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    Incompetent Cervix
    martinawilliams posted:
    Hello, I was on these boards back in 2009. At about 20 weeks I had to do a cervical suture due to an incompetent cervix. Im now pregnant with my 2nd child and I'm wondering if I have to undergo another suture this time around. I would just love to know what are the odds of this happening again.

    Also, I had an emergency c section with my 1st child. How risky is it to try a VBAC? I would love to have a vaginal delievery but I was told the 1st time that my pelvic was too small.

    Thanks for any help or advice.
    scperdomo7 responded:
    Hello and welcome back! I'm not really familiar with all that, so perhaps another member could give you some more information.

    I would definitely be speaking with my OB about all that though, as he/she would be more privvy to your health information that us.

    Either way, best wishes!!
    Robert O Atlas, MD responded:
    You will certainly have a number of decisions to make here.

    First, the issue of the cervical insufficiency. if you truly had this issue, most individuals would recommend you undergo an elective cerclage between 12-14 weeks.

    You did not include what your cervix was, what was the reasoning behind doing the cerclage. This is all important information to know. I believe your physician and you are the best to decide this however.

    I am very familar with this issue, one I deal with quite a bit.

    The other issue of whether to have a trial of labor after C/S (TOLAC), is another issue. The risk of uterine rupture is the biggest fear individuals have. The risk is approximately 0.4-0.7%. This is considered fairly low.

    However, if you have been told you have a small pelvis, then there is literature which would suggest a repeat C/S would in fact be the safest option for you.

    Again, these will need to be discussed with your physician. good luck with your decisions.

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