cerclage or progesterone shots?? please help.

I need to make a decision soon. I'm scheduled to have a stich placed this wed but now i may not need it. My dr had me consult with another dr to find out if I truly have an incompetent cervix. I went into preterm labor at 26wks with my daughter last yr (had an infection in the amniotic fluid) and drs thought it was because I had a weak cervix. After reviewing my history the consult dr does not think I have incomp cervix and that I'm just at risk for going into preterm labor again. He suggested I just need the progesterone shots. I'm very confused and don't know what to do. The consult dr said they don't recommend getting the progesterone shots if a stitch is placed. I'm worried I'll make the wrong decision and lose this baby. If I get the shots what if my cervix starts to change and it's too late for a stitch or what if I get the stitch but still go into preterm labor??? Agh why can't they just tell me what to do. I'm pretty sure my dr wants me to get the cerclage bc he's already scheduled it but now I'm having second thoughts. My cervix measured at 3.4 and a wk later it measured 3.1 and my dr did an internal exam and said my cervix was softening. It sounds like incomp cervix right? I've read some msgs on here that some girls have gotten both the stich and p shots together. Any stories and advice would be greatly appreciated. Thx
REPLIES
By: BabyBumpUser
Member since May 22, 2010
Posted: on Aug 15, 2010
I am 17w now and got my cerclage at 14w. I have incompetent cervix and also went into preterm labor with my son. So I have the cerclage for the IC and will start on the progesterone shots at 20w for the preterm labor.

Did they tell you why they can't do both? I don't really think they should be making you choose between one or the other. If there is a valid reason why they can't do both, the doctor should recommend which option is best for you. It sounds like one doctor thinks it's IC and one doesn't. Maybe you should see a third doctor to break the tie. Or maybe your doctor and the consult doctor need to discuss it together to come up with the best plan for you. I'm sorry you're being put in this position! I would just discuss it with your main doctor more and if you don't feel comfortable see someone else. Sorry, wish I had more advice for you. Good luck with everything!
By: BabyBumpUser
Member since Jul 07, 2010
Posted: on Aug 15, 2010
No I didn't get a real reason just that they recently had a sit down with other drs and they agreed it was best to just get one or the other. I was planning on calling my dr tomorrow and to have him call the consult dr to discuss my case and come up with a plan because this is really stressful.
By: BabyBumpUser
Member since Aug 03, 2010
Posted: on Aug 15, 2010
Hi busybea. I've just had a cerclage at 13w and I'm almost 16w now. In my last pregnancy I had to have hospital bedrest from 28w until delivery at 38w. At that time my cervix had shortened to 2cm and dilated 3cm and there was some funneling of the membranes. I am sure my cervix began to efface a lot earlier (20w or so).

From what I know, it's safest for you and baby to have the cerclage early (13-15w). Later on there will be a higher chance of miscarriage due to rupture of the membranes etc. or the stitch might be ineffective due to effacement or funnelling.

Another option apart from progesterone shots is nifedipine which helps to stop preterm labor. I am currently on voltaren until 25w for inflammation etc associated with the stitch. At 26w I will be on the nifedipine just in case I go into preterm labour.

Good luck and I all the best busybea.

Jessica
By: BabyBumpUser
Member since Jul 07, 2010
Posted: on Aug 16, 2010
Thanks guys for your stories and advice. It's sounds like my dr doesn't have a problem with me getting the stitch and also the shots but we shall see after he talks to the consult dr.

What should I expect during/after getting the cerclage? Were you put on bedrest after having it? Are you getting more ultrasounds to check the cervix?

My dr said a wk or 2 of bedrest then maybe I can return to work since I'm sitting all day and it's not stressful. I only work 2-3 days a wk and really don't want to stop. I need to pay everything off before baby comes. I'm 13 wks today and due Feb 20th. I also have a 13 month old daughter so I'll definitely be a full time mom when baby #2 comes.
Why does having a baby have to be so complicated?
And to top it off my sister is pregnant too. I'm happy for her but at the same time I'm not. She's 18 just finishing hs, has no job, on and off bf and is taking everything about having a baby so lightly. I'm 24, married, have a job, a nice home and can't have a normal pregnancy. I'm not sure I can handle another baby in the nicu. My daughter was in nicu for 5 months and had 2 surgeries and almost died a few times. I'm trying to take it one day at a time but it's very frustrating. I'm sorry for ranting a bit I just need to vent a little.
By: BabyBumpUser
Member since Apr 20, 2010
Posted: on Aug 16, 2010
Busy- I wish you nothing but the best of luck. I hve lost 2 babies in the second trimester. One I went into labor early, 14 weeks, and the other had no heartbeat at 16 weeks. I've been on progestrone this pregnancy since 9 weeks pregnant. I'm now 21 weeks. So far so good. I know what you mean though. Us high risk women who want our babies soo bad... And we have to go through so much to get them here and healthy. Lots of us suffering through many losses to get a healthy baby. It's such a bummer. Then there are women who get pregnant and it wasn't planned, they aren't ready...and they could are less,... But they have easy pregnancies!! I remember about a week after I lost my first son I was at target and I saw a pregnant lady and I got angry,,, I shoulnt have but I couldn't help it!! Good luck with everything and please keep me updated!!
By: BabyBumpUser
Member since May 22, 2010
Posted: on Aug 16, 2010
Busybea, for my cerclage, it was an outpatient procedure. I was at the hospital for about 8 hrs total. They procedure itself wasn't bad. It was just uncomfortable to have my legs up in the stirrups and not too fun waiting for the spinal to wear off, but it was over pretty quick. I spent an hour or so in recovery, them moved to a labor and delivery room where I waited to get the feeling back in my legs. I had to be able to get up and pee on my own before I could go home.

I had a little bit of crampy type pain for a day or two after and some spotting, but it wasn't bad.

I was told to be on bed rest for a couple days after, but that was it. I work from home though so I've been taking it pretty easy most of the time.

I'm now seeing my doctor every two weeks for an internal ultrasound so they can measure my cervical length. That will be increased to once a week later on in the pregnancy (I'm almost 18w now).

I hope everything works out for you. Good luck!
By: BabyBumpUser
Member since Aug 03, 2010
Posted: on Aug 16, 2010
Hi busybea. My cerclage was also as an outpatient procedure. From admission to departure, it took a total of 4hrs. The operation was about half an hour. I had a general anaesthetic before the operation started. When I woke up in recovery I felt soreness and cramping and there was some bleeding. I took paracetamol for it. The cramping lasted about 3 days for me and that's how long I had the bedrest. I took it easy for the first week. I did have a small clot come out the first day but my doctor said it's normal and nothing to be concerned about. I spotted for about a week after the cerclage.

Jessica
By: BabyBumpUser
Member since Aug 03, 2010
Posted: on Aug 16, 2010
Btw I'm getting an ultrasound next week to check on the cerclage. I see my doctor once a month and later in my pregnancy, once a fortnight.
By: BabyBumpUser
Member since Apr 17, 2010
Posted: on Aug 17, 2010
Hi!
I'd say get both! I had a cerclage placed at 12 weeks and am now 37 weeks. I was on progesterone suppositories from about 16 weeks when I had my first contraction until 36 weeks. No problems through the pregnancy, I have had to take it easy but other than that I could pretty much pass as a normal lazy pregnant woman! The only bedrest I did was the week following my cerclage.
By: BabyBumpUser
Member since Apr 11, 2010
Posted: on Aug 18, 2010
I would try to get the 17p shot if possible. I have had two preterm babies, this is my third baby and I will be 34 weeks tomorrow, I have been taking the shots since 18 weeks. Tomorrow is my last shot and I only have had one hospital visit for preterm labor at 29 weeks. So only 5 weeks of bed rest this time (I am off bedrest as of tomorrow-yay!!) I have felt much better this time around because I am not pumped full of meds to stop contractions, although I do have Procardia and Terbutaline filled in case. I have had a great experience with my 17p shots though and i do truly think they helped out my pregnancy a lot, I mostly got to enjoy this pregnancy and not be in constant pain and bedridden for weeks and weeks on end... Best of all NO MAG!!! Hope your doctors talk to you more about it, your cerclage is important but the shot will relax your uterus from contracting and causing any progress. So I would think the two together would be a great combo in getting you to term. Good luck!
By: BabyBumpUser
Member since Jul 07, 2010
Posted: on Aug 20, 2010
@heather
I'm sorry to hear about your losses and that you had to go through something so horrible. I'm glad to hear you're further along and doing well. How's the bedrest going? I think it was you who told me the progesterone shots made you sick. Are they still? I almost laughed when my dr said there's no side effects and that it won't make me sick. But maybe they wont.
Did you get a stitch also and at how many weeks?
By: BabyBumpUser
Member since Jul 07, 2010
Posted: on Aug 20, 2010
@jessiexd
How did your ultrasound go? It's good you only have to go in once a month. I was going in once a week and now it 'll be twice a week.
Hope everything is well.
By: BabyBumpUser
Member since Jul 07, 2010
Posted: on Aug 20, 2010
I had my u/s and dr visit yesterday and am happy that it went well. My cervix measured 3.3cm. Last weeks measurement was wrong at 3.1 so no stitch right now. Anyway my dr, consult dr and a third high risk dr discussed my case a few days ago and came to the conclusion that I get both the cerclage and progesterone shots. Which im so glad they did bc i was starting to look for a third dr to go see. I'll get the shots at 18wks and not sure about the cerglage. I'll be seeing my dr once a wk and u/s every two weeks. I'll be taking it easy now just to be on the safe side. I've been trying not to carry my DD so much. She's almost 20lbs. And it hurts my back and arms. She's heavy. Anyway she just wants to crawl and stand up. So for the moment I'm very happy. Hope everything is going good for you all. Will keep you guys updated.
By: BabyBumpUser
Member since Aug 03, 2010
Posted: on Aug 20, 2010
Hi busybea. It seems like you are being very well looked after by your doctors. I'm glad you have the option of getting the cerclage and the progesterone shots. Your cervical length seems quite good too. And seeing your doctor every week and having an ultrasound every 2wks is very reassuring.


By: BabyBumpUser
Member since Aug 03, 2010
Posted: on Aug 22, 2010
@busybea

Just went for my ultrasound and everything seems to be going well. Baby's heart was beating strong and he is a good size for his dates. The sonographer said everything looks normal. My cervix is surprisingly long at around 3.5cms. My mind is more at ease now.

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