Sunday, April 21, 2013

What is a TAC??

TAC = Transabdominal Cerclage

How did you know you had an Incompetent Cervix:
I knew I had IC because I went in for my A/S and they checked my cervix with a trans vag u/s. I had the typical U shaped funneling of my cervix, with "silent" contractions. meaning the cervix was funneling from the inside out, and it was too far gone to do an emergency transvaginal cerclage (TVC). It looks like this:
And my little Josh was kicking the bottom of the U.
After I lost J and Z I decided there was no other answer for me than the TAC. So on April 15th I had it placed Lapriscopically. 

Having a TAC placed essentially cures incompetent cervix. it has over a 90% success rate (a traditional vaginal cerclage has about a 55-60% success rate).
Here is a picture of the various cerclages. 
 
A TAC is a band of mersaline tape (one 8" piece of this material can hold the entire weight of an adult!!!) placed AROUND the very top of your cervix (in my case lapriscopically, others have a c/s type incision). The TAC prevents the membranes from even beginning to funnel and "holds" the cervix shut.  A typical cerclage (TVC) is sew THROUGH your cervix at the base, since the doctor needs to access it through the vagina.
So typically a vaginal McDonald cerclage is placed around 12-14 weeks gestation (or in an emergency situation) while it canbe successful, what usually happens is that your membranes funnel to the point of the cerclage, at which point the cerclage can either hold and be fine, rip through the cervix completely (and deliver a premature baby) or funnel to that point and get an infection which then makes you pprom which results in preterm delivery.  
Will it allow you to TTC sooner?
After having the TAC done my doctor suggests you wait 2 cycles before getting pregnant. In my case we had intended to do our next IVF cycle in July, so this works out just fine for us. We could have had the surgery earlier and TTC-ed sooner, but July works out better for our jobs and for EDD as well.
Often times OBs see this as an "extreme" measure to be taking and try to counsel patients out of it. They see it as too invasive when a TVC could work. I'm not playing with the word could here, I'm going as dang extreme as I can. With as difficult as it is to get the baby in there in the first place I dont have a real margin for error (not that people who get PG the "normal" way should EVER have to endure this pain, but you know what I mean).

Please feel free to ask any other questions. I dont mind answering at all!!
Here is a video of the surgery being preformed by the doctor that did mine:


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