I will be 6 weeks on Saturday (or Sunday, depending on how I measure). I’ll have two ultrasounds next week – one with my OB on Wednesday morning, one with my RE on Thursday afternoon. Praying and hoping that all goes well, we should see the heartbeat both times, and I’ll discuss plans for my 14-week cerclage with my OB. Unfortunately, I don’t know what kind I want yet.
I kept telling myself that I wasn’t going to over-research things during this pregnancy, but I’ve broken that rule about cerclages – and, unfortunately, haven’t been able to find a clear-cut answer on which type is best for treating incompetent cervix. I’ve looked at tons of studies, and there isn’t a clear statistical difference between using Shirodkar and McDonald, at least not in any studies I can find. All I find is anecdotal evidence and preferences.
Here are my choices. I absolutely LOVE my OB, and trust him with the world – he’s wonderful. He only does McDonald cerclages, and we live in a relatively low-population area, so I’m not sure how many he does. There are two high-risk OB’s about 60 miles away – one does Shirodkar, one does McDonald. I’m not sure if I should go with my local OB and get the McDonald, or if I should go to one of the doctors who does them more frequently. If I do, I don’t know which style to get, as there are different risks to each. I’m just torn. I’m thinking about just asking my OB if he would prefer to do it, or would prefer referring me out, but I don’t know. Does anyone have any experience with the different types of cerclage?
Wednesday, November 25, 2009
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I don't have any advice for this, but I know you'll get some good stuff here.
Happy Thanksgiving!
You are so, so sweet, Cheryl! :) Thank you - I'm thinking so, too!
My only experience is my own sucky cervix and my own internet searches. My doctor and my perinatologist recommend the McDonald. They really shyed away from the Shirodkar. I'd tell you if it were my choice, I'd choose the Shirodkar. I just like knowing that it is placed higher and tighter than the McDonald. Especially because I don't have a lot of cervix on the outside. But, what do I know. I'm not a doctor. My husband actually stayed up all night (seriously til' 5 am) reading research papers and doing his own statistical analysis (what he does for a living) on McDonald V. Shirodkar. He came to the conclusion that the McDonald is good. Are you planning on doing bedrest? My doctors say I can continue working as long as my cervix doesn't change. You know I'm totally freaked out. I have 2 blog buddies who have just had their cerclages. I'm going before you. Hopefully, I can ease your mind a bit. You can email me anytime- briannemeg@yahoo.com.
I have no advice to give on the choice of the cerclage, but I do think that it is worth asking your OB what his thoughts and preferences are - he may make the decision very easy for you. Good luck and keep us posted!
(And Happy Thanksgiving - this year I am thankful for you and for your willingness to share your Maddie with us.)
Bree - you're awesome!! I'll shoot you an e-mail - I'm going to ask him some more about bedrest, and which method he prefers. I love that your husband spent so much time looking it up/analyzing - that's great!
F&F - You just made me cry! Thank you so much, and I wish all of you the happiest of holidays, too! There are going to be a ton of little hands grabbing for turkey! :)
I don't have any advice for you, but I can pray that all works out well for you and that you make the best decision. I know you will. *hugs* Happy THanksgiving.
As a cerclage mom, honestly, I would not have a McDonald placed on me. McDonald's are great if you have a shortening cervix. However, my research and conversations with OBs have showed that for a true IC case, a McDonald is much more likely to fail than a Shirodkar. The Shirodkar is harder to place, no doubt, which is why most doctors dont do them. But my Shirodkar held during hardcore contractions and didnt fail. It is the reason I was able to carry as far as I did.
These are my opinions, of course, but I felt obligated to share. Feel free to email me if you want to chat.
Jess - thank you! :)
Michele - thanks, that's the type of stuff I definitely want to hear! :) That is such a huge help - I'm going to e-mail you, if that's okay!
I had two McDonalds and they failed. I am the exception of course - my case is baffling Dr's. I would ask for the Shirodkar - it is placed much higher and the chances for failure are less. Some Dr's make the determination when doing the cerclage itself. What does your Dr recommend?
Thanks, Marie! I think I'm pretty sure I'm going to go for the Shirodkar. My local OB only does the McDonald, which is why he recommends it - but he said he's absolutely fine referring me out for a Shirodkar to the high-risk OB. I am pretty sure that's how I'm leaning at this point.
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