To get a preventative cerclage or not seems controversial in the HOM world. Getting a cerclage is not without its risks. There is a risk of rupturing the membrane, infection and a few other complications. For some people these risks don’t out weigh the benefits. My Peri was one that does not believe in preventative cerclages. I did end up with one at 14 week because I had some beginning funneling so they did it before it got to be a problem. I feel the cerclage helped my pregnancy because of the funneling. But I never have any PTL that put the stich to the test. On the flip side I met a lady who was seeing another peri practice that did do preventative cerclages and she lost all three babies to infection as a result of the procedure. If I had to do it over again I would only get a cerclage if it was warranted.

If your friend is not happy with the decision to not get a preventative cerclage I would recommend she seek a 2nd opinion from another practice to look at her medical history and see if they think it is warranted or not in her case. Then she can make and educated decision on what she wants to do in her case.

Tasha
Have children afraid of monsters or just looking for a fun kids app? http://www.goawaymonster.com/

My peri didn't do a cerclage on me. It was not even mentioned. I carried to 32 weeks 2 days.

Beth
Dylan-8
Tommy,Karli,Abby- 10/14/02 32w 2d

Beth
Dylan-12
Tommy,Karli,Abby- 5yrs. 32w 2d

I had a scheduled preventative cerclage that turned into an urgent cerclage.

I went into the hospital at 14w3d to have a preventative cerclage performed by my OB at the instruction of my Peri. As it turns out, I had a very stressful morning in trying to get to the hospital (Murphy sent about every law my way) in addition to being hungry and tired and hormonal. Anyway, when I got into preop, I found out I was bleeding -- a lot. I was so freaked out. They called in my OB, and he called off the procedure for the day, did a U/S to check movement and heartbeats of the babies (I think mostly so my blood pressure would fall below 167/128), and admitted me to the hospital for observation.

By the next morning, my BP was a sane level (124/67) and the bleeding had stopped. The peri came in to do a u/s to check what caused the bleeding -- I had started funneling. My cerclage was done that day (and I have been on bed rest for the 5 weeks since).

My point in telling my story is one of erring on the side of precaution: If I would have been home, stressed out, and started bleeding; I would have been in so much more trouble -- stressing myself out more, I would never have been able to drive to the hospital (my husband works an hour away), and my blood pressure would have shot up so much more. I personally am grateful that my peri had the sense (in my opinion) to have the cerclage ordered and even more grateful that these scary events played out where they did -- in the hospital when I was already in the care of doctors and nurses.

Since the cerclage, my cervical length is unchanged. I admit fully to being victim to fear -- especially in this instance -- and tell you this as a means for you to filter my thoughts and feelings. But I cannot imagine not having a cerclage done. I think often about what might have happened had I had the procedure done the day before -- or before the funneling -- I wonder if my cervix might still be full length (or at least longer than it is). And I wonder what implications my need for cerclage might mean for any potential pregnancies.

That's my story, so take from it what you will with all my disclaimers of fear intact.

Stephanie
West Rogers ^i^ b
Keaton Edward ^i^ b
Rebecca Joy ^i^ g
1/6/04 19w5d

Hi, I'm new to the HOM information and am currently 18 weeks pregnant with triplets. My doctor said that they do not do preventative cerclages in their practice. I'm seeing the head Peri in a Bay Area practice that sees pretty much all multiples for the entire San Francisco Bay Area. I trust their judgement, but because of your post, I will ask again why they don't do the cerclage preventatively for triplets. I appreciate your concern for your friend and indirectly the rest of us on the forum. My next appt. is 1/13 and I'll let you know what they say.

Jami

mom to fairy-girl & spontaneous b/g/g triplets born at 36 weeks.

I'm at 23 weeks and my cervix is in good shape - no mention of a cerclage since my initial visit when they said at some point it may be necessary.

I'll keep your friend in my prayers and you can do the same for me!

JenK

I had a cerclage at 14 weeks and feel it was the key to carrying 35 weeks. Why? - just a hunch. If you guys feel it is necessary, ask if her doctor would do on her recommendation. What does she have to lose. It would only be taking a safe messure which is worth it in my book. OR - get a second opinion. Just a thought. Good luck.

Beatrice Casey - mother of Aidan, Connor and Fiona Casey (5 months) and loving it.

Bea and Mike
Parents to BBG (3 years)

LOVE is a wonderful thing!

I also had a cerclage at 10 weeks. It was more preventative. My first doctor said that there is no way I had an I.cervix because I was able to carry my first baby to full term plus two weeks. (This was a maternal fetal specialist.) I would encourage your friend to ask why he wont put in a cerclage. If it is due to infection, I have had infections end three of my other pregnancies and my doc- gave me to I.V antibodics and then flushed me with antibodics. I would not let that be an excuse. Encourage her also to see another doctor. It doesn't hurt to get someone else's advice.
Goodluck!
Meli

Meli
Elijah-4yrs. old
Spontaneous BBB triplets born at 34.3 weeks 6-8-04
Adam- 5lbs 11 oz. 18.5 inches
Ryan- 4lbs 6 oz. 17.75 inches
Joshua- 5lbs 17 inches

I didn't have a cerclage, and never had any real shortening of my cervix and did not have any pre-term labor. My peri mentioned the possibility of a cerclage in my intial consult as something that was in his "bag of tricks" that he would use if necessary, but he did not believe in prevative cerclages simply because someone was pregnant with triplets. He's definitely up on all of the latest research in multiples pregnancies (and conducts much of that research himself), and does take aggressive care with triplet pregnancies, so I trusted his judgment. In my case, it was the right decision.

Melinda
mom of Annabelle, Lillian and Charlotte, 2/25/03
35 weeks, 6 days

Karen,

I'm 32w3d today and I've had no preterm labor and no cerclage. My peri informed me that 50% of triplet pregnancies would need one but he puts them in only if the cervix falls below 3 cm. Mine has been between 4-5 cm long and thick through this whole pregnancy. I thank God I didn't need one. How thick is your friend's cervix now? Is this her first pregnancy? I would think putting one in for no reason is dangerous and unnecessary. My peri studied under Dr. Elliot so I feel that his education and experience were very good to make this decision.

Michele
g/g/b

Michele
Sarah, Gregory, Amanda
born 1/22/04 at 35w1d

Our surprise baby Austin born 06/15/2005

www.fourtimesthefun.blogspot.com

I carried to 32 weeks 2 days, with no cerclage. I think there is validity to each side here. Yes, it would be good to have it in place should she go into PTL, but it would be horrible to put it in unecessarily and then possibly lose the pregnancy. I guess you are taking a chance either way. Your friend will have to weigh all risks and benefits and decide which she feels is best for her.

Amy
Mom to:
G 00
B 01
BBB 02

My peri did not do preventative cerclage and I carried my three until 32w5d. I delivered b/c of a high fever and pre-eclampsia. My cervix was still long and closed when I delivered.

Tammy + 3 (7/7/01)

The practice where I went did not do preventative cerclages either - and they are a very big East Coast based hospital. I think it depends of the practice and there are 2 different thoughts on the matter. I delivered at 33 wks 1 day, due to pre-eclampsia - never had any cervical problems.
If in doubt, certainly she should seek a second opinion. Like someone else said, I would hate to get one for nothing - then have problems because of it.

Jan
Mom to 5 blessings
Ricky 17, Matthew 11, Jared, Brandon & Lisa, age 5 (33.1 wks)

JW
b 20 b 14 b/b/g 8

"I am too blessed to be stressed"

No cerclage here either. And I went into PTL at 29 weeks, dialated to 2, and after 48 hours of mag and terb closed back up again.

I don't think that preventative cerclages are as routine as you think they are.

MTM - mom to Michael(84),Stephan(85), Thomas, Matthew and Kathryn - born 12/27/99 at 32w 0 days

I didn't have a cerclage and one was never mentioned. I delieverd at 30 wks b/c nothing could stop the contractions. I have no clue what would determine if a person would need one.

Click here to subscribe to a parent's group with triplets born in the summer of 2002: tripletsquads2002-summer-subscribe@yahoogroups.com
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Mom of SuperTwins
I believe in miracles - I have three that live in my home. June 2002 @ 30 wks

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I received my care from a peri at a teaching hospital. Preventative cerclages were not performed. If a patient had a history of an incompetent cervix or had early cervical changes then a cerclage was
done. There are risks associated with a cerclage so that is why some peris may not routinely do them without a medical indication.

Lisa
Mom to Aidan, Christian, and Rachel (10.03.01 @ 36wks)

Lisa
Mom to Aidan, Christian, and Rachel (10.03.01 @ 36wks)

One more issue to add to the debate:

Yale-New Haven Perinatal does NOT do preventative cerclage, BUT they DO do weekly transvaginal ultrasound from 16 weeks onward. The peris showed DH and I all the latest literature and the consensus seems to be that preventative cerclage is too great a risk (of infection, PTL post-surgery, or even amniotic rupture) when compared to weekly US monitoring and cerclage when medically indicated.

I had an emergency cerclage at 19 weeks, 5 days, after two weeks of shorter and shorter cervical length (but with no funnelling, not that I ever quite understood that). I went on to carry to 32 weeks, 4 days, at which point I had premature rupture of membranes (PROM) and contractions that couldn't be controlled with meds.

Jody
g/b/g born Jan 2001
http://www.geocities.com/hombiblio/

Jody
g/b/g born Jan 2001
http://www.geocities.com/hombiblio/

I had one at 16 weeks as preventive, if I did it all over again I would demand a cerclage, I am sure it carried me to 35 weeks, when my peri cut the cerclage out I dilated immediately to a 3! If I were your friend I would get a 2nd opinion now! Wishing her the best!

Carol, Mom to Rex, Owen & Macy, 4 months old!

Karen,

I had an emergency cerlage at 17wks 6days due to a shortened cervix. My peri does them only when necessary. I was admitted on a Friday evening and started on antibotics and a low dose of mag sulfate. Then had the procedure done that Saturday morning. I was taken off the antibotics and mag. sulfate Saturday night and released Sunday afternoon. I was on bed rest after and ruptured at 23wks 5 days, which was mistaken as a bladder infection. I began PTL at 23wks 6days (contractions 2-3 min apart by the time I got to the hospital 15min away). I had contractions off and on for over a week to the point they maxed me out on all the meds they could possibly be given to keep me from delivering. I finally had to deliver because of infection from the ruptured bag at 25wks 1day. Which is why my OB and Peri feel they could not stop my contractions with all the meds available. With all the labor I had and believe me the last two days before I delivered I thought I would die from the contractions. My cervix was still closed the day I delivered.

I truly believe my cerlage helped keep my trio in for the short time they were inside cookin'. As for you friend, she may never need one. Each pregency is different, but if she is worried about not having a preventive cerclage then she should get a 2nd opinon.

I will keep your friend in my prayers for a long uneventful pregency.


Amy
Wife to Jason(pixelpusher)
Mom to Gwynne, Connor, Chloe 11/03/03
25wks 1day

Amy
Wife to Jason(pixelpusher)
Mom to Gwynne, Connor, Chloe 11/03/03
25wks 1day

www.ferristrio.blogspot.com

http://lilypie.com>

In my mind, the cerclage was NOT the "smart, safe way". Early on I had spoken to the husband of a woman who had lost her triplets after her cerclage at 12 weeks and he begged me not to do it. On the first visit with my peri I explained to him that I wouldn't be having a preventative cerclage. He then explained to me that he didn't do preventative cerclages, he only did them if the cervix was showing early signs of changing or incompetency. I said that was fine and we never revisited the topic

I delivered at 33 weeks/5 days and all three babies were in the five pound range. Of course it took months of bedrest/meds to get them to that point (at home and in the hospital), but it was worth it! I also wanted to mention that I started having contractions at 24 weeks, cervical changes started at 27 weeks, however I was able to stay 3-4 cm dilated for many weeks - on major tocolytics and contracting the whole time

With my second pregnancy (also triplets, but I lost two babies early on), I started contracting/dilating early on. I went back to the hospital/bedrest, but I ended up going to term! No cerclage that time either.

I'm not sure there are any stats on the subject, but I'd guess for every doctor who does them routinely is another doc who doesn't. Maybe it would be worth doing a phone consultation with Dr. Elliott? Just to see what he recommends. He is normally very generous about taking phone calls and we all know that he has tons of experience!

Best wishes to your friend!

Take care,
Kristin
Mom to Hayden, Evan, Conner-13 and Kelsey-11
www.cure4conner.org

Wow. I must admit I am shocked (but glad ) to hear all the positive stories about how many women did not have cerclages and went to term. I guess all doctor do have different opinions, but in my case, I of course am still glad I recieved one since it is what kept my babies inside me. But if faced with the option again, I would still opt for the cerclage. I feel the risks definitely outweight the benefits. I am so sorry to hear of the women who lost her babies at 12 weeks due to the cerclage, but stats show that is VERY rare, and it would be worth it to take the chance to me and loose them at 12 weeks than at 20+ weeks or so when you are that much more into the preganancy and attached after feeling them kick,move, etc. Thank you for all the responses. It was a wealth of information.



Karen,Paul
Ethan,Dylan,& Parker
3/24/03
33weeks, 4 days

Karen - blessed wife to Paul,
Proud mom to spontaneous boys
3/24/03
God is soooo good!

No cerclage here. My doctor didn't do preventative cerclages. I carried to 35w,2d. My boys were 5-4, 5-11 and 5-15. No cervical changes until the very end. I was 1 cm. dilated for the last month. No drugs, just modified bedrest.

Just wanted to give you some information from a different perspective.

Sharon
6 year old b/b/b + 10 year old son