Pregnancy after Trachelectomy

Hi Ladies,

I have just found out I am pregnant after having a trachelectomy in 2012. It’s still very, very early days but I feel so lucky to get this far!

I live out in the sticks in Wales and no one here has even heard of a trachelectomy!! This was fine for my 6 month check ups but I want to get more specialist care during the pregnancy.

Does anyone know which hospitals I should be contacting or what protocol I should be following please? I feel totally in the dark and I’m going around in circles!!

Thanks so much

Hi Lisa 

CONGRATULATIONS!!  Wonderful news.  Were you trying for long??

I can't help with hospitals i'm afraid, but I did come across this very handy guide which was written for medical professionals to help them plan for managing a trach pregnacny.  Most people have no idea what a trach is i'm afraid!!!  I plan on taking a copy of this with me to any appointments when I fall pregnant. (fingers crossed!)

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3651944/

The one thing I do know, is that they often get you started on  progesterone pesseries pretty early on.  This helps to build a mucous plug to protect baby. 

Also, if you are not already a member, there is a closed facebook group with almost 100 women from around the world who have had trachelectomies.  LOADS of them have been pregnant and some are pregnant at the moment.They are a wonderful support network and a wealth of information. Let me know if you want more details and I will private message you.

Lots of luck - I am sure it will be nerve racking at times but you will be just fine!!!

N x

Hi Nellie,

 

Thank you!! No I wasn't trying for very long at all, around 6 months.

 

This is brilliant thanks, I'll take it along to my appointments. I do feel like they need a bit of guidance here!

 

I'm trying not to get too excited and take every day as it comes, I'm sure I'll feel much better once I've had my 1st check up.  I honestly didn't think this would happen so hopefully it will give some hope to others in the same situation.

 

Thanks again and good luck to you too 

xx

Hi Lisa

Congratulations on your pregnancy! 

I'm on my second pregnancy after a trachelectomy. I went to 37 weeks with my son and I'm now at week 30 with twins.

I was looked after very well and there were a few things that were done to make sure I got to a good term. 

1) the progesterone pessaries twice a day. There's a lot of conflicting info about how effective these really are but the consensus is that they don't do any harm so probably worth doing 

2) A transvaginal stitch which should be put in by week 12. This was to reduce the risk of infection as a mucus plug doesn't usually form for us trach ladies 

3) fortnightly cervical length scans and to check for funnelling (cervix starting to open)

4) a lot of rest and lying on my side when cervical length went below 1cm. This happened at week 23 and I had to give up work. When I delivered I had about 2mm left of cervix.

there are so many trach ladies that have had successful pregnancies now. My consultant said they used to celebrate each one in the early stages but don't bother any more as its so common! So that's very comforting to know. 

definitely go armed with info if they don't know much about it and push for what you want. i know lots of people have had the experience of doctors saying they don't need to do cervical length scans often or even at all but i think these scans are crucial as they are the best indicator of how the pregnancy is going. 

Wishing you lots of luck!

all the best

Hi,

 

Thanks so much this is so reassuring and helpful, I actually feel more relaxed after reading that.

 

Is the transvaginal stitch in addition to the cerclage that's put in during the trachelectomy op? My care has now been transferred to a hospital in England so I'm hoping they are more clued up, but I will be going in armed with info as you say!!

I think I have an early transvaginal ultrasound coming up, are they safe for us ladies??

Sorry for all the questions!

Congratulations to you too and thanks again

Lisa

Great that you have been transferred to a different hospital. Which hospital is it?

Yes the transvaginal stitch is in addition to the Cerclage. 

The transvaginal scan is fine, thats what I've been having all the way through the pregnancies. 

Feel free to ask me whatever x

I've been transferred to the Shrewsbury/Telford hospital.

Good to know about the stitch and the scan. I'm really going to push for the measuring of the remaining cervix if they don't suggest it, it sounds so important.

My midwife called me today to say they will send a letter with my 12 week scan appointment, I was expecting to see them sooner than that. Maybe it's normal?!

Thanks so much again xx

A transvaginal stitch should be put in by your 12th week so you would need to speak to someone about it before your initial appointment. 

if there is no department at the hospital that focuses on preterm birth prevention then phone the antenatal department to see if there is a specialist you can meet with to discuss the stitch before 12 weeks. Don't be afraid of pushing and chasing to get what you need. One thing I've learnt over the past few years is how much I have had to be in control of my care, as amazing as I think the NHS is. X

Hi there Rocket

Out of interest, what kind of cerclage do you have??  I've never heard of anyone having an additional TVC done as a preventative - only as a rescue stich if the cerclage fails.  I have also heard of an occlusion stitch where they stich a flap of flesh over the opening to prevenet ascending infection, but very few people perform this.  Just very curious. x

I will get onto the hospital about the stitch, thanks. They do have a neonatal unit so hopefully I can arrange it.

 

How do they actually make the stitch? I'm assuming it's safe for the baby or it would'nt be offered. It makes so much sense to have an extra 'safety net' to help prevent pre term labour.

xxx

Hi Nellie

i was told the TVC was more about keeping infection out. I don't know if it had a specific name. They didn't use a flap of skin though, I've never heard of that before.  I also had a trans abdominal Cerclage put in to help with preterm birth prevention as it wasn't during the trach. X

Hi Lisa what do you mean by how do they make it? Do you mean how do they put it in? X

Hiya,

Yes, sorry I didn't word that very well!!

As in, what kind of op is it? Did the hospital offer you this straight away, or did you have to ask for it?

Thanks x

I had a local anaesthetic and was out the same day as soon as anaesthetic wore off. The op didn't take long at all. They of course have to say there are risks attached as with any op. 

I didn't have to ask they offered it to me but I did have to chase to make sure it was done within 12 weeks. X

Thank you x

I live in Wales and my consultant referred me to the Wales Fertility Clinic (based in Cardiff and Port Talbot) :) 

Hi I live in Cornwall had a radical trachelectomy in 2010 and lymph nodes removed i have just found out i am 8 weeks pregnant, i have had an early scan because of pain but all seems good. My Consultant has decided to retire which has left me with no one i am feeling very unsettled because no one down here has ever heard of a radical trachelectomy my midwife has refered me to the premature baby comsultant but wont get to see them until after my 12 week scan, after reading this thread i am wondering does anyone have any advice on who i should contact about this additional stitch and pesseries etc Do i contact midwife? premature consultant or my gyny unit? please help :)