Re: I have a bicervical bicornuate uterus w/twins 17 weeks

[Guest guest]

Hi le,

I'm so sorry that you are feeling scared and confused. Pregnancy

with a funky uterus is very hard on us, insn't it.

Can I ask a few questions? What kind of doctors are you seeing?

You need to get to a good perinatologist, also called a maternal-

fetal medicine doctor, also called a high risk pregnancy doctor.

Forgot a regular OB--you want to go to someone who has seen high

risk cases. Second, have you had vaginal ultrasounds to measure the

length of your cervix?

It's not a bad idea to have a cerclage (stich) with twins in a BU,

but it's not required. Sometimes, if the cervix is long and closed,

they will just very closely monitor you. They can check your cervix

every 2 weeks by vaginal ultrasound and make sure it's closed. If

it's opening, then they can perform the cerclage. It's hard to give

you advice without knowing more of your history. Have you been prg

before? Is your cervix damaged in any way?

Best advice I can give you is to go to a peri, if you aren't going

yet, and to get that cervix checked every two weeks by vaginal

ultrasound. INSIST on the checks!

Hugs,

Jill

SU resected

> I have 2 cervixes and a bicornuate uterus and am carrying twins.

> Everything that could work against me has so far. I am so scared.

One

> doctor tells me to stitch me cervix and the other tells me not to.

I

> am so confused. Any info. would help

>

> le

[Guest guest]

Hi le,

I'm so sorry that you are feeling scared and confused. Pregnancy

with a funky uterus is very hard on us, insn't it.

Can I ask a few questions? What kind of doctors are you seeing?

You need to get to a good perinatologist, also called a maternal-

fetal medicine doctor, also called a high risk pregnancy doctor.

Forgot a regular OB--you want to go to someone who has seen high

risk cases. Second, have you had vaginal ultrasounds to measure the

length of your cervix?

It's not a bad idea to have a cerclage (stich) with twins in a BU,

but it's not required. Sometimes, if the cervix is long and closed,

they will just very closely monitor you. They can check your cervix

every 2 weeks by vaginal ultrasound and make sure it's closed. If

it's opening, then they can perform the cerclage. It's hard to give

you advice without knowing more of your history. Have you been prg

before? Is your cervix damaged in any way?

Best advice I can give you is to go to a peri, if you aren't going

yet, and to get that cervix checked every two weeks by vaginal

ultrasound. INSIST on the checks!

Hugs,

Jill

SU resected

> I have 2 cervixes and a bicornuate uterus and am carrying twins.

> Everything that could work against me has so far. I am so scared.

One

> doctor tells me to stitch me cervix and the other tells me not to.

I

> am so confused. Any info. would help

>

> le

[Guest guest]

--- Thank you for resonding it means so much to me. This is my 1st

pregnancy. I have a regular OB who sent me to the High Risk guy for a

consult. He would not give an opinion but otons. I could have

selective reduction which would kill one baby and try to sav the

other. My husbandand I did not feel comfortable w/that. he said I

could have a cerclage. He said at worst it could be a waste of time

b/c I could still loose the babies due to premature delivery. Or he

could check it every 2 weeks. I do not know the measurement of my

cervixes I go to see him on Tuesday. My only hesitation of the

cerclage is that something will go wrong b/c they would stitch around

both cervixes and the babies could get hurt. The doctor said we have

to make the decision and he does not say what he would do so it is

hard he said there is no right or wrong, no way of knowing. I am so

afraid of doing the wrong thing. I need to decide on Tuesday.

Thank you soooooo much for writing back.

le

[Guest guest]

--- Thank you for resonding it means so much to me. This is my 1st

pregnancy. I have a regular OB who sent me to the High Risk guy for a

consult. He would not give an opinion but otons. I could have

selective reduction which would kill one baby and try to sav the

other. My husbandand I did not feel comfortable w/that. he said I

could have a cerclage. He said at worst it could be a waste of time

b/c I could still loose the babies due to premature delivery. Or he

could check it every 2 weeks. I do not know the measurement of my

cervixes I go to see him on Tuesday. My only hesitation of the

cerclage is that something will go wrong b/c they would stitch around

both cervixes and the babies could get hurt. The doctor said we have

to make the decision and he does not say what he would do so it is

hard he said there is no right or wrong, no way of knowing. I am so

afraid of doing the wrong thing. I need to decide on Tuesday.

Thank you soooooo much for writing back.

le

[Guest guest]

--- Thank you for resonding it means so much to me. This is my 1st

pregnancy. I have a regular OB who sent me to the High Risk guy for a

consult. He would not give an opinion but otons. I could have

selective reduction which would kill one baby and try to sav the

other. My husbandand I did not feel comfortable w/that. he said I

could have a cerclage. He said at worst it could be a waste of time

b/c I could still loose the babies due to premature delivery. Or he

could check it every 2 weeks. I do not know the measurement of my

cervixes I go to see him on Tuesday. My only hesitation of the

cerclage is that something will go wrong b/c they would stitch around

both cervixes and the babies could get hurt. The doctor said we have

to make the decision and he does not say what he would do so it is

hard he said there is no right or wrong, no way of knowing. I am so

afraid of doing the wrong thing. I need to decide on Tuesday.

Thank you soooooo much for writing back.

le

[Guest guest]

Hi le,

Wow, your RE sounds like he doesn't have a very good bedside manner.

Selective reduction for twins in a UU is really not called for at

all, and to say that any treatments would be a " waste of time "

because you could " lose the babies anyway " is just terrible. Is

there anyway that you could see another high risk doctor? Could you

ask your OB for another name to consult with? Perhaps if you see two

doctors, you might have a better feel for things and have more info

to make your decision with.

It's important to find out if your RE thinks your cervix *right now*

is getting soft and short, or if it's still long and firm and

closed. If it's already softening, you'd want to go for the

cerclage, even with the small risks. I think in general, cerclages

are pretty safe, but maybe Beth could answer you and help (she had

one done). If it's not softening, you might be ok with monitoring it

every 2 weeks and then seeing if you need a cerclage later. You

should mentally be preparing for the fact that you might need to go

on bedrest. When you know about the BU, and are being monitored

carefully, and are paying attention to your body for ANY sign of

premature labor, then the outcome is usually very good for the baby.

I'm sorry I can't give you an answer, but do try to see another

doctor, and also, find out the measurement of your cervices on

Tuesday. So you know, anything over 3 cm is good and anything under

3 cm is not so good.

Good luck,

Jill

SU resected

> --- Thank you for resonding it means so much to me. This is my 1st

> pregnancy. I have a regular OB who sent me to the High Risk guy for

a

> consult. He would not give an opinion but otons. I could have

> selective reduction which would kill one baby and try to sav the

> other. My husbandand I did not feel comfortable w/that. he said I

> could have a cerclage. He said at worst it could be a waste of

time

> b/c I could still loose the babies due to premature delivery. Or he

> could check it every 2 weeks. I do not know the measurement of my

> cervixes I go to see him on Tuesday. My only hesitation of the

> cerclage is that something will go wrong b/c they would stitch

around

> both cervixes and the babies could get hurt. The doctor said we

have

> to make the decision and he does not say what he would do so it is

> hard he said there is no right or wrong, no way of knowing. I am so

> afraid of doing the wrong thing. I need to decide on Tuesday.

>

>

> Thank you soooooo much for writing back.

>

> le

[Guest guest]

Hi le,

Wow, your RE sounds like he doesn't have a very good bedside manner.

Selective reduction for twins in a UU is really not called for at

all, and to say that any treatments would be a " waste of time "

because you could " lose the babies anyway " is just terrible. Is

there anyway that you could see another high risk doctor? Could you

ask your OB for another name to consult with? Perhaps if you see two

doctors, you might have a better feel for things and have more info

to make your decision with.

It's important to find out if your RE thinks your cervix *right now*

is getting soft and short, or if it's still long and firm and

closed. If it's already softening, you'd want to go for the

cerclage, even with the small risks. I think in general, cerclages

are pretty safe, but maybe Beth could answer you and help (she had

one done). If it's not softening, you might be ok with monitoring it

every 2 weeks and then seeing if you need a cerclage later. You

should mentally be preparing for the fact that you might need to go

on bedrest. When you know about the BU, and are being monitored

carefully, and are paying attention to your body for ANY sign of

premature labor, then the outcome is usually very good for the baby.

I'm sorry I can't give you an answer, but do try to see another

doctor, and also, find out the measurement of your cervices on

Tuesday. So you know, anything over 3 cm is good and anything under

3 cm is not so good.

Good luck,

Jill

SU resected

> --- Thank you for resonding it means so much to me. This is my 1st

> pregnancy. I have a regular OB who sent me to the High Risk guy for

a

> consult. He would not give an opinion but otons. I could have

> selective reduction which would kill one baby and try to sav the

> other. My husbandand I did not feel comfortable w/that. he said I

> could have a cerclage. He said at worst it could be a waste of

time

> b/c I could still loose the babies due to premature delivery. Or he

> could check it every 2 weeks. I do not know the measurement of my

> cervixes I go to see him on Tuesday. My only hesitation of the

> cerclage is that something will go wrong b/c they would stitch

around

> both cervixes and the babies could get hurt. The doctor said we

have

> to make the decision and he does not say what he would do so it is

> hard he said there is no right or wrong, no way of knowing. I am so

> afraid of doing the wrong thing. I need to decide on Tuesday.

>

>

> Thank you soooooo much for writing back.

>

> le

[Guest guest]

le:

My thoughts are with you. The risk averse position is to get a

cervical cerclage. You should discuss with your doctor whether a

Shirodkar or modified Shirodkar cerclage would be most appropriate

under your circumstances. I had a modified Shirodkar and started

contracting at 28 weeks. I got to 37 weeks on tocolytics and with

the modified Shirodkar (put in at 18 weeks after Mc cerclage

failed). I really think the cerclage got me to " full term. "

Best of luck to you! Also, make sure you are being seen regularly by

a perinatologist as soon as possible. I am not a doctor, but you

probably should go on bed rest if it is an option for you financially.

t

SU? unresected

Mom to Maxwell, 14 weeks

> I have 2 cervixes and a bicornuate uterus and am carrying twins.

> Everything that could work against me has so far. I am so scared.

One

> doctor tells me to stitch me cervix and the other tells me not to.

I

> am so confused. Any info. would help

>

> le

[Guest guest]

le:

My thoughts are with you. The risk averse position is to get a

cervical cerclage. You should discuss with your doctor whether a

Shirodkar or modified Shirodkar cerclage would be most appropriate

under your circumstances. I had a modified Shirodkar and started

contracting at 28 weeks. I got to 37 weeks on tocolytics and with

the modified Shirodkar (put in at 18 weeks after Mc cerclage

failed). I really think the cerclage got me to " full term. "

Best of luck to you! Also, make sure you are being seen regularly by

a perinatologist as soon as possible. I am not a doctor, but you

probably should go on bed rest if it is an option for you financially.

t

SU? unresected

Mom to Maxwell, 14 weeks

> I have 2 cervixes and a bicornuate uterus and am carrying twins.

> Everything that could work against me has so far. I am so scared.

One

> doctor tells me to stitch me cervix and the other tells me not to.

I

> am so confused. Any info. would help

>

> le

[Guest guest]

le:

My thoughts are with you. The risk averse position is to get a

cervical cerclage. You should discuss with your doctor whether a

Shirodkar or modified Shirodkar cerclage would be most appropriate

under your circumstances. I had a modified Shirodkar and started

contracting at 28 weeks. I got to 37 weeks on tocolytics and with

the modified Shirodkar (put in at 18 weeks after Mc cerclage

failed). I really think the cerclage got me to " full term. "

Best of luck to you! Also, make sure you are being seen regularly by

a perinatologist as soon as possible. I am not a doctor, but you

probably should go on bed rest if it is an option for you financially.

t

SU? unresected

Mom to Maxwell, 14 weeks

> I have 2 cervixes and a bicornuate uterus and am carrying twins.

> Everything that could work against me has so far. I am so scared.

One

> doctor tells me to stitch me cervix and the other tells me not to.

I

> am so confused. Any info. would help

>

> le

[Guest guest]

le,

I can't really give you any specific advice, but I can share my experience and

decision

factors with you. I am 29w4d pregnant with a BU, but only one cervix and only

one

baby! This is my first pregnancy also.

I was referred to a group of Perinatologists, in addition to having a regular

OB.

Therefore, I've had the opportunity to speak with more than one individual Peri.

Opinions about treatment of our conditions seem to vary greatly, because there

really

is no " right " or " wrong " answer. It doesn't sound like you were comfortable

with the

Peri you saw and maybe you can talk to another one. Not to pressure you or

anything, but at this time in your pregnancy you have to be getting monitored

because now is when things can start to go wrong with the cerviix(es) if it's

going to

happen. Whoever you see, whether you like them or not, make sure you are being

watched for cervical changes.

We decided to watch my cervix instead of automatically doing a cerclage. This

seemed to be what all the Drs agreed on, but I felt that if I insisted otherwise

it would

have been OK. At 14 weeks they started doing trans-vaginal ultrasounds every

two

weeks. At 17 weeks my cervix started to change (it was closed for the u/s but

showed

evidence that it had been doing something because there was a clot of blood in

the

middle of it). The Peri then told me to start coming in once a week to watch

the

cervix more carefully. At 19 weeks, the cervix had gone from 4.5cm to 2+cm in a

week. They sent me right over to L & D for an emergency cerclage. I did fine

with the

cerclage and have been on bed rest ever since. I have onlly had one episode of

PTL at

28 weeks and after one night in the hospital it seems to be under control.

There are pros and cons of waiting to do the cerclage. By getting it sooner,

the stitch

could be put in higher if you haven't " lost " much of your cervix yet, and if the

membranes are already hanging down into your cervix, the stitch could possible

" crimp " (leading to rupture) your membranes. These negative outcomes could be

avoided if you are getting the cerclage early enough because you were being

carefully

monitored and they caught it early enough. By waiting, you can see if you

really need

it. The thinking there is: why subject yourself and your babies to a procedure

if you

might not have any problems with your cervix(es) anyway? These quandaries are

why

the doctors won't " tell " you what to do.

I am glad that we waited, even though I ended up needing the cerclage. The key

to

my positive outcome is the careful monitoring that I received. INSIST on this!

One of

the OBs at my practice got all pissed off that the Peri wanted to see me every

week

and she told me that was unnecessary and not to go every week. I ignored her---

thank God I did because it was at my next Peri visit that the cerclage was

ordered.

I was also on modified bed rest from weeks 14 or so on, and I think this reduced

activity helped slow the progression of my cervical problems. This was possible

for

me because I had gotten laid off from my job a few weeks earlier. You might not

have

such a " luxury " .

As you can see, each case is individual and you have to decide what you think is

best

for you. I hope my experience can be useful to you in some way. Feel free to

contact

me if you have any questions about the procedure or want to know more about my

case.

Good luck and remember that whatever you decide, it will be what you feel is

best for

you and there is no " right " answer. Trust your instincts and have faith in your

body

and your babies!

34

BU and Fibroids

29w4d first pregnancy

Emergency cerclage at 19 weeks