I am a 26-year-old female and have had two miscarriages (one at 14 weeks and another at 19 weeks). I was diagnosed with an incompetent cervix, so I had a cerclage done for both pregnancies. My doctor ran numerous amounts of tests, including a hysterosalpinogram, and all came back negative. My doctor cannot find anything that would cause me to miscarry and now wants to do a trasabdominal cerclage the next time I get pregnant.
How effective is the cerclage? What makes it different from the vaginal cerclage other than it's done through the abdomen? Can I continue to work?
I think your doctor's on the right track. The abdominal cerclage is indicated after a failed vaginal cerclage with an incompetent cervix. It is placed around the cervix, but behind the vaginal wall. The consistency of the cervix there is much better for holding when constricted by the wrap-around nature of the cerclage.
I prefer to do mine before a next pregnancy, because there's less bleeding since you're not operating on someone who's pregnant, no risk to a baby of course, and doesn't interfere with conception. It means you need C-sections thereafter, but if that's the only way to have babies, it's worth it.
I've had mixed results with the comfort level with an internal cerclage. Some of my patients were able to work to the day of delivery. Others had cramping throughout the pregnancy, which confused me into ruling out preterm labor, which I did. But these patients had frequent episodes of this, which is a little nerve-racking, but harmless.