My Ordeal after a cerclage at 21 weeks

amysl

New Member
While this forum is meant to be a happy place, i want to share my painful experience to ensure all mummies to be, take care and not to only listen to 1 gynae's advise when a surgery is involved. Regardless how small a surgery can sound like, the position of the Gynae and even if its someone you think you can trust.

My short cervix was discovered at week 19. The 2nd trimester scan - tranvirginal ultrascan was optional. Not even mandate. I was advised to put a cerclage. My Gynae advised it was common and the success rate is 85 percent of carrying baby to full term. As I only reviewed my scan with him on Week 20, the ops was done on Week 21.

4 days after the cerclage ops, my water bag ruptured. i was admitted on the 4th Jul 2015. There the long fight began. It was called PPROM - Preterm premature rupture of membrances. While the gynae wanted to terminate the pregnancy and 'save my life', however, I was still adamant to save my baby and fight the infection. All mummies advised me to give baby a fighting chance. The day by day readings did not help. My white blood cells count escalated from 11, 13, 14, 16 and eventually 31. CRP (C Reactive Protein) skyrocketed until *187. The reference should be <5.

The first 5 days of hospitalization, I drank tons of fluid to recover my water bag. The scan reviewed AFI (Amniotic Fluid Index) was still good and baby's heartbeat still good. I was hopeful. As there was no fever (yet), I clinged onto the hope that my membranes can spontaneously recovered. Wishful thinking. I had a 2nd Gynae opinion in the same hospital and he was grim. Reason being only a infection can caused the membrane to rupture and once infected, baby literally has no chance at all. I debated with the idea of a preterm baby. However at 23 weeks, even baby's survival is tough, furthermore, there WAS a INFECTION!. Gynae warned me of blood infection, infertility, further complications. All these didnt mean anything at that point.

Finally fever set in on Fri, hit 40 degrees, onto heavy anitbiotics now. Sat, bad contractions but those you have to bear and not to push out. Remembered I was still on the hope of fighting the infections? hence i didnt want the cerclage to be cut yet. Sun, the pain was so intense, indescribable. Literally 5 mins each time lasting 20 secs and for a long long long time. Many antibiotics and strong painkillers and sleeping pills, I passed the night. The threatre was booked on Mon 9am to cut the string. My partner knew baby was gone on Sat. Baby bidded Daddy goodbye. We didnt want or dare to measure baby's heartbeat on Sun anymore. In pain, physically and emotionally, we stitched our little baby's clothes.

Mon 9am, I had the unstitch ops. As baby has already passed away, there were medications to help me induce labor. Baby was so handsome. Finely formed. Good features just like his dad. We cried hard. We held baby. We are proud of you for fighting with Mum, we were sorry that the world is not ready for you. Go in peace Baby. The angels are with you now. We called the undertakers and arranged for cremation.

I was discharged the following day, after 11 days. Sadly, this day was my birthday. While the nurses were kind to give a little Happy Birthday song and cake, I cant imagined how this birthday will haunt me forever. My partner and I grieved once again. I struggled with the afterbirth pain, still feel and looked like 5 months pregnant, uterus contractions pain, we went to shop for some little toys and baby's temporary urn, a music box from Precious Thots, printed Daddy & Mummy's photo to burn for Baby to remember us. We then went to the undertakers to dress baby.

Went through the night with baby's face flashing up each time I closed my eyes. Tears flowed involuntary. We went for the cremation in the afternoon as scheduled. Bye our handsome child. We will see you again. Non-stop crying the night. Not at peace yet. The next day, we finally took back Baby's ashes home. We had placed order for a very unique urn to be shipped from USA. Meanwhile, we had him in the bedroom, where we had wanted him to be, with us and our 2 dogs.

As if pain is my best friend and in lots of disguise he had, a new pain began.

Dealing with postpartum was something i least expected. I didnt even know of this word. Well, among many other new words and abbreviations I had recently learnt. Technically a mother's body, but with confused hormones. Totally unprepared. Gynae did not advise me what to expect, nor give me the medi to stop lactation.

The important sharing.
1. History - I had cervix infection few years back, did -52 degress Celsius freezing, did a LEEP surgery as there were still bad pre-cancerous cell existence, followed by a 1 yr hormones therapy and then, I had a endrometrosis cyst and required another keyhole surgery.

This is the 'probable' result of a short cervix. After all the readings, I realised that the gynae should have put in a cerclage as early as Week 12 /13. Remember the transviginal ultrascan at 2nd Trimester was optional. It could have never be discovered. This is the 1 reason you will read that no reason was given to Mothers who lost their babies at T2. Maybe one day they will eventually learn, maybe unfortunately after a few miscarriages.

2. Preempt
I went back to the same doctor. He is a Senior and RD. (i think RD stands for Resident Director or the R for that hospital name) He is definitely not cheap. The reason i choose him was because, he was the doctor who did all my operations. I did enquire about incompetence cervix, he said well, not really because my T1 was good. No spotting, no bleeding etc. That sometimes, short cervix can happened. I asked if I can continue my normal routine. Daily walking and weekly swimming. I was told yes.

Once again, the good answer should have been NO. Reason being the history of cervix infection and LEEP can result in short cervix. Activities should have eased after T1. So as to prevent unnecessary weighing down onto the cervix as possible once the cerclage is in place at the earliest possible.

3. 2nd Opinion and understanding the risks appropriately
While you trusted the Gynae, you trusted his opinion. Like many laymen, this is not wise at all. He told me the success rate of cerclage was 85% and informed me the risks lightly. Lightly being, he drew a picture of the cervix, how to stitch and wrote down the risks, 1. infection, 2. tear, and 3. bleeding. Did we go into the details of each risk scenarios? No. He did not give me the alternative of NOT doing the cerclage either. He merely said this is a common practice for short cervix and to prevent premature baby.

Let me share on these.
Infection - this word didnt mean a lot then but now i could fully comprehend.
Infection can be as bad as resulting in infertility, blood poisoning and complications such as non immunity to antibiotics in future. I wouldnt explain about infertility nor the non immunity to antibiotics. However, how many people actually understand about the meaning of blood poisoning? It send down chills each time i recalled my fight in the hospital. My friends asked me the risks and i said then, blood poisoning? well, given today technology, i dont think i will die. Now, mind you, Blood poisoning is worst than death. You probably had read that some mothers lost their fingers or toes. Blood poisoning means your body unable to function due to the infection and affecting the blood stream and its functions to deliver and ensuring the body organs to function. Worst than death.

What was my alternative if I had understood the risks and NOT do the cerclage?
Bedrest could have been ordered and I try as much as possible to have baby in me, until 24 weeks and above. Each week gestation indicates a higher rate of survival. What if the water bag ruptured? Baby can be premature and fight in ICU, however there will be no infection risks as there was no stitch. Be informed and be prepared of managing a preemie. No guarantee but at least, a chance there.

My partner was shocked when he saw the stitch tape. It was 2 to 3mm. My cervix measured at Week 19 was 1.2cm. How much was it left at week 21? Let's take it as 8mm. Then again, 8mm. It was a spell for disaster. Literally waiting for the infection to happen. I did asked if i needed antibiotics after the cerclage ops. I was told by my gynae that the anesthesia doctor advised not to have antibiotics.

4. What happens after stillbirth/miscarriage?
It is not as easy as that the gynae had advised. He said I will bleed / spot for about 2 to 4 weeks. Nope. It was dealing with the postpartum / postpartum depression. Technically I am a Mother. My body thinks there is a baby and started lactating. My breasts swelled to 4 times its size. Solid hard as rock, pain like hell and my arms couldnt be lifted up. I cant turned once I lie down in bed. I slept 2 days sitted.

What could have been done?
Proper advise on postpartum/ postpartum depression, what to be expected and how to deal with it. Given the appropriate medi to stop lactation and painkiller to ease the pain as required. Arrangement for your confinement to be continued. (if affordable and applicable as was planned) My partner had to run to my GP, get the prescription letter, to 2 pharmacies before having the medi.

My GP was thoroughly disgusted. There were lots of 'Didnt your gynae tell you?' My friends want me to name and shame. My partner and I wont pursue, neither will we name and shame. It wont bring our baby back. We had learnt through the hard way and once is more than enough. I had always pride myself as being well informed as I read alot. However, you do not googled the things unheard of. You merely looked for the knowledge and information when as needed or chanced upon.

Mothers, Mothers to be, I pray for you and your little ones. It is not easy being pregnant for such a long time. Stay good, Be informed, be aware. I hope this sharing goes a long way.

amysl
 

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My deepest condolences to you and your partner.

It must have been extremely difficult to relive the whole experience by writing it down.

Thank you for sharing your story with everyone.
 
Sorry to hear about your loss.. Please take care and hope you will be blessed with a rainbow baby soon. Thanks for sharing..
 
Hi, I know exactly how you feel. I lost my baby at 20 weeks too in Feb. The postpartum depression cum engorgement was unbearable. I even avoided shopping as the sight of seeing pregnant woman and babies reminded me of my pain. It's hard not to think about it, but trust me, time will heal the pain gradually.

I pray that you and your hubby will be able to move on from this soon. Pray that you will have a rainbow baby soon! Hugs...
 
Thanks gals for the blessings. It has been tough. I wish to recover soon. Body Just feels so funny. Sorry to hear ur lost. Do take care.

I wish us all be bless with a good pregnancy and beautiful kiddos to come.
 
Yes, the body will feel funny. I took TCM to recuperate the body after the miscarriage and find it helpful.
 
Hi amysl
I am so sorry for your loss. Teared up while reading it. Like you I also underwent a Leep procedure and was told that pregnancies thereafter may be more fraught. I followed up with the same Dr when i fell pregnant some months later. I was watched like a hawk for changes to cervix weekly nearing 2nd tri and we caught it (we elected to wait and see how short it will go) in time stitiching up when it was around 1.2cm at 15wks.

I strongly believe your Dr was very unprofessional in that he did not advice you on the risks after having had a Leep, not prescribing you with a short course of antibiotics during and days immediately after surgery and starting with a trans muacular jab of progesterone weekly and not telling you to severely restrict your activities. Am now on 2nd tri with no2 and the protocol from Dr is no different.

Your loss and pain could have been very preventable. Please, please do go to another Dr when you are blessed with another and never settle for less than fortnightly trans vaginal scans with measurement each time.
Do rest and recover well. If you like I can also share with you more in depth of my cerclage journey and my gynae.
 
I teared while I read your article...God bless and may you recover soon from your ordeal both physically and mentally.
 
Thanks kookynooky. I will not go back to him anymore. Totally irresponsible and just waiting for things to happen. how to i pm you? Not good with this appls.

Thanks folks for your well wishes. Body has more or less recovered. Except for that hand that was Poked many times for 11 days stay, still swollen. But all is good now.

Recovery and strengthening Now.
 
Hi amysl
I am so sorry for your loss. Teared up while reading it. Like you I also underwent a Leep procedure and was told that pregnancies thereafter may be more fraught. I followed up with the same Dr when i fell pregnant some months later. I was watched like a hawk for changes to cervix weekly nearing 2nd tri and we caught it (we elected to wait and see how short it will go) in time stitiching up when it was around 1.2cm at 15wks.

I strongly believe your Dr was very unprofessional in that he did not advice you on the risks after having had a Leep, not prescribing you with a short course of antibiotics during and days immediately after surgery and starting with a trans muacular jab of progesterone weekly and not telling you to severely restrict your activities. Am now on 2nd tri with no2 and the protocol from Dr is no different.

Your loss and pain could have been very preventable. Please, please do go to another Dr when you are blessed with another and never settle for less than fortnightly trans vaginal scans with measurement each time.
Do rest and recover well. If you like I can also share with you more in depth of my cerclage journey and my gynae.

Hi Kooky

I have a previous leep done too. And am 4 weeks pregnant. Im overwhelm with fear and anxiety.. could u share your experience with cerclarge and your gynae with me?
 
Im so sorry for your loss. I pray for peace and Gods strength to be with you amysl. It broke my heart to read your story. Thank you for sharing. Have a good recovery.
 
Hi Kooky

I have a previous leep done too. And am 4 weeks pregnant. Im overwhelm with fear and anxiety.. could u share your experience with cerclarge and your gynae with me?


Hi Polly Molly
You can watsapp me. My no is listed above. No need to be too anxious now, first trimester is generally safer than second which is when the bulk of miscarriages occur for patients like us.
 
Hi Kooky

I have a previous leep done too. And am 4 weeks pregnant. Im overwhelm with fear and anxiety.. could u share your experience with cerclarge and your gynae with me?

Hi Polly
Sorry didnt have much time to write much previously as kiddo kept interrupting. You may want to try looking up my gynae. She operates out of MENH but can deliver at TMC too. Dr Lee Lih Charn or commonly known as LC Lee. Her clinic is LC Lee Urogynae Center. I would suggest you make an appointment to see a dr or her by your 6th week or 8th latest. Do let her or your gynae know that you had a Leep procedure done before.

You can expect close monitoring once you hit 12wks. Close as in weekly to fortnightly checkups to check cervical length. As Dr Lee is extremely cautious and conservative, you will be expected, if proven to have cervical incompetence, to abstain from swimming, sex, and most other activities once the cerclage is in place ( if you choose tp dp a cerclage). She will also advise you to take Mc or Hl for the entire duration till 35-6wks when it is removed.

If you choose to go to other gynaes, make sure they do not brush off your Leep, as a very large percentage do go on to have cervical incompetence. If they are as flippant about it as was the case with amysl, then you better run to another. But make sure you have a fixed dr by the time you hit 2nd trimester .
 
While this forum is meant to be a happy place, i want to share my painful experience to ensure all mummies to be, take care and not to only listen to 1 gynae's advise when a surgery is involved. Regardless how small a surgery can sound like, the position of the Gynae and even if its someone you think you can trust.

My short cervix was discovered at week 19. The 2nd trimester scan - tranvirginal ultrascan was optional. Not even mandate. I was advised to put a cerclage. My Gynae advised it was common and the success rate is 85 percent of carrying baby to full term. As I only reviewed my scan with him on Week 20, the ops was done on Week 21.

4 days after the cerclage ops, my water bag ruptured. i was admitted on the 4th Jul 2015. There the long fight began. It was called PPROM - Preterm premature rupture of membrances. While the gynae wanted to terminate the pregnancy and 'save my life', however, I was still adamant to save my baby and fight the infection. All mummies advised me to give baby a fighting chance. The day by day readings did not help. My white blood cells count escalated from 11, 13, 14, 16 and eventually 31. CRP (C Reactive Protein) skyrocketed until *187. The reference should be <5.

The first 5 days of hospitalization, I drank tons of fluid to recover my water bag. The scan reviewed AFI (Amniotic Fluid Index) was still good and baby's heartbeat still good. I was hopeful. As there was no fever (yet), I clinged onto the hope that my membranes can spontaneously recovered. Wishful thinking. I had a 2nd Gynae opinion in the same hospital and he was grim. Reason being only a infection can caused the membrane to rupture and once infected, baby literally has no chance at all. I debated with the idea of a preterm baby. However at 23 weeks, even baby's survival is tough, furthermore, there WAS a INFECTION!. Gynae warned me of blood infection, infertility, further complications. All these didnt mean anything at that point.

Finally fever set in on Fri, hit 40 degrees, onto heavy anitbiotics now. Sat, bad contractions but those you have to bear and not to push out. Remembered I was still on the hope of fighting the infections? hence i didnt want the cerclage to be cut yet. Sun, the pain was so intense, indescribable. Literally 5 mins each time lasting 20 secs and for a long long long time. Many antibiotics and strong painkillers and sleeping pills, I passed the night. The threatre was booked on Mon 9am to cut the string. My partner knew baby was gone on Sat. Baby bidded Daddy goodbye. We didnt want or dare to measure baby's heartbeat on Sun anymore. In pain, physically and emotionally, we stitched our little baby's clothes.

Mon 9am, I had the unstitch ops. As baby has already passed away, there were medications to help me induce labor. Baby was so handsome. Finely formed. Good features just like his dad. We cried hard. We held baby. We are proud of you for fighting with Mum, we were sorry that the world is not ready for you. Go in peace Baby. The angels are with you now. We called the undertakers and arranged for cremation.

I was discharged the following day, after 11 days. Sadly, this day was my birthday. While the nurses were kind to give a little Happy Birthday song and cake, I cant imagined how this birthday will haunt me forever. My partner and I grieved once again. I struggled with the afterbirth pain, still feel and looked like 5 months pregnant, uterus contractions pain, we went to shop for some little toys and baby's temporary urn, a music box from Precious Thots, printed Daddy & Mummy's photo to burn for Baby to remember us. We then went to the undertakers to dress baby.

Went through the night with baby's face flashing up each time I closed my eyes. Tears flowed involuntary. We went for the cremation in the afternoon as scheduled. Bye our handsome child. We will see you again. Non-stop crying the night. Not at peace yet. The next day, we finally took back Baby's ashes home. We had placed order for a very unique urn to be shipped from USA. Meanwhile, we had him in the bedroom, where we had wanted him to be, with us and our 2 dogs.

As if pain is my best friend and in lots of disguise he had, a new pain began.

Dealing with postpartum was something i least expected. I didnt even know of this word. Well, among many other new words and abbreviations I had recently learnt. Technically a mother's body, but with confused hormones. Totally unprepared. Gynae did not advise me what to expect, nor give me the medi to stop lactation.

The important sharing.
1. History - I had cervix infection few years back, did -52 degress Celsius freezing, did a LEEP surgery as there were still bad pre-cancerous cell existence, followed by a 1 yr hormones therapy and then, I had a endrometrosis cyst and required another keyhole surgery.

This is the 'probable' result of a short cervix. After all the readings, I realised that the gynae should have put in a cerclage as early as Week 12 /13. Remember the transviginal ultrascan at 2nd Trimester was optional. It could have never be discovered. This is the 1 reason you will read that no reason was given to Mothers who lost their babies at T2. Maybe one day they will eventually learn, maybe unfortunately after a few miscarriages.

2. Preempt
I went back to the same doctor. He is a Senior and RD. (i think RD stands for Resident Director or the R for that hospital name) He is definitely not cheap. The reason i choose him was because, he was the doctor who did all my operations. I did enquire about incompetence cervix, he said well, not really because my T1 was good. No spotting, no bleeding etc. That sometimes, short cervix can happened. I asked if I can continue my normal routine. Daily walking and weekly swimming. I was told yes.

Once again, the good answer should have been NO. Reason being the history of cervix infection and LEEP can result in short cervix. Activities should have eased after T1. So as to prevent unnecessary weighing down onto the cervix as possible once the cerclage is in place at the earliest possible.

3. 2nd Opinion and understanding the risks appropriately
While you trusted the Gynae, you trusted his opinion. Like many laymen, this is not wise at all. He told me the success rate of cerclage was 85% and informed me the risks lightly. Lightly being, he drew a picture of the cervix, how to stitch and wrote down the risks, 1. infection, 2. tear, and 3. bleeding. Did we go into the details of each risk scenarios? No. He did not give me the alternative of NOT doing the cerclage either. He merely said this is a common practice for short cervix and to prevent premature baby.

Let me share on these.
Infection - this word didnt mean a lot then but now i could fully comprehend.
Infection can be as bad as resulting in infertility, blood poisoning and complications such as non immunity to antibiotics in future. I wouldnt explain about infertility nor the non immunity to antibiotics. However, how many people actually understand about the meaning of blood poisoning? It send down chills each time i recalled my fight in the hospital. My friends asked me the risks and i said then, blood poisoning? well, given today technology, i dont think i will die. Now, mind you, Blood poisoning is worst than death. You probably had read that some mothers lost their fingers or toes. Blood poisoning means your body unable to function due to the infection and affecting the blood stream and its functions to deliver and ensuring the body organs to function. Worst than death.

What was my alternative if I had understood the risks and NOT do the cerclage?
Bedrest could have been ordered and I try as much as possible to have baby in me, until 24 weeks and above. Each week gestation indicates a higher rate of survival. What if the water bag ruptured? Baby can be premature and fight in ICU, however there will be no infection risks as there was no stitch. Be informed and be prepared of managing a preemie. No guarantee but at least, a chance there.



amysl
Hi, thanks for sharing. It's been almost a year since you posted. Wondering how you got along? I had a similar experience last week. My cerclage was placed at week 13 but I think the one week course of antibiotics didn't help. A week after the cerclage, my gynae put his gloved finger in to feel the stitches and it hurt me so badly that I yelled. The next day I started bleeding n had to be warded for five days. I too had high fever, elevated white blood cell count and blood poisoning for which I am still taking very strong antibiotics for now. We just buried our baby who was 14 weeks. This is my second loss at 14 weeks. I don't know how I am going to find answers for this. I am thinking if I really hv incompetent cervix or just a tendency to hv infections when pregnant that cause me to have contraction-like feelings (I hv never given birth so dunno how they feel). like you, I too wondered how can I get potentially fatal blood poisoning in modern Singapore???
 
Hi Lady P and all,

It has been more than a year. I'm now almost 29w preggy and hanging on well. Changed a new gynae who also advised on cerclage cos of the short cervix 2.3cm at week 16. However, placenta was Low lying and the risks of Not being successful was much higher. We hang on until week 23. I was funnelling and left with 1.3cm I was advised to stitch, the placenta has moved and it's a better chance now. Still.. i did not want to. Instead, I admitted myself to KKH and was monitored closely for 2 weeks. Finally discharged at week 26. I had steroids shots. Since week 6, i have oral progesterones, insert progesterones and weekly jab progesterones. These supported my pregnancy well and kept the cervix quiet. I had slight bleeding on week 16 and gynae upped my dosage. I was put on antibiotic on week 20 to prevent any infections and nifedipine to prevent cramping. Looking forward to my rainbow baby.
 
Hi, thanks for sharing. It's been almost a year since you posted. Wondering how you got along? I had a similar experience last week. My cerclage was placed at week 13 but I think the one week course of antibiotics didn't help. A week after the cerclage, my gynae put his gloved finger in to feel the stitches and it hurt me so badly that I yelled. The next day I started bleeding n had to be warded for five days. I too had high fever, elevated white blood cell count and blood poisoning for which I am still taking very strong antibiotics for now. We just buried our baby who was 14 weeks. This is my second loss at 14 weeks. I don't know how I am going to find answers for this. I am thinking if I really hv incompetent cervix or just a tendency to hv infections when pregnant that cause me to have contraction-like feelings (I hv never given birth so dunno how they feel). like you, I too wondered how can I get potentially fatal blood poisoning in modern
How are u doing? I don't know how to pm u.
 
Hi Lady P and all,

It has been more than a year. I'm now almost 29w preggy and hanging on well. Changed a new gynae who also advised on cerclage cos of the short cervix 2.3cm at week 16. However, placenta was Low lying and the risks of Not being successful was much higher. We hang on until week 23. I was funnelling and left with 1.3cm I was advised to stitch, the placenta has moved and it's a better chance now. Still.. i did not want to. Instead, I admitted myself to KKH and was monitored closely for 2 weeks. Finally discharged at week 26. I had steroids shots. Since week 6, i have oral progesterones, insert progesterones and weekly jab progesterones. These supported my pregnancy well and kept the cervix quiet. I had slight bleeding on week 16 and gynae upped my dosage. I was put on antibiotic on week 20 to prevent any infections and nifedipine to prevent cramping. Looking forward to my rainbow baby.
Hi can i know what antibiotics you have put on to prevent infection?
 

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