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Transabdominal Cerclage

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Transabdominal Cerclage

Postby karenthescorpio » Tue Aug 24, 2010 1:46 pm

Hi, ladies. I'm on a mission to advocate for the transabdominal cerclage. If you or any other mommie you know has lost a baby or had a preemie due to issues/cervical changes that brought on PTL, then they most likely have an incompetent cervix i.e. it can't hold a pregnancy until due date. Or if you or any woman you know has had any surgeries, procedures or abnormal paps...please be aware you are at risk for PTL due to a weak cervix. When this happens, the cervix shortens, funnels and/or dialates much too early. This exposes your uterus/baby to infection. Your membranes can rupture or contractions will start. After a loss due to this issue, most doctors (including high risk doctors, MFM's) will only advocate for a transvaginal cerclage (the stitch they put on your cervix via your vagina). I had one put on in my 19th week. They almost always fail to get you to term for various reasons. And are highly associated with infections. The best way to support a weak cervix is with a transabdominal cerclage. Also referred as a TAC. It is still a "stitch" but is put around the cervix (not through it)...and it is placed at the tippy top of your cervix where it meets the uterus. Because of this placement, it is put on via opening your abdomin much like when you have a c-section (but less painful!). This prevents the pressure from pregnancy from causing cervical changes i.e opening, early shortening or early funneling. Thus, preventing infections, PROM and PTL. You will have to have a c-section for delivery. This kind of cerclage never has to come out/off.

Many doctors also do it laproscopically. It can be done pre-pregnancy, as well. I'm having one put on next month before starting my next IVF cycle. This kind of cerclage makes your cervix bionic! If you need a cerclage...get the best one...the TAC. If you ask your doctor about it...beware...most will say it is for extreme cases...and it's not. Usually they just don't put them on or have experience with them at all, so they don't recommend them. If you want to know more about a TAC, please refer to http://www.abbyloopers.org. They have a yahoo group, as well, that you can join if you have a cervical issue. You can also send me an email. There are select doctors in the US that are experts with putting them on.

Karen
Me: 40, mild pcos
DH: 38, male factor
IVF#2 BFP! Twins! PTL at 23wks
IVF #3 Nov '10 BFP
Gemma Grace was born June 24, 2011!
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Re: Transabdominal Cerclage

Postby annashope » Fri Aug 27, 2010 3:08 am

I have a trans abdominal cerclage because of cervical surgery and it was placed laprascopically. It never bothers me and it is possible to do IVF and IUI's with it in. It never bothers me and is the best decision I ever made. My RE was delighted when I told him that I already had it and the best part is that it is permanent and regardless of whether I have 1 or 3 more pregnancies this never has to be done again.

Thanks just wanted to share
Me 30
DH 30
DS 10 from previous marriage
ttc 5 yrs, Cervical cancer- in remission
IVF# 1 BFP m/c at 7 weeks
FET Nov 2010 BFN
IUI #5 12/02 BFP! Paul NIcholas
April 2012 Natural BFP on baseline to start cycling-- beta 4/11 35 beta 4/13 121

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Re: Transabdominal Cerclage

Postby richellemedina » Sat Jan 22, 2011 2:03 pm

A disadvantage of this approach is the possible need for two laparotomy during pregnancy. There are no studies comparing the results of cerclage transabdominal and transvaginal in similar populations of patients. transabdominal cerclage is a procedure more morbid than transvaginal cerclage. transabdominal cerclage placement is usually done either before conception or during early pregnancy.
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Re: Transabdominal Cerclage

Postby karenthescorpio » Sat Jan 22, 2011 5:50 pm

There are more disadvantages to a transvaginal cerclage than to a transabdominal cerclage. Everyone and every doctor has their own opinions. You have to do what you think is best for you. The bottom line for me was, if I need a cerclage, I'm getting the one that gives me the best possible outcome! There is no surgery worse than losing a baby!
Me: 40, mild pcos
DH: 38, male factor
IVF#2 BFP! Twins! PTL at 23wks
IVF #3 Nov '10 BFP
Gemma Grace was born June 24, 2011!
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Re: Transabdominal Cerclage

Postby angelaezra » Sat Jan 29, 2011 4:45 pm

Karen – I have to agree with you. Considering the results if you don’t get a TAC, I would make the same decision as you did! We both have been down that road of losing our babies late in our pregnancies and it was truly devastating to say they least! I am just so happy for you that I can’t explain! Look at your ticker go…

Angela
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1 miscarriage 2002 (nat)
1 ectopic pregnancy 2006 (nat)
1st IVF 10/08-BFP twins/misc-6 1/2 wks & stillbirth 21 wks
2nd FET 6/09-BFN
3rd IVF 2010-April-BFP - DD born 12/7/10

Lost Ashley Nicole Thomas at 21 weeks
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Re: Transabdominal Cerclage

Postby shoopshoopshoop » Sun Mar 20, 2011 5:56 am

hi.
I lost IUI conceived twins at 22 weeks. They didn't know if it was an infection or Incompetent cervix. I am now pregnant again with a singleton and had to have an emergency cerclage at 22 weeks when IC was formally diagnosed in this pregnancy.
I'm on hospital bedrest for the duration of this pregnancy and pondering future pregnancies. there is no way I could do extended bed rest again, so my options are either no more babies, surrogacy or a cerclage that doesn't involve bedrest, hence my interest in the tac.

My question is whether anyone knows if you have a pre-pregnancy tac, if it is more difficult than usual to conceive through IUI/IVF and also, I've had a few laparoscopies to remove mild endometriosis, if I had the TAC, would they still be able to carry these out in future if I have the TAC? I'm assuming not, as there would be no "way in" for the equipment to clear out the endometriosis.

If anyone has any experience on this issue, I would love to hear from you.
Thanks
:)
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Re: Transabdominal Cerclage

Postby shoopshoopshoop » Sun Mar 20, 2011 5:57 am

P.S Bedrest bites! :roll:
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Re: Transabdominal Cerclage

Postby karenthescorpio » Sun Mar 20, 2011 3:02 pm

Shoops- I'm sorry to hear about your loss. I know the pain. I'm so glad you are hanging in there with this pregnancy..even if on bed rest. I know it stinks bc I was on it too at the end of my last pregnancy when I lost my twins. After my loss I had a pre-preg TAC. It is EXTREMELY important that you get a TAC for your next pregnancy. Just as critical is that a very experienced doc who does a lot of them with high success rates places it. I also recommend that you join an organization called Abbyloopers. They have a yahoo group that is very active and can answer every question about the TAC that you can imagine.

The two top docs in the world for a TAC you can count on is Dr George Davis in southern NJ (he did mine) and Dr Haney in Chicago out of Univ of I'll. The Abbyloopers group also has a list of other docs but I wouldn't let anyone but Dr Haney or Davis do it.


I had my TAC two months after my loss at 23 weeks (vag delivery with a failed TVC that ripped an 8cm tear in my cervix). I then started IVF fresh cycle after one menstrual period. I did a SET and it worked and I'm now almost 21 weeks. No problems what so ever. We are having a girl and I can't wait to meet her!

I would be willing to bet your loss was due to IC, which has an high occurance of infection. I got one too with my twins.

Be sure to join Abbyloopers yahoo group. You will find endless info, resources and support. Keep baking! Xoxo
Karen
Me: 40, mild pcos
DH: 38, male factor
IVF#2 BFP! Twins! PTL at 23wks
IVF #3 Nov '10 BFP
Gemma Grace was born June 24, 2011!
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