Removal of cervical cerclage

At week 37, my cerclage was removed. I had a day surgery only and was released in the evening. I was under general anesthesia so I didn't feel anything. The procedure took around 30 minutes (from the time i was awake). I had some bleeding afterwards and it was a bit painful when I'm urinating.

Like the usual surgery under general anesthesia, I was asked to fast for at least 8 hours-- no food and drinks after 12mn. We went to the hospital at 7am and was immediately prepared for the procedure. They gave me dextrose and have given me the ampicillin skin test injection. They also checked my baby's status via CTG. My baby has been actively moving since last night. But during the CTG, he's not moving so well so they have to repeat it. Therefore, my surgery was delayed from 10:15am to 11:30am.

After the procedure, my doctor instructed that I can only pass urine and eat my lunch after 2 hours. I was so hungry and want so much to pee. Finally, I was given a bed pan to relieve my urine. My baby has been active since after the surgery. Probably because he wants me to eat. I had some bleeding (bright red every time I urinate. The doctor said that it is normal because of the stitch removal. If it becomes heavier, then i need to be back to the hospital immediately. She also told me to be back should I feel that my baby is not moving, if my water breaks or if I have frequent contractions or severe cramping. Otherwise, we'll have to wait for labor to come. My follow up appointment is after 3 days. She will also be monitoring me twice a week to be sure that my baby is doing well.

Third trimester

Week 28
Finally, we have reached the third trimester! I had an ultrasound scan at 28 weeks. My baby is healthy. However, the abdominal circumference (AC), which indicates fetal weight, is a bit off (by 1 week) so the doctor told me to take 3 egg whites a day in order to boost my protein intake. By the way, I started to feel my baby while having hiccups. He's so cute! I can feel the rhythmic pulse of his hiccups. He's getting more active everyday. He's actually more active during the night.

Week 31
I had a detailed ultrasound scan at 31 weeks. My baby is healthy, heartbeat is normal, heart is normal, and blood flow is normal. The AC is still off by 1 week so I need to continue taking 3 egg whites a day. The radiologist said that my baby's AC is not alarming and that some babies will measure a bit late or a bit advanced. When I saw my doctor, she said that everything is okay but not completely fine. She said that in my case, from the start, nothing is normal. So she needs to monitor me closely in order to know the right diagnosis for my case. I will be subjected to more ultrasound and doppler scans before every appointment. She also asked me to take the GTT (glucose tolerance test), just to rule out diabetes.

I asked her about my birth plan. She said that at this point, she cannot say anything yet. But we will still strive for a normal delivery. However, if things don't go smoothly, I need to be prepared to take CS delivery. By the way, during the detailed scan, we asked the radiologist to check our baby's gender again. She confirmed that we are having a baby boy!

At 31 weeks, I started to have frequent leg cramps, acid reflux, more discharge, baby hiccups, stronger kicks, and stretch marks. My baby bump is getting bigger and I am becoming larger! I can feel my bump getting heavier now. I take extra careful when walking especially while taking a bath. I am actually sitting in a chair while in the shower!

By the way, my parents left but my mother-in-law came and stayed with us. My parents will be back before my due date. I was still on modified bed rest and just staying at home. I found a new hobby to get me through my everyday mundane life-- making my baby some crochet clothes (mittens, hats, and shoes). I learned the basics of crocheting when I was in school. I found some video tutorials from YouTube and modified some patterns to suit my preference. I was getting more and more excited while doing the crafts and imagining how my baby would look like wearing them!

Week 33
I was back in the hospital at 33 weeks. I had a detailed ultrasound with doppler. All is fine. Baby is healthy. AC is still behind by a week as well as the femur length. But the head is ahead by a week. I also have placental calcification which shouldn't be present till around 36 weeks! It just means that my placenta is maturing earlier than it should which may affect the supply of blood at oxygen especially when the patient is diabetic or has high blood pressure. The doctor is not so alarmed but said that I just needed to be monitored closely. He told me to stop taking Aspirin after a week. My next appointment is after 2 weeks.

Week 35
My doctor is back from her emergency leave. She saw the ultrasound result during my last check-up (at 33 weeks) and said that baby is okay but the placenta might not support the baby till due date. I need to be closely monitored twice a week and do a regular CTG and ultrasound. Aspirin and Clexane injection will be stopped by next week; while Cyclogest suppository will be stopped by 37th  week. My cerclage will be removed at 37th week.

I had my first CTG today. They attached a device to detect my baby's heartbeat. I was given a button that i need to press every time i feel my baby move. We went back to Dr. Mary after. She said that my CTG result is good; my baby is doing fine. By the way, I am having trouble sleeping since after the New Year. I don't know if it's just because of excitement. I feel like a zombie!

Week 36
Yey! I finally graduated from my daily Clexane injections and Aspirin! Right now, I'm just taking my prenatal vitamins, calcium, and progesterone suppositories. My check up yesterday is good. My CTG is good; baby is doing fine. I just got stalled a bit in the CTG room because my baby is not moving initially so I have to drink water and change positions first before we achieved the right amount of fetal movements. My husband asked our doctor if we could have an elective CS because he is worried that there may be a problem after I stop Clexane and Aspirin and when my cerclage is removed. But the doctor said that we need not worry because she is monitoring me closely. She said that after the removal of my cerclage, she will keep me in the hospital for at least a day so she could monitor my baby. Her aim is to at least keep our baby brewing for 38 weeks. Then she will decide what will happen next, depending of what our status is. So just hang in there baby! 2 weeks is just around the corner!

Yay! I'm getting more and more excited! I already arranged our hospital bags (one for the baby, and one for me). I've also almost completed my checklist and just waiting for a few items to be delivered. My eldest sister has pledged the stroller for my baby. We'll buy it together with the car seat. I asked my other sister to buy for me some of the baby products that I cannot find in here. She also gave me my baby bags. I received a lot of pre-loved clothes from my dear friend in Oz and from my sister-in-law. So we only bought a few sets of newborn clothes.

I can feel that my baby has started to descend. I can feel his movements in my pelvic floor. He's usually very active around 12mn to 2am. I describe it as my baby "partying". Sometimes I even feel quite alarmed because his "kicks" are so intense-- it's as if he's trying to make his way out of my uterus.

Week 37
My doppler ultrasound result is all good. AC and FL is still behind by a week while the head measurement is advanced by a week. My doctor said that everything is normal and that my baby is on a good weight range. He is now around 6.5 lbs.. Yey! Very good baby! The egg whites have surely taken effect. My cervical length is at 4.2cm.. I thought that it has already started to shorten. My baby is still very active especially at night. Good thing that i am getting my regular naps in the morning and afternoon. I am also suffering from heartburn so I am taking Gaviscon when I feel like I can't handle it at bedtime.

Second Trimester

My second trimester is generally more relaxed compared to the first trimester. The cervical cerclage reassured us that my cervix won't open prematurely and cause a sudden miscarriage-- just like what I have experience during my previous pregnancy. We have also asked my parents to come over so I won't need to move around the house to cook or do the household chores. They came here just before my cervical cerclage operation. So from then on, I was on bed rest. I was confined in the four corners of our house, leaving only when it's time for our hospital check up. Per doctor's advice, I limited myself on my internet usage and refrained from reading too much regarding pregnancy complications. Looking back, I can't imagine how I spent this trimester with limited activities on house-arrest and kept my sanity!

I guess what kept me from losing my mind is having this positive thought that in a few months time, we will be with our healthy baby! At 17 weeks, I also started to feel his movements. I am so thrilled whenever I feel them. But I think it's only around 20 weeks when the movements were more pronounced that my husband can see/feel them too.

My hospital check ups were scheduled every 4 weeks. I had an anomaly (detailed) scan by the radiologist at 20 weeks. She made a thorough scan of everything. We're very happy that the results are all normal and our baby is healthy. During the scan, our baby's legs are closed so she can only confirm with 80% accuracy that our baby is a boy. My husband is so glad upon hearing this, although honestly, the gender is not that important. What matters is that we have a healthy and normal baby!

At week 20, I stopped taking Prednisolon. But I am still taking Duphaston, Aspirin and Clexane injections daily, together with my prenatal vitamins and calcium. I have experienced getting heartburn again so I am taking Gaviscon when needed.

At week 24, my OB is on leave so I consulted the other high risk doctor instead. The ultrasound scan showed that our baby is healthy with healthy heartbeat. All measurements are normal, the chambers of the heart are normal and blood flow is normal. He also said that our baby's gender is boy. I stopped taking Duphaston as per my doctor's instructions.

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.