Torn Cerclage

[stykat7]

This is my 4th baby and am high-risk due to an incompetent cervix. I am currently 16 weeks pregnant and had a cerclage (my first) placed 2 weeks ago. Everything was going smooth until Wednesday when out of the blue my cerclage tore and ripped an artery with it. I was rushed in for emergency surgery and thankfully everything was able to be repaired and baby stayed strong. 

I am so blown away with everything that has happened and am not sure how to process it all. I'm now on bed rest until further notice and am terrified to move in fear of ripping again. Anyone ever had this happen before? Did everything heal and were you able to get up on your feet and have a regular active life? I don't want to live the rest of this pregnancy in fear, but I also don't want to be careless either. 

[Nittany]

I'm so sorry that happened. I'm on modified bed rest now with a cerclage and terrified to think it could tear! I'm glad they were able to repair everything for you and I hope it holds out for you now.

[mylittleladiesandlad]

OH goodness that sounds painful! I had an emergent cerclage placed at 22 weeks and now I am 33 weeks. I have not been on bed rest, but no signs of PTL to warrant bed rest either. Did they replace the cerclage? What caused the cerclage to tear?

[RedAero]

I work on a prenatal unit where we look after women with cerclage, although in our setting it's usually women who've had a rescue cerclage done at 18 weeks or later, and are on complete hospital bedrest for long periods. (Yours sounds like it was done around 14 weeks? Those women usually have it done on an outpatient basis, go home, and are able to up and about for most of the pregnancy.)

I've only seen two cerclages tear and have to be placed a second time, which to be fair is not a lot of experience with it, but in both cases the second cerclage didn't hold for very long. (Although your case may be different; no two women are the same. Also these were rescue cerclages, which are a different situation than preventative ones like yours.) The doctors were thinking it was because the cervix was weak and friable to begin with, plus the trauma from tearing the first time, a second stitch just didn't have a lot to work with and couldn't do a very good job of holding things together.

Since you're 16 weeks and still a ways from viability at this point, it's probably better to be overly cautious for now, and just take things one day at a time. Once you're further along, you and your doctor may be able to reevaluate things. For now, I'd stick to the bedrest as much as you can. Some doctors also suggest limiting your time sitting upright, to limit pressure on the cervix as much as possible. Do your best to stay really hydrated and avoid getting constipated (pushing too hard to have a bowel movement puts pressure on your cervix too).

Hang in there, mama. I'm really sorry you're stuck in this situation. Big hugs, and I hope your little one stays cooking for as long as possible.

[stykat7]

The doctors are unsure as to how the cerclage ripped. At the time I was just sitting at the table painting with my kids. I didn't feel a thing. It was repaired as apparently the front stitch held in place.

RedAero Did the ladies who had to get a 2nd cerclage end up delivering early that you know of? 

[RedAero]

Mar 15, 2015 22:51:11 GMT -5 stykat7 said:

The doctors are unsure as to how the cerclage ripped. At the time I was just sitting at the table painting with my kids. I didn't feel a thing. It was repaired as apparently the front stitch held in place.

RedAero Did the ladies who had to get a 2nd cerclage end up delivering early that you know of? 

I'm glad at least one of the stitches held! It sounded from your original post like the whole thing tore through completely. Glad that wasn't the case. How bizarre that it happened while you were just sitting there, too, that must have been pretty scary.

The ladies with a second cerclage did wind up delivering early, one because the stitches tore out a second time, and one because of other complications. Their situations were different from yours, though -- with a rescue cerclage, there's usually considerable cervical dilation and/or shortening before anyone realizes there's an issue, so when the cerclage is actually placed, there's less tissue to work with. The stitches are a bit more precarious in that situation. If yours was done around 14 weeks, there's a lot more cervix to work with at that point, so things are comparatively more secure, if that makes sense.

[stykat7]

Mar 16, 2015 14:44:33 GMT -5 RedAero said:

Mar 15, 2015 22:51:11 GMT -5 stykat7 said:

The doctors are unsure as to how the cerclage ripped. At the time I was just sitting at the table painting with my kids. I didn't feel a thing. It was repaired as apparently the front stitch held in place.

RedAero Did the ladies who had to get a 2nd cerclage end up delivering early that you know of? 

I'm glad at least one of the stitches held! It sounded from your original post like the whole thing tore through completely. Glad that wasn't the case. How bizarre that it happened while you were just sitting there, too, that must have been pretty scary.

The ladies with a second cerclage did wind up delivering early, one because the stitches tore out a second time, and one because of other complications. Their situations were different from yours, though -- with a rescue cerclage, there's usually considerable cervical dilation and/or shortening before anyone realizes there's an issue, so when the cerclage is actually placed, there's less tissue to work with. The stitches are a bit more precarious in that situation. If yours was done around 14 weeks, there's a lot more cervix to work with at that point, so things are comparatively more secure, if that makes sense.

Yes, that makes sense. I appreciate your knowledge and input. Thank you!

[joolaya]

stykat7, I am so sorry that you are experiencing complications. I hope things go well from here.

I am also having a cerclage placed in about a month when I will be 14 weeks.