10 doctors weighed in:
Can I insist upon a preventative cerclage after having suffered a loss at 23 weeks due to amniotic infection that caused the sac to protrude?!
10 doctors weighed in

Dr. John Botti
Obstetrics & Gynecology - Maternal Fetal Medicine
5 doctors agree
In brief: Don't insist!
There is still a lot to learn about the continuum of preterm birth, but cerclage should be reserved for two or more consecutive midtrimester deliveries, or a shortened cervix by ultrasound (<1.
5 cm) between 16-24 weeks. Other therapies include 17-hydroxyprogesterone caproate injections, vaginal progesterone, and early pregnancy treatment of vaginal infection/inflammation. Confer with your ob!

In brief: Don't insist!
There is still a lot to learn about the continuum of preterm birth, but cerclage should be reserved for two or more consecutive midtrimester deliveries, or a shortened cervix by ultrasound (<1.
5 cm) between 16-24 weeks. Other therapies include 17-hydroxyprogesterone caproate injections, vaginal progesterone, and early pregnancy treatment of vaginal infection/inflammation. Confer with your ob!
Dr. John Botti
Dr. John Botti
Thank
3 comments
Dr. Pam Yoder
I would add to Dr. Botti's excellent answer that this might be a topic to discuss with a perinatologist also.
Dr. Hassan Harirah
You might benefit of cercalage if there if cervical length is < 1.5 cm at < 20 weeks gestation. Other treatment includes vaginal progesterone.
Dr. Bryan Levey
Pediatrics
In brief: Agree with "don't"
The problem with insisting is, sometimes, that some doctors might give you what you insist upon even if it's not appropriate.
We don't like to think about things like, that but it happens. It's always better to express your concerns, ask questions, then arrive at a course that both you and your doctor agree upon. Remember, you can always get another opinion if you disagree.

In brief: Agree with "don't"
The problem with insisting is, sometimes, that some doctors might give you what you insist upon even if it's not appropriate.
We don't like to think about things like, that but it happens. It's always better to express your concerns, ask questions, then arrive at a course that both you and your doctor agree upon. Remember, you can always get another opinion if you disagree.
Dr. Bryan Levey
Dr. Bryan Levey
Thank
Dr. Pavel Conovalciuc
Family Medicine
In brief: Depends
Cerclage is a procedure that helps the incompetent cervix to sustain the stress (pressure) caused by the gravid uterus.
If your cervix measurements are normal (length, consistency) and no prior hx of cervical incompetence, there may be no need for cerclage. This is to be decided by your OB provider. Amniotic infection might have resulted from premature membrane rupture and this is a separate issue.

In brief: Depends
Cerclage is a procedure that helps the incompetent cervix to sustain the stress (pressure) caused by the gravid uterus.
If your cervix measurements are normal (length, consistency) and no prior hx of cervical incompetence, there may be no need for cerclage. This is to be decided by your OB provider. Amniotic infection might have resulted from premature membrane rupture and this is a separate issue.
Dr. Pavel Conovalciuc
Dr. Pavel Conovalciuc
Thank
Dr. Marsha Davis
Internal Medicine
In brief: You can try
But you can never force a doctor to do something that for good medical reasons that should be explainable to you, they do not feel is not best for you.
They should always explain to you the reasoning and together you should come up for a plan that is a good solid medical plan.

In brief: You can try
But you can never force a doctor to do something that for good medical reasons that should be explainable to you, they do not feel is not best for you.
They should always explain to you the reasoning and together you should come up for a plan that is a good solid medical plan.
Dr. Marsha Davis
Dr. Marsha Davis
Thank
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