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  1. #1
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    Default Incompetent cervix

    Hi everyone

    i lost my angel Ethan at 24weeks 2 days last week. It's been a terrible road from there. The only thing keeping me going right now is preparing for pregnancy again. I'm 42 so I don't have time on my side.

    can anyone recommend a good ob in Sydney or newcastle that has a lot of experience with cerclages and IC? Also, is there anything I can do to strengthen the cervix? I heard raspberry leaf tea can strengthen the uterus but could be just a wives tale.
    Thanks so much

  2. #2
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    I don't have any idea about the obs sorry but just wanted to say how sorry I am for your loss and I'm sure your baby boy is watching over you this Christmas Day. Perhaps you could select which hospital and see if they have a list of obs on their website or maybe through your health insurance if you have any?

  3. #3
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    Default Incompetent cervix

    Hi erika

    I'm so sorry for your loss. It must be a terrible thing to grieve over Christmas. But take heart that soon after Christmas brings a New Year and new hope. You are showing great strength and resilience to try to move on and plan for pregnancy again.

    I, too, have an incompetent cervix. My son, who is now 15 months old, was almost lost at 22 weeks. We conceived him first try, just after we got married. At 22 weeks, i suddenly started experiencing strong, painful and continuous contractions. My husband rushed me into hospital, where an ultrasound and my ob revealed to me that my cervix was rapidly shortening. My cervix went from 4.2cm to 2.2cm in one day. She told me i was at risk of losing our baby as my body was preparing for labour.

    I spent 2 weeks i hospital and then 4 months on strict bedrest at home, but miraculously managed to carry our son to 39 weeks. I was on Nifedipine every 4 hours to soften the contractions, but they did still continue nonstop, although not as strongly, until the end of my pregnancy. I was on progesterone pessaries which i had to insert every 6 hours and push them up against my cervix. The hormones were supposed to harden my cervix and stop it from shortening. It stayed at 2.2cm until the end of my pregnancy. The only time i got out of bed or the couch was for a short walk each day, to go to the hospital for checkups and ultrasounds, and to go to the toilet/shower/eat. The horizontal position kept the pressure off my cervix. But my muscles were literally wasting away.

    It was not an easy 4 months, but i hung on to every prayer from my loved ones and listened to every instruction from my ob. Even my ob was praying for me. Each hour, each day, each week and each month was agonisingly long, but every bit of progress was received with relief and thankfulness.

    In the end, my waters broke exactly at 39 weeks that morning and we rushed into hospital. My labour was 3 hours and i pushed for an hour and he was in our arms. It was a short and easy birth compared to the long and fearful second half of the pregnancy. After all, my body was more than ready - it had been preparing for 4 months!

    My ob works at Sydney Adventist Hospital. She is excellent, although a little bossy hehehe, but she sure knows her stuff when it comes to managing high risk pregnancies. She will make sure you take every precaution and enforce a "better safe than sorry" approach. She is also a family friend. Let me know if you have found any of this helpful or if you have questions. All the best.
    Last edited by mimimama; 25-12-2014 at 16:58.

  4. #4
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    I'm so sorry for the loss of your baby. I lost my last bub at 27 weeks 12 months ago but due to a cord accident not IC.

    I have had 2 vaginal cervical sutures done by Dr Miller in Hurstville & a transabdominal cervical suture (permanent) done by Dr Greg Cario also in Hurstville. My ob referred me to Dr Cario as not many drs do the trans abdom stitch by laparoscopy because it's a more complicated procedure. If you have any questions, let me know.

  5. #5
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    Hi Naomimiprincesa

    That is a wonderful story. I'm so glad it worked out for you. I spent a week in hospital, 2.5 days in that trellenberg position (lying on a slant head down) and another week at home on strict bed rest. Unfortunatley I had to go back into hospital to investigate some fluid leaking on a Sunday and the registrar on used a faulty machine to scan for amniotic fluid. she made the call that my sac had broken and removed my stitch. I was in labour one day later and Ethan arrived the day after that. It was the most heartbreaking time of my life, especially since the sac had never broken. It was misdiagnosed. He was my miracle baby and it was taken from me so harshly.
    Please let me know the details of your ob. I want to make sure this never happens again and that also I get the best advice early on. I cannot bear another loss. This has been 4 now and the next one I will carry to term and deliver safely and healthily

  6. #6
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    thanks Jenga, I will look him up. I am based in Newcastle, so here is better, but I'm willing to travel to sydney for the best advice if I can find it.

    When did they put your trans abdom stitch in? Why did he choose that method over the cervical stitch? Was it because there are better outcomes?

  7. #7
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    I'm so sorry for the loss of your little boy. This must be a very tough time for you.

    I can't speak for all OBs (and I'm in Brissie, so can't recommend anyone), but many will only consider a TAC after a TVC has failed, because of the additional invasiveness. I'm not sure that they would technically consider yours a "failure" in this situation, because of the other circumstances with the stitch being removed, etc.

    I'd expect that in a future pregnancy, most would likely recommend a prophylactic TVC, placed around the 12w mark as a preventative measure. Progesterone has been shown to be effective in preventing PTL, and is often used in conjunction with prophylactic cerclage. They would usually also do fortnightly ultrasound monitoring of the cervix length, starting around the 16w mark, because then they would typically notice any changes to the cervix, and be able to act accordingly.

    However, given the circumstances, and your age, I think you would be within reason to push for a TAC if you were inclined. A TAC does need to be placed pre-pregnancy though, and having one placed can interfere with your fertility by making it more difficult to fall pregnant naturally, which could also be an issue from an age perspective. Not so much of a problem if you were doing IVF though.

    Keeping all that in mind, prophylactic TVC do have a really high success rate - much higher than emergency ones placed in the second tri. They are not 100% effective, but do work in most situations. It's a pretty personal decision as to what will make you feel comfortable.

    If you haven't already, perhaps Google "Abbyloopers", which is a TAC-specific support forum. It could be worthwhile from a research perspective, as my input is only based on my experience, and also my own research.

    ETA: apologies, for some reason I thought you had had a successful prior pregnancy. Were your other losses unrelated? (I'm currently 32 weeks, pregnant for the eighth time, after seven losses).
    Last edited by HamsterHoney; 26-12-2014 at 10:20. Reason: Oops

  8. #8
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    Hi hamsterhoney

    oh wow 8 losses that is terrible. We're they all miscarriages? I had two miscarriages at around 10 weeks, one trisomy 21 termination at 14.5 weeks (they said it was unlikely bub would make it to term) and then my little miracle baby Ethan who was perfect but then I lost him to IC. I feel I let him down. Saddest day of my life watching him try to breathe and die in my arms. I wouldn't wish it on the most despicable person on earth.

    thanks for the info on TAc. The doc who has looked after me in public hospital here does seem quite good. She is suggesting half tab aspirin while trying to conceive and then close monitoring of my cervix with a stitch put in around the 16 week mark. I guess at this stage I don't know how good my cervix is and how much intervention I need, but from what I have read so far the TVC or TAC has good outcomes and you may not need to do lengthy bed rest.

  9. #9
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    I was 9 weeks pregnant when they put it in. It's amazing what they can do! I went for my first ob appt with a new ob (he actually delivered my daughter by emergency csection and then looked after me when I had a 15 wk m/c because my ob was away both times) & he consulted with Dr cario that afternoon (wed) & he called me Thursday to say they had me booked in for surgery on the Friday. They chose the TAC because my cervix was very difficult to stitch vaginally both times due to a previous cone biopsy so they thought this would give me the best chance of carrying to term. As mentioned before we lost that baby at 27 weeks (unrelated to the stitch) & we chose at the time to have the stitch taken out during the csection because after 2 consecutive losses we didn't think we would want to get pregnant again. If we do want to try again they will put the stitch in before pregnancy to get the best result.

    Benefits
    *Stronger stitch can be placed at the top of the cervix rather than the bottom.
    *can be permanent if you are planning more than one child.

    Disadvantages
    *Laparoscopic surgery with recovery time - 4 puncture wounds.
    *More expensive than TVC
    *Requires a csection whereas a TVC be taken out before delivery this one is permanent/can only be taken out by laparoscopic surgery or csection.

    I'm unsure about the potential difficulties with conceiving whilst having the stitch in as I was already pregnant at the time and whilst my ob didn't seem to think it's an issue this is a point I would like discussed in depth prior to the surgery if we considered another pregnancy.

    If you have a TVC placing the stitch at around 12 weeks has a much higher success rate than an emergency stitch placed later in pregnancy but I guess it would depend on your circumstances, length of cervix etc. either way ensure you are monitored regularly.

  10. #10
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    Hi jenga

    Thanks for that information. I'm interested in at least talking to dr cario. I really need to research this and find the best option. I am positive I can get pregnant again and carry the baby to term, and I think I deserve it!!!


 

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