I am 20 weeks 1 day today, with girl girl boy triplets. I go in every week for cervix checks.

My history, is I had 16 weeks identical twins (in their own sac) due to PROM. I was never even given the option to stop labor and try to refill or hospital bed rest. I was induced to get the process over with. My cervix was still closed. I had two losses after that as well. They then found out that I have three mutations that attack pregnancy in different trimesters. I then had my singleton son. He is now 9 months old. Even with my son I went in every 2 weeks for cervix checks. I stayed normally around a 3 with him. At 37 weeks I was induced because of preclampsia.

So heres my problem. So I've made it to 20 weeks, which I am so happy about, I am counting every day down to 24 weeks. Every day after that, I know is a miracle. A few weeks ago I was at a 4.6 in length for my cervix. Then it went to 4.0, then 3.6, then 3.4, now this past Tuesday it is down to a 2.5. I am on bedrest. I am allowed to get up for something to eat/drink, and bathroom. At my last appt with the MFM, (there are multiple doctors in the practice), I saw the female dr. She said she is comfortable with 2.5, and that even if they did do a cerclage, because it is triplets, she is afraid they would do more harm then good. The male MFM that I see more often, has said that he starts to worry at 2.5 and under. I asked her what will happen if it gets smaller, she said they will just watch for dialation and labor, and stop what they can.

Wouldnt it be safer now just to put the cerclage in, before it turns into a complete emergency? As weird as it sounds, I can feel when my cervix is changing. I get very sharp pains where my cervix is at. Yesterday the pain was pretty bad. Im scared that I will have no length to my cervix at all and wind up in labor. Im 20 weeks, Ive made it this far. I HAVE to make it farther you know.

So at what stage/week did you have a cerclage put in, and what are the risks that she is afraid of? I tried looking it up but didnt find much of anything about it, just other people with shortened cervix but with a singleton pregnancy.

I got my emergent cerclage at 19 weeks 5 days. My MFM doesn't do preventative cerclage unless you had a cerclage in a prior pregnancy. I was always around 3.2 and I went for my Tuesday appt and I was 1.4 with funneling. He told me to come in the next a.m. and he put in the cerclage.

At that point I was put on tocolytics but not on complete bedrest. I ended up in preterm labor at 28.3 and was in the hospital until I delivered at exactly 30 weeks. I know cerclage got me to 3 babies. I would do it again in a second.

I was told that it was not without risk of infection, PROM and I signed papers to do a c section that day if he needed to. Many MFM do not do late cerclages. I will however need a cerclage preventative at 12 or 13 weeks with any future pregnancy.

Good luck with your decision

Lisa
bbg identical/fraternal
30 weeks

I was 50% effaced at 9 weeks. My cervix was still measuring around 4. At 12 weeks they put in a permanent cerclage. I felt safe and that I would have a long pregnancy. At 18 weeks I went into ptl. I was put on bedrest, medicine off and on and monitored daily. I was put into the hospital at 25 weeks and I delivered at 30 weeks. The only time that my cervix was shorten was when I was in labor. At one point it measured 1 something but they stopped my labor and the week it was back up to 3. I was on hospital bedrest and only allowed up for a short shower once a day. I know that the cerclage helped me get to 30 weeks. It sounds though if you can feel things that you might be having PTL. You need to be very careful about that.

My cervix measured the same, or a bit less, around week 20, from pre-term labor. Do you know if your cervix is shortening due to pre-term labor or IC (cervical shortening without contractions)? If you are having contractions that are causing the shortening, then a cerclage may make it worse by causing more contractions. My doctors put me on strict bedrest, terbutaline and progesterone at week 20. My cervix went up and then down again, and I was put in the hospital at week 27 since the drugs and bedrest were no longer working. While at the hosptial, they put me on mag. sulfate to slow the contractions a bit...and I didn't deliver until nearly 4 weeks later.

Nik
GBG triplets born 4/2/05
30w5d
www.thebestthingscomein3.blogspot.com

I do have contractions every once in awhile. I am trying to drink as much water as I possibly can as well. The contractions I have are in my back. When I feel them I drink a lot and switch sides that I am laying on. The pressure I feel, if it hasnt gone away by tomorrow I am calling them even though I have an appt on Tuesday. Normally it goes away but this is the longest it has been staying. I do not feel any tummy contrations. When I first saw the MFM, they said that 20% of triplets are born before viability. Im terrified at this point that, I will eb one of those statics you know. I know mentally I cant handle any more losses. After my twins, it took me over a year to even talk to anyone again. I have to be sane to care for my son. I am laying down as much as possible. Sometimes I sit up to relive the pressure on my back but only for a few minutes at a time. I have a small fridge in my room, and tomorrow my hubs will put a microwave up here to so I dont have to do any stairs to get some food to eat. Right now I am the size I was with my son at 37 weeks. I know after awhile sometimes the uterous just isnt able to stretch anymore either. Im just very on edge. I will talk to them more about a cerclage and see when I would be able to do the steroid shots for their lungs.

If you are serious about a cerclage, it would need to be done ASAP. You are around the point that most doctors won't do them anymore. They will generally not be willing to give the steroid shots until 24 weeks.

Just remember, if something doesn't feel right, go get checked then. Don't wait for an appointment or for your doctor to be in regular office hours. I would think that almost all of us spent some time at the hospital after hours getting checked. Sometimes you go and it is a false alarm. Sometimes it isn't. That isn't something you can know unless you get checked. It is better to go in several times for false alarms than miss a real emergency.

Lori

http://yesidohavemyhandsfull.blogspot.com/

I agree with Lori. Do not ever heisitate to get something checked out. If you are having contraction and can feel them then the chances that you are having PTL is possible. You cannot feel PTL and that is the scary part about it. I knew that I was having PTL because at 20 weeks they put me on a home monitoring system for contractions and there was several times that I was not under my threshold and I felt fine.

I had a cerclage at 20 weeks after my cervix went from over 3cm to less than 2 in the two weeks since my previous check. My OB wanted to wait and check again the following week to see if it stabilized on its own, but my MFM said that we might have even less to sew shut if we waited so I had it done the next day. I was on restricted activity the rest of my pregnancy. I probably should have taken it even easier than I did, but I made it to 30w6d and I'm positive my cerclage had a big role in that, especially since it started changing so suddenly.

I think the biggest risk of a cerclage is infection, but you should ask your doctor.

Mom to GBG born in July 2009 at 30w6d: 3#10oz, 3#12oz, 3#2oz

A lot of MFMs don't do cerclages because there is no evidence it is beneficial in triplet pregnancies, but it is not like they have a lot of data for triplets, so other MFMs just do everything possible. I had a cerclage at 17 weeks after I went in for my routine check and my cervix shortened to 2.5 cm. In retrospect, I think I had been having a few contractions before then but didn't realize what they were (not painful at all, just fluttering/tightening). I went on home bedrest after the cerclage. I had intermittent contractions and was in the hospital a few times after that and on indocin and procardia at home, then ultimately went in the hospital at 24 weeks when I had membranes pushing through a paper thin cervix. I was then on mag and then a terb pump.

I delivered at 25+4 when the contractions got so strong that my cervix ripped through the stitch. I truly believe I would have lost the pregnancy completely if I hadn't had all these things done. I always wonder what would have happened if I had gone in the hospital earlier, or stayed on mag longer, etc but I have 3 healthy beautiful girls so I feel blessed!

Good luck with your decision.

Lara
Mom to GGG born at 25+4 on 12/25/09

I am currently 28 weeks 1 day with BBG triplets. I had a preventative cerclage put in at 14 weeks. I had no prior issues with my cervix with the pregnancy with my daughter though, my high risk doctor does a cerclage to prevent anything from happening early. I went to the doctor two weeks ago and my cervix was a 3.6cm and last week it was a 2.8, going to get checked again tomorrow to see if it has decreased more. I am feeling a lot of pressure down there now and lots of discomfort. My doctors said they could not do a cerclage after 14 weeks unless it was an emergency cerclage. The risks they told me at 14 weeks to having a cerclage put in was like preterm labor, infection and rupture of membranes (which i had no issues at all). They explained as I got further along and the babies started growing thats when it would pose a risk to having a cerclage put in due to rupturing the bags or causing preterm labor. Good luck, take it easy! I am doing that as well so I don't get put on strict bedrest but I guess I will know after tomorrow! If you want to email me, my email address is cnwoods1783@gmail.com

I am certain my cerclage helped me make it to 35 wks 4 days. My perinatologist always puts in a cerclage for triplets at 14 wks. At my 1wk check up after the cerclage was in (15w4d), he said it was "beautiful"- 3cm. At my 19 wk appt it had shortened, not sure of the measurement. He then put me on a progesterone gel (Crinone), which I applied vaginally everyday. At 22 wks, cervix shortened more & I was put on bed rest. Up until 22 wks I had been working as a physical therapist, on my feet, very busy all day, & I think this contributed to the shortening. I was scheduled to go off work at that time anyway, just didn't expect bed rest so soon. Anyway, at 25 wks my cervix was 1 cm, then at 28 wks, he said it was better(I have no measurement)... So my story got a little long, sorry, I feel the cerclage was very beneficial to me & my babies. The progesterone gel prob helped too, as well as drinking a TON of water & doing as I was told as far as bed rest goes. It was all worth it, to last 35w4d & have perfectly healthy girls! Good luck to you & whatever direction you & your healthcare provider take!

Debbie, proud Mom of triplet girls:
Amelia, Jordyn & Olivia
born 10/28/10 at 35 wks & 4 days

I had an elective cerclage done at 14 weeks. There is always a risk for infection with any procedure. I am not sure what else. Ask questions! That's why the doctors make the big bucks because they know everything. Good luck!

Debbie
33wks
1/25/08

Well 23 weeks and 4 days today. 3 more days to 24 weeks, then the count down begins to 26 weeks and so on. Ive been put on meds for contractions, still on home bed rest, and no cerclage put in. I am down to 1.8.