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Is A Healthy Pregnancy Possible When Diagnosed With Incompetent Cervix?
Question: Hello
I had 2 miscarriages at 15 weeks nd 17 weeks due to incompetent cervix. My first pregnancy was a Singleton and without any signs and symptoms my cervix dilated and membranes ruptured.
After a year, I fell pregnant with twins. In view of my history, doctor placed cercelage at 12 weeks itself after NT scan. When ever they do scan, they used to say that I have dynamically active uterus and cervix. I was on total bed rest from 11 weeks.But, at 15 weeks, my cervix opened till stitches and I was having contractions. they gave duvadilan retard medicine to stop contractions. But at 17 weeks, my cervix dilated and I had bleeding nd resulted in miscarriage on 1st April. With these 2 losses, I lost hope to try next time. Can I ever carry baby to full term. If cervical cercelage didn't help this time, how it works next time? How to strengthen my uterus so it will not be irritable next time nd instead of CC can I try for abdominal cercelage. Will that be effective than CC and increase my chances? First pregnancies is spontaneous conception nd 2nd one I used CCQ tablets for ovulation induction. I have PCOD problem from the time of puberty. Can you please advise. If obvious outcome is loosing another baby, I don't want to try again.
I had 2 miscarriages at 15 weeks nd 17 weeks due to incompetent cervix. My first pregnancy was a Singleton and without any signs and symptoms my cervix dilated and membranes ruptured.
After a year, I fell pregnant with twins. In view of my history, doctor placed cercelage at 12 weeks itself after NT scan. When ever they do scan, they used to say that I have dynamically active uterus and cervix. I was on total bed rest from 11 weeks.But, at 15 weeks, my cervix opened till stitches and I was having contractions. they gave duvadilan retard medicine to stop contractions. But at 17 weeks, my cervix dilated and I had bleeding nd resulted in miscarriage on 1st April. With these 2 losses, I lost hope to try next time. Can I ever carry baby to full term. If cervical cercelage didn't help this time, how it works next time? How to strengthen my uterus so it will not be irritable next time nd instead of CC can I try for abdominal cercelage. Will that be effective than CC and increase my chances? First pregnancies is spontaneous conception nd 2nd one I used CCQ tablets for ovulation induction. I have PCOD problem from the time of puberty. Can you please advise. If obvious outcome is loosing another baby, I don't want to try again.
Brief Answer:
Do not lose hope.
Detailed Answer:
Hi,
Thanks for your query.
I understand your concern. I would advice you to first of all not lose hope. By your complaints it is the length of your cervix that is causing the problem leading to incompetent cervix or cervical insufficiency.
Transabdominal cerclage may be successful in women who deliver very
preterm despite placement of a transvaginal cerclage. So I think you should
try transabdominal cerclage.
Last time the cervical cerclage did not work because you had a twin pregnancy. In women with a twin or triplet pregnancy neither progesterone treatment or cerclage reduce the rate of preterm birth. Neither is recommended to prevent preterm birth in these groups of women.
I would suggest you to go for transvaginal cerclage next time if its a singleton pregnancy.
You can try other interventions :
- Pessaries: Though it is not adviced for women with short cervix, but there is 80% reduction in preterm births.
- Indomethacin: Women with a short cervix at 14 to 27 weeks appeared to reduce preterm births <24 weeks of pregnancy.
- Progesterone supplementation: For sustaining the pregnancy which you had taken previously.
- Tocolytics: To prevent uterus contractions which you have taken previously.
- Lifestyle interventions: Cessation of work and exercise, abstinence from coitus, bedrest/limited activity.
It is best to discuss these options with your treating doctor and proceed with
the appropriate treatment.
I hope this answered your query.
With regards,
Do not lose hope.
Detailed Answer:
Hi,
Thanks for your query.
I understand your concern. I would advice you to first of all not lose hope. By your complaints it is the length of your cervix that is causing the problem leading to incompetent cervix or cervical insufficiency.
Transabdominal cerclage may be successful in women who deliver very
preterm despite placement of a transvaginal cerclage. So I think you should
try transabdominal cerclage.
Last time the cervical cerclage did not work because you had a twin pregnancy. In women with a twin or triplet pregnancy neither progesterone treatment or cerclage reduce the rate of preterm birth. Neither is recommended to prevent preterm birth in these groups of women.
I would suggest you to go for transvaginal cerclage next time if its a singleton pregnancy.
You can try other interventions :
- Pessaries: Though it is not adviced for women with short cervix, but there is 80% reduction in preterm births.
- Indomethacin: Women with a short cervix at 14 to 27 weeks appeared to reduce preterm births <24 weeks of pregnancy.
- Progesterone supplementation: For sustaining the pregnancy which you had taken previously.
- Tocolytics: To prevent uterus contractions which you have taken previously.
- Lifestyle interventions: Cessation of work and exercise, abstinence from coitus, bedrest/limited activity.
It is best to discuss these options with your treating doctor and proceed with
the appropriate treatment.
I hope this answered your query.
With regards,
Above answer was peer-reviewed by :
Dr. Kampana
Answered by
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