your doctor is taking, make a fuss until you are given what you want.

Below are a few links you may find interesting:

apps.who.int/rhl/pregnancy_childbirth/complications/preterm_birth/vqhcom/en/i ndex.html

www.iame.com/learning/cervlength/cervlength.html

www.healthline.com/bl ogs/pregnancy_childbirth/2008/08/cervical-incompetence-and-cerclage-3.html

You're a star illuminasam. What you say makes perfect sense, thank you. I will certainly have a good read through those links.

Very sorry to hear of your experiences. I cannot even begin to imagine what it must be like to suffer a late miscarriage. It must have been a frightening experience to have to go through the process of having a stitch again.

Very good to hear that you were still keeping 'active' though before you had it . I guess the stitch has put a stop to that now though!

Yes - although we are nearly 37 weeks and will get back to it asap!

Hi

can anyone please suggest that travelling by train (AC2) after 12days of cervical stitch.

Please reply ASAP COZ, we don't have time?

checked with couple of doctors, one was suggesting travelling was not a problem if have a safe journey,but other's are not.

Awaiting for reply,

Vamsee this is a Zombie thread from 5 years ago. You will get more advice if you start a new thread.

Hi Blueberry69,

I know it's been some time since your last post but I can't help but wonder your pregnancy outcome. I too had two LLETZ procedures.
My first pregnancy I had an emergency cerclage at 23weeks, water broke at 24weeks and delivered a baby girl at 25weeks at 610grams.

Now I'm on my second pregnancy, had an early cerclage at 12 weeks and started Progesterone at 15 weeks. I'm quite on edge about the pregnancy. Would love here
your story as there is not a lot of research or studies on women with more than one LLETZ.
Xx

Hi @ddfresh05,

As this is a zombie thread, come over and join us over here: www.mumsnet.com/Talk/antenatal_clubs/1776448-The-Short-Cervix-Club

I had my cervical stitch 2 weeks ago and am also on progesterone. There are others sharing success stories and current progress over there.