Cervical cerclage

Cervical cerclage or cervical stitch is a non-invasive operation for cervical incompetence or insufficiency. My doctors are convinced that I have a weak cervix after having a miscarriage at 17 weeks. Therefore, in order to prevent another miscarriage, they are recommending that I have my cervix stitched. Yes, literally "stitched" (but of course under a general anesthesia)!

So after passing on all my clinical tests, I was scheduled to have my cervical cerclage at 12 weeks GA. I was asked to fast from 12 midnight and discontinue taking aspirin, prednisolon, and clexane injection.

My operation is at 9am but I was asked to check-in at 7am. After changing to the hospital gown, I was injected progesterone oil in the butt and allergy-check shot in my forearm. The nurse also fixed my IV. The nurse tried to check baby's heartbeat via doppler but failed to hear it. I felt nervous but tried to stay calm. She ordered an ultrasound machine instead so my baby can be checked before the operation.

I was wheeled to operating room at 9am. The operation started past 9am because we waited for the ultrasound machine to arrive first. I was given general anesthesia and was down before I finished counting from 1 to 10!

I was wheeled back to the private room after an hour or 2. I was on strict bed rest-- no sitting, standing or walking. I may pee using a bed pan only (while lying down). I had minor bleeding but no disturbing pain. I continued with all my medicines except for Clexane, Aspirin and Prednisolon. I have new medicines for recovery: Coamoxiclav (2x daily), Metronidazole (2x daily), Duphaston (3x daily).

The next day, I was still on strict bed rest but I can go to the bathroom with assistance. My doctor came by to check me up. She described how terrible my cervix was and that she has to put a more sturdy stitch. She said that there was also a lot of bleeding when she put the stitch that she has to press for a while in order to stop the bleeding (perhaps this is due to the blood thinners that I am taking). But overall, the operation went well. She told us that she checked on our baby before and after the operation.

I was discharged from hospital the following day around noon. We went to see our baby at my doctor's office. Our baby is doing well-- kicking and jumping! I was advised to continue with all my meds except for Aspirin and Clexane (but continue taking after 1 week). I was also advised to continue bed rest, drink plenty of fluids and avoid constipation.

First trimester

9-Jun-14
First ultrasound scan @ 5w1d

In the beginning, there were two! We are very thrilled when we saw two gestational sacs on the screen. But our worries never stop at this positive confirmation. After experiencing a miscarriage (at 17 weeks), our anxiety ends only when our baby is born.

14-Jun-14
Second ultrasound scan @ 5w6d

One gestational sac (right) has a visible yolk sac already. Thank God, my doctor told me that I can stop taking the Progesterone injection (my butt rejoices)! Although, I still have to continue taking all my medicines including the "bee sting" Clexane injection!

25-Jun-14
Third ultrasound scan @ 7w3d

There are still two visible gestational sacs (one GS is not shown in the picture). However, my doctor still cannot find any developments inside one of the GS. The picture shows our Baby A, together with the yolk sac inside the GS. This is my last appointment in the IVF clinic.

8-Jul-14
First OB appointment (outside the IVF clinic) @ 9w2d
I tried to search for an OB who specializes in high-risk pregnancy and has background in IVF. I found two doctors in the hospital where I plan to give birth. One of them is a male doctor, so I chose to see the lady doctor. The first time I saw her, I knew that she is good. It's also comforting that she listened with concern on my pregnancy history. She said that we have gone through a lot and we need to be more careful and take all the necessary precautions in order to achieve a safe delivery. She agreed to my IVF doctor's advice on all the medicines that I am taking (aspirin, prednisolon, clexane injection and progesterone suppository) including the plan to put a cervical cerclage at the end of the first trimester (12 weeks). We asked about the bad side effects of the medicines especially on our baby(ies). She said that the negative effects (if any) outweighs the advantages. She also testified that other high risk pregnant women delivered healthy babies with the aid of these medicines. My doctor said that it's good that I am not working and asked me to take extra care especially after having a sudden miscarriage on my last pregnancy. She prohibited me on staying too long on the internet and reading too much or stressing myself. She advised me to just take it easy and pray.


My ultrasound scan still showed two GS. The other sac is still empty and its growth has slowed down. Our doctor said that there is only a minimal risk on the other embryo and normally, my body would just absorb the empty sac as my pregnancy develops. She also observed some bleeding, which might be because of the empty sac.

22-Jul-14
Targetted scan @ 11w2d
The purpose of this appointment is to check my baby's status before I undergo an operation for the cervical cerclage.

This scan is more detailed and was performed by a radiologist. My baby is healthy, active (yes I saw him moving!), and perfect! Nuchal translucency (NT) is 14mm, which is on the normal range. NT is used in the early detection of down syndrome. So we are glad that our baby is normal and healthy.
My blood and urine test results are all good. Although my swab test showed that I have some infection. Therefore, I was advised to take betadine suppository in addition to all the medicines that I am taking.