Emergency cerclage & bedrest

I went for my weekly cervix check with my peri, DrGav, on Tuesday.  I was a pretty happy and healthy little chick as I bebopped into the office. Things were great, I could feel the babies move here and there, a little tap, a slight jiggle when I didn’t expect it.  I had a walk in the sun the day before.  Life felt normal and good.  Got results back from karyotyping amnio test, but am still awaiting the final CGH microarray results.  So far no problems, but I want to save that post until all results are in.

As you may or may not recall, during my 16 week ultrasound, they noticed a blood clot right behind the top my cervix.  DrGav was concerned about this as it could cause irritation to the cervix and wanted me to see him for a cervical check every week until things looked fine.  A week later, I had a tiny bit of spotting and while the cervical check measured 3.5cm and closed, I was asked to come again in one week for another check.  On week later, two days ago, Tuesday came and I went in for my cervical check, which involves our good friend, dildocam, aka “Wanda”.  The babies were checked briefly, their heartbeats were fine and they seemed active.  Then the ultrasound tech started checking my cervix.  She looked both with the abdominal and vaginal transducer.  She had me move a bit and push to see how it was reacting.  She was very nice and didn’t give away too much, but at the end of the exam, told me to stay put and wait for DrGav as he may want to double check things himself.

He checked me out with Wanda and then started talking to me and the ultrasound tech.  He pointed out that the internal cervical os was completely open, that there was significant funneling (even I could see it with my untrained eye) and while my external os was currently closed, I had the beginnings of effacement.  The diagnosis:  Incompetent Cervix.  My cervix had gone in one week from 3.5cm and closed to .6cm with funneling.  I felt absolutely no cramping, no pain, no contractions and there was no spotting.  It’s very scary to know that it all could have been lost so easily.  The only thing keeping my babies from harm was my placenta previa.  The edge of the placenta of baby A was still stretched over the top of the cervix and acting as a bridge, keeping it from splitting wide open.  The previa was moving and getting near the edge of when it was going to break free.  A manual check of my cervix was also found to be very soft, which could allow for dilation starting at any time. 

DrGav and I discussed the situation.  We decided that this was all looking very dire.  His recommendation was to place a cervical cerclage.  He did an excellent job of answering all of my questions and describing the procedure, why he was choosing to do it, what type of stitch, etc.  He explained that he preferred the Shirodkar stitch technique. He also wanted to make sure the stitch was placed very high, closer to the internal os as he felt this has worked better for patients in the past.  I was actually very worried about having an incompetent cervix due to my prior uterine surgeries, so I had done many hours of reading on this subject.  I had no problem agreeing to the procedure.  Anything to keep them in here and safe was best.  Even with strict bedrest at 18 weeks, it was very unlikely that they would make it to viability, much less term.  DrGav checked his schedule and the OR at the hospital and we decided to do a cervical cerclage that same day in a few hours.  I went to the hospital, was put on intraveneous antibiotics and had the procedure with a general anesthetic four hours later.  MrBeep came to be with me after work and arrived a few minutes before I went to the OR.  He met with DrGav and discussed the procedure and asked questions.

According to DrGav (he talked to MrBeep after the surgery was complete) it went very smoothly.  I had no bleeding from the placenta, everything seemed to go very well and with no complications.  They checked the babies whose heartbeats were both doing fine. I awoke in recovery with little pain, was dispatched to a maternity ward room and rested for a couple of hours.  The contractions monitor they put on me showed no contractions after the procedure.  I had a tad bit of crampiness, like the day before AF arrives with a vengeance, but it was managed with medicine. I went home that night around 9pm.  I didn’t want to stay in the hospital and DrGav said I could go home if I felt fine.  I had a little bleeding just after the surgery and it’s fading to a smaller amount and today it is just a little bit of pink on the TP.

I am on modified bedrest until my next appointment with DrGav on Tuesday 2/2.  I have a friend who is unemployed right now over as my “official babysitter” for the next few days.  We are giving him a little $ to help him out.  He cooks my food, keeps me company and we needed to do some movie production work this week, so it really turned out well for us both.

Even though this all seems scary and nerve wracking, I am glad and so relieved that we caught it in time.  Many women who have an Incompetent Cervix don’t find out until they have had a pregnancy loss.  It is more common with twins and is most likely to happen between 18-22 weeks.  DrGav is hoping if the cerclage is holding well that I won’t have to be on bedrest for too long, but we’ll see.  I have my little countdown calendar on my browser.  I have 36 days to go until viability (24 weeks), my first goal.  Hoping that in the end it all works out and my monsters are with me for as long as possible.