Help: Anyone have a preventive cerclage with no history of incompetent cervix?

(5 posts)(4 voices)
  1. Hi ladies. I need your input, please!

    I'm 11w prego with twins and I will see my OB at 11w2d for an u/s to decide if I will have a preventive cerclage. I have a DD who is now 2 and did not have any pre-term labor issues and don't have an incompetent cervix. My OB said she likes to place a cerclage on most of her twin pregnancies as a preventive measure (especially those with small frames - I'm 5'2\"), but is leaving it up to me. I don't necessarily want to go through a surgery, where they would give me an epidural, if I don't necessarily have to, but would hate to not do it and heaven forbid something would happen in the coming months.

    Did anyone without an incompetent cervix have a cerclage??? They will need to place the cerclage before week 13 so I need to gather all the facts asap. Thanks!

  2. I can't say I'm in your exact situation, but I will tell you my experience.

    I have a DS who is 4, whom I delivered at 37 weeks with no complications during the pregnancy or delivery.

    Last year I got pg with twins and since I had a previous successful pregnancy, I had no extra monitoring and was treated like a normal pregnant lady. My level 2 u/s showed two healthy boys, and a cervix measuring 4.0 cm. Then at 21 weeks exactly, my water broke on both babies. I was only able to hold onto them for about 36 hours, when labor set in and they were born. They died about an hour later. The doctors do not know why it happened as I was already dilated when I arrived at the hospital. I had chorioamnionitis, but that could have been from being ruptured for 36 hours. Or, it could have caused me to rupture. There is no way of knowing.

    So, my loss could have been caused by an infection, incompetent cervix, pre-term labor, random fluke (1% of women pPROM in pregnancy for no reason) or a combination of the above.

    When I found out I was pregnant with twins again this time around, my OB immediately consulted with a perinatologist and they both decided it was in my best interest to have a preventative cerclage placed. I had a double McDonald done at 13w5d. I am now 23w3d (boys again!) and at my last CL u/s my cervix measure 3.4cm. I had a fetal fibronectin test done on Thursday that came back negative, so I'm probably going to make it at least another two weeks, and hopefully many more! I am also on 17p injections weekly and Procardia (20mg every 6 hours) to keep PTL away.

    You have a difficult decision to make, because the cerclage can also cause problems--infection being the most common. But, with regular swabs and frequent monitoring, a preventative cerclage is generally safe. Emergent cerclage (done when you're already dilated or funneling with membranes bulging) are much riskier. The procedure itself is pretty easy to recover from; just a couple of days lying around afterwards and you should be good to go.

    Good luck with your decision and let me know if you have any questions about the procedure!

  3. Hi Patty,
    I have never heard of a dr placing preventative cerclage with no signs of any problems in current or previous PG. At least not on this board. I would get a second opinion before commiting to the surgery.

    Sara, very sorry to hear about your tragic second PG!
    I wish you a long and unevetful PG this time!

    Jen 34w b/g twins, 5'4\" but my body is very short, I got longer legs. Plus I have problems with my spine that make my body even shorter and give me backpain during PG .

  4. Sara, I'm so sorry for your loss, and congrats on your current pregnancy with twins again! Thanks a ton for the information. I will be seeing a peri next week and will ask his for a second opinion. My cervix measured 6cm this past Monday so for now, no cerclage. I will be monitored very closely b/c I have 2 large cysts, so once I see my peri and have another scan at 14 weeks by my OB we'll decide then. Thanks again and many blessings to you and your twins.

    Jenny, you are right, I have not been able to find any info on having the procedure without any prior history to be concerned about. A second opinion from a peri would be best. Thanks!

  5. Unless you have a clear indication--previous incompetent cervix, a known cervical anomoly, cervical surgery/cone biopsy etc, the recommendation is not to do do it. You are risking infection, rupturing your membranes, plus all of the sideffects of spinal anesthesia. Because you are pg with twins they should do a cervical scan (vaginal) every 2-3 weeks and monitor the length and check for funneling. If there is found to be shortening and/or funneling than you might want to discuss doing a cerclage. No one knows what will be either way (if you do it, or not), but you need to make a decision that makes the most sense to you. FWIW, I got pg with twins (well, started off as triplets from IVF#6), and although it was a difficult pg (bedrest, uterine irritability, several trips to L&D), I thank G-d made it to 37 weeks, and I am 5'2''. I also consulted with several perinatalogists when I first found out I was pg with triplets and they all said that unless there is an outright indication none of them recommended a cerclage. Good luck to you!!

    Sara-I am so sorry for the loss of your twins... I hope that this twin pg will go smoothly for you!

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