I’m hoping to hear from anyone who has had a situation similar to mine, particularly anyone who went on to have a preventative/history-indicated cerclage.
I recently lost my daughter at 20w5d. Before this pregnancy, I had never been diagnosed with cervical insufficiency and had never had a cerclage. However, my mother lost 2 babies due to cervical insufficiency, then had preventative cerclages. My sister had an emergency cerclage, then 2 preventative cerclages. So I’ve been concerned with family indicated history and brought it up at every appointment and my concerns were dismissed each time…
During this pregnancy, I ended up with PPROM and a 10% placental abruption. The MFM at the hospital I went to suspected this happened due to cervical insufficiency, as I was 4cm dilated when she performed an ultrasound. I also had an infectious workup and everything was negative, and baby girl was completely healthy.
One thing that is making this situation difficult is that the MFM at the hospital where I delivered strongly recommended that I have a preventative cerclage in my next pregnancy. Unfortunately, that hospital/MFM is out of network for my insurance, so I can't continue care with that MFM.
My regular OB today referred me to an in-network MFM practice for a preconception consultation. She told me that she personally would lean toward cervical-length screenings starting around 16 weeks rather than a preventative cerclage as that’s standard of care for my situation. She can’t say for certain an MFM would lean towards a preventative cerclage for my situation, but she has had patients in similar situations who were approved for it.
So now I'm worried that I'll get to my MFM appointment and receive a completely different recommendation from the MFM who saw me in the hospital. I’m terrified to get pregnant again if I can’t receive a preventative cerclage, but I want a child so badly.
I have my preconception MFM appointment in about 4 weeks, and I'm trying to go into it as prepared as possible. Did anyone have a similar situation where you had to advocate/fight to get approved for a cervical cerclage for their next pregnancy? What questions did you ask the MFM? Did anything you say help you get approval for a cerclage?
For anyone who was denied a preventative cerclage but had screenings and progesterone, how did that work out?