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Old Oct 13th, 2010, 18:08 PM   151
lizziedripping
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Quote:
Originally Posted by jessabella View Post
thanks for the info lizzy...but how do you know if the cervix is the same as time passes..I guess it can only be told by a check or scan right?? I havent had ti checked so Im assuming it is okay...
Maybe I only have a short cervix with funnelling and not IC...I dont know ..they werent clear with me about it all. Im just asking as I want to know how it affects me as baby gets bigger...and also how it will affect when stitch is taken out..like will I most likely go into labour a week or so after ..or is there no way of indicating how it will happen at all.
Hi JB. If your cervix funnels as early as 18wks or so then it is incompetent. A long closed and strong cervix should not open at all under the weight of a second trimester pregnancy. Cervix length is variable from woman to woman, and a shorter cervix does not necessarily mean it is incompetent.

The reason a shorter cervix can be a potential problem is that all cervixes shorten naturally as a pregnancy progresses. If its starting length is short, then there is less room for this to happen and a risk that as it shortens under the growing weight of the baby it might then begin to soften and open too soon.

The idea behind the stitch is that an IC can shorten and funnel, but it won't do so past the stitch. As long as you have a good length of closed cervix below the stitch then that is enough to maintain the pregnancy.

A stitch does not prevent pre-term labour however. If your body triggers labour, then the cervix can and will open as a result of regular, strong contractions despite the stitch. THis is a seperate issue tho, and a woman with IC rarely has the additional problem of going into spontaneous labour too early. Such women cannot be helped with a stitch. Having IC has its up side in that it is possible to do something about it. Unfortunately for those women who experience preterm labour, as yet little can be done to prevent it

With this in mind, once your stitch is removed there is nothing to say you will go into labour within a week or less. If the stitch is the only thing holding your cervix closed, then it will open, but on by a few cms. Because your baby will be big by then, he/she cannot just come out any more You have to go into labour. You are likely to go to full term.

SOmetimes stitch removal can irritate the cervix and be enough to trigger labour, but I have only heard of this happening a handful of times hun. I was anxious not to have my stitch removed at 34wks with the twins, because it was embedded and took some removing. I suspected this might trigger labour in an already over-burdened uterus With twins they take the stitch out earlier, and I felt 34wks was still a little too early to have them if this did happen.

Hope I've explained things a bit better



 
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Old Oct 13th, 2010, 19:35 PM   152
jessabella
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oh that helps alot..Im going to be asking some questions when I see the consultant friday....I really dont know what is going on down there. I dont know if my cervix was short before 18 weeks or not..nothing was mentioned at my 12 week scan..but at the 21 week scan is when they noticed something and said there was opening. Then the mc donald stitch was put in..and I assume it was above where the opening/funneling was happening..but I dont know much detail...although its all in my whitenotes..but hard to understand when I read them..hahah doctor's handwritting!
Anyway you have helped me and I think I just have to wait to see what happens..I feel bad for wanting baby to arrive right at 38 weeks..Im so impatient yet so happy that she isnt arriving too early..but I guess I still have the same symptoms like other mums and cant wait to meet her!
Im not even sure when they will remove the stitch..im assuming at the 38 week mark..
oh ps..everyone got my GTT results back and I dont have GD which was great to hear!! dont know why I was worrying so much that I did!



 
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Old Oct 14th, 2010, 04:45 AM   153
lizziedripping
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In singleton pregnancy stitch gets removed at 37ish wks. Not good to labour with stitch in place, so it is removed before a presumed labour.

Macdonald stitch placed after funneling should have closed your cervix, and is placed about half way. Any funneling after placement can still happen, but if stitch does its job, then funneling shouldn't go past it. A shirodkar stitch is placed at the very top of the cervix, so cannot be used if it has already funneled - good luck today xxx



 
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Old Oct 14th, 2010, 06:25 AM   154
HelenGee
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Thank you again Lizzie, you explain everything so clearly, it really does help.

Jessabella - glad your results are clear - got my MW appointment today so presume will have GD test too
I've been told that they plan to take my stitch out at 36 weeks. I'm in the same situation as you - my cervix wasn't measured prior to 20 weeks so I don't know if it is true IC or just a short cervix. However, i felt really odd from about 7 weeks onwards (lots of pressure and mucous discharge (sorry!)), and i went to L&D at 17 weeks specifically asking them to check my cervix. They did speculum exam and abdominal scan and said cervix was long and closed. At 19w6 my cervix was measured 18mm no funnelling then at 20w4, I was 13mm with funnelling. At 13mm I felt really weird, struggling to pee (it shot off in all directions tmi!) but like i constantly needed to pee). I think mine is IC just based on gut feeling. Fingers crossed our stitches do their jobs xxx

Mich - have seen he Ewan Macgregor motorcycle stuff and it's great - will send hubby to blockbuster later! Glad you are feeling great, I'm really pleased xx



 
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Old Oct 14th, 2010, 07:09 AM   155
Susanah
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Hello everyone.
Been away for a little while. Had my 16 week scan today and the stitch seems to be keeping things in place. I didnt have my cervix measured, just the baby checked. So far things ok. Am terrified of having another infection and am trying so hard to keep a level head, but its hard. Again I was upset when discussing things through with my consultant.
Lizzie - i feel that you are right about trying to avoid going back to work. I am torn as I feel there is a bit of pressure on me to go back, but perhaps I need to just accept that this time needs to be spent resting at home. I have days when Im feeling positive and that working would be fine, and others where I have flashbacks to losing the last baby and fearful of going through that again.
Susanah



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Old Oct 14th, 2010, 09:48 AM   156
radish
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Lizzie - you are such a font of knowledge it is fantastic! I love reading your posts they make me feel so much better.

Glad to see everyone else doing well too....

I had my 20w (i'm 20+5) scan today and baby is absolutely fine which is the good news. There is no change with my cervix again, in comparision with the last scans. I am funnelled to the stitch but not below. Baby is relatively high up and transverse.

I have been signed off work indefinitely and am on orders to rest as much as possible which is what I am doing anyway. I go back in 3 weeks for another scan and review and steroids. The consultant said the priority at this stage is get to 24 weeks (which is the 6th November). She also advised me to try and avoid getting constipated as that can cause problems if straining at the toilet so will keep intermittently taking the lactulose.

I am counting down those days



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Old Oct 14th, 2010, 10:05 AM   157
mich1365
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HelenGee...from what I gather, the diagnosis of short cervix for me is based on the fact it remains unchanged for the most part. They said if it were IC, it would have significantly changed over the course of the last 5 weeks, which happened to be the most telling weeks for IC. My issue now will be that all women's cervixes shorten, beginning naturally around 29 weeks, to prepare for childbirth. Since I am only 1.7 plus or minus a bit each visit, I dont have much to shorten. Most women are still above 2cm at 40 wks, even after 10 weeks of gradual shortening. So I am still prepared to go early.



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Old Oct 14th, 2010, 13:06 PM   158
jessabella
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oh that is an interestng point..I was thinking about that...if the normal pregnancy starts to shorten and weaken and that we already have weak cervix how will that affect when we will start labour... But im woundering if the stitch will prevent my body from actaully preparing for natural labour? anyone know?



 
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Old Oct 14th, 2010, 14:38 PM   159
Susanah
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Radish - good to hear your scan went well
im counting down the days to 24 weeks also
have also been thinking about the constipation issue and feel it probably is really important to reduce it as much as possible



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Old Oct 14th, 2010, 17:34 PM   160
lizziedripping
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JB - an incompetent cervix is only an issue in the second trimester, when baby is small. A weak cervix is exactly that, it 'gives' slightly under the pressure of a growing baby - this is very different to dilating fully under the influence of contractions.

Your cervix should behave no differently to anyone elses in labour. Once the stitch is out it will not suddenly fully dilate to 10cms. If it opens at all, it will only open a little. Labour will then begin as it would have if your pregnancy had progressed without incident hun.

Remember, my cervix was approx 2.8 from 25wks on, and remained that way without shortening further. My consultant was only concerned when she thought my cervix had opened, not shortened. A cervix which begins to shorten before 20wks is a warning for possible IC and early labour, but not a prerequisite for it.

Susanah - I feel so sorry that you are under such stress at what should be a happy time for you. You have had a really traumatic time this year, and it is perfectly understandable that you are scared.

Though it's easy for me to say, please try not to be pressured into returning to work too soon. No one else can know how much strain you are currently under, and how important it is for you to see this pregnancy through safely. I believe you are on course for a happy, healthy outcome; something you deserve. You owe it to yourself to think only of you and this baby at this moment in time - try not to give work a second thought.

As an aside, I was constipated from 20-28wks and it didn't bother my stitch or cervix at all

Helengee, yours does sound like IC, which is why it's good you have the stitch hun.

Radish, glad to hear your cervix is holding its own - the stitch should do its job, with plenty of rest.

Love and best wishes to all, and keep us informed xxx



 
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