Two Daughters After Successful Treatment

Maryann Gates now has two beautiful, healthy daughters. But five years ago, she was mourning the loss of twins 19 1/2 weeks into her pregnancy.

After losing her babies--Angelica was stillborn and Brianna lived for 20 minutes--her obstetrician diagnosed her with an incompetent cervix, a condition that can cause recurrent pregnancy loss. With incompetent cervix--also called cervical insufficiency--the cervix opens too early in the pregnancy, causing the baby to fall into the birth canal. The doctor suggested a vaginal cerclage to treat Maryann's condition.

A cerclage is a band of woven synthetic material that is placed around the cervix to reinforce it and prevent it from opening prematurely. There are different types of cerclage procedures available. Transvaginal cerclage (TVC) is when the cervix is shown shut with a suture placed through the vagina. This approach requires bed rest and has an approximate 85 percent success rate. A less common, but more effective approach is transabdominal cerclage (TAC), which involves placement of the cerclage high in the cervix to prevent it from opening. TAC has a more than 95 percent success rate and requires no bed rest, but the mother must deliver via C-section.

Maryann turned to the Internet for support, where members of a group called Making Miracles suggested she have her cervix measured. The women on the site also pointed her to a site called Abbyloopers, which aims to educate women about transabdominal cerclage. Their advice and Maryann’s research led her to Arthur Haney, MD, at the University of Chicago Medicine. By the time the Bolingbrook, Ill., resident called Haney’s office and made an appointment, she was pregnant again, after an in vitro fertilization cycle.

A consultation with Dr. Haney showed that Maryann had no external cervix, which would make vaginal cerclage impossible. At 11 1/2 weeks into Maryann’s pregnancy, Dr. Haney performed a transabdominal cerclage. The mom-to-be still had fears about losing her baby and found herself asking, "Is this really going to work?" But as her pregnancy progressed to 18 and then 24 weeks, Maryann became more and more confident about the treatment. Her daughter Katrina was born, without complications, via C-section in July 2005.

Maryann and her husband Mark wanted to have another child. She called Dr. Haney to ask about the safety of trying again and was relieved to hear that if the transabdominal stitch had been safe throughout the previous pregnancy, it would be fine for this one. Maryann became pregnant using an embryo from their previous in vitro fertilization cycle--and the pregnancy was "smooth sailing," she said. The Gates’ younger daughter, Isabella, was born in October 2007.

Maryann, who was an accountant before her girls were born, now stays home full-time and also runs a Yahoo! group for Bolingbrook moms. She tries to share her story about transabdominal cerclage with other women who learn they have incompetent cervix.

The procedure has "such great rates of success," she said, and typically no bed rest. Maryann’s regular obstetrician had heard little about it until she began research after losing her twins. Transabdominal cerclage "is used as a last resort" for treating incompetent cervix, she said, but she wants more doctors and patients to know about the promise of the procedure. "You’re letting the women lose these babies."

"It is so hard losing your pregnancy," Maryann said. But she remembers hearing stories from the people on Abbyloopers when she first heard about transabdominal cerclage. "Any reassurance makes a big difference."


Original Published Link Two Daughters After Successful Treatment

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