# cervix shortening--when to worry



## curiouscat6

I finish 20 weeks tomorrow and have found out we are having a baby girl and boy--we are super psyched... However, we also found out today that my cervix is now measuring at 2.9... The docs said they won't be concerned until they see 2.5 and that both of the babies heads were pressed against it in the ultrasound so it's MAYBE possible that's why it decreased (my cervical length was 4.2 just three weeks ago and I've never had cervical issues in my entire life). I'm just really worried, since I don't have experience in this area.. :nope:

I wanted to get your thoughts on cervical lengths with twins. What was your experience with cervical shortening--what do you guys know about it--can it go back up or once it goes down it stays that way? and how fast can it shorten?


----------



## CaliGirl35

I don't have any answers since I'm 16 weeks, but I go next Thursday to have mine measures again... But I have been curious about this exact thing, I hope someone here can share their experience.

Did your Dr. put you on light bed rest or tell you to take it easy?


----------



## curiouscat6

Cali,
No, that's the strange part of it.. he said just continue my regular routine (making sure I don't overexert myself) and that he wasn't worried because the cervix can be 'dynamic' (whatever that means) and that I'd be monitored again in two weeks and if there was another reduction that's when we'd discuss options which I assume will include bedrest.


----------



## CaliGirl35

That is pretty weird. I guess it's a good thing, because if it was something to really be worried about, he would have put you on it right away? He does not have you coming back for tow weeks??!! 
To be safe, if I were you, I'd rent some movies and get some good food prepared, and rest all weekend. Put your feet up and relax. Let your OH take care of you if it's possible... :) It can only help you to be safe now and give it a chance to get better, if that's something that can even happen..


----------



## curiouscat6

totally agree--but I really like this place--it's a high risk fetal medicine firm so the docs are on point. Aside from this number, he said my cervix looks strong--no funneling or softening so that was good and according to him, women with twins during their 20s often have a measurement of 3.2-3, so he said I wasn't that far off, but still, it's concerning.


----------



## lizziedripping

Hi hun, I have lots of cervix related experience and would like to help if I can.

Your cervix is currently within normal range, but is at the shorter end of normal. It has also shortened significantly in 3wks so I would personally exercise caution despite what the medics are advising.

If everywoman were scanned in pregnancy, there would be a huge variation in cervical length, and it is normal for some gradual shortening as a pregnancy progresses. It is also true that twins exert greater pressure on the cervix, and the extra stretching of your uterus much earlier on also adds to this strain. In women who might otherwise carry a singleton fine with no cervical issues, there is sometimes a 'twin related' cervical incompetence which causes a possible problem around 16 to 24wks. It is one of the reasons why twin pregnancy is considered 'high risk', and the reason your team have been so proactive in checking your cervix with regular scans.

A dynamic cervix is one which constantly shortens and then lengthens again day by day, sometimes even hour by hour! It might well be that yours was 2.9 today, but tomorrow has regained some length and is 3+. This scenario is possible and very common and women in that position can continue like that to term.

It might be that your cervix now remains stable for several weeks, or it could shorten further. In my experience both are equally possible, BUT since you have had an early 'warning' that your cervix is changing, albeit minimally, then I'd personally do as much as possible to give it a helping hand and take the strain off it just to be on the safe side. 

It is good news that there is no funneling yet (which is when the cervix opens at the top, but remains closed at the bottom). Shortening usually comes first, then funneling and finally dilation. With an incompetent cervix all this happens without contractions and is purely a mechanical issue as the weight of the uterus gently exerts pressure on the top of the cervix, gradually opening it. Yours is nicely closed and may well stay that way for the duration, but given it has shortened in recent weeks then take it as a sign to rest hun.

You are actually in a great position, because most women do not get to see how their cervixes are holding up. 2.9 could actually be normal for you, and you could just have a short but strong cervix which holds up fine. My feeling is that you should take precautions and rest until you know for certainhowever.

I have Incompetent cervix and gave birth to my second child at 24wks as a result. With the twins I had a cervical stitch placed at 12wks and apart from some funneling at 25wks, made it to my planned section at 38wks. I wish I had known my cervix was 'misbehaving' early in my second pregnancy because I could have atleast done something about it. 

Genuine IC is rare, and I don't want to worry you uneccesarily, but now that you have discovered some cervical shortening and are carrying two babies (always more complex), I'd definitely take the opportunity to take things easy chick.

Hope that helps, and please get in touch if you need anything xxx


----------



## heyyady

What they told me was they don't get really worried until it's 2 or under- 2.9 sounds like a great length to me! But I agree with the girls- about taking it easy- and stay super super hydrated!


----------



## SquirrelGirl

I'm in about the same situation. At about 18 weeks I measured 4.6. At 21 weeks it was 4.1. Three days later after I had a spell of contractions I was down to 3.2. I completely freaked out. If it could go down so much in three days who was to say what it would be like in another 3 days! 

Well, three days later it was 3.18. Three days after that it was 3.75. :shrug: That's where I'm at right now. been on strict bedrest for a little over a week due to contractions and I'm doing so much better. 

I also didn't understand how a cervix could be dynamic. All I'd read on the internet was that once it shortens it doesn't re-lengthen. But I'm proof that it can vary day by day. 

Taking it easy / being on bedrest seems to be helping my situation. It's not always a barrel of fun, but I will do what I need to do.


----------



## curiouscat6

Hi guys, 
just an update on me: I went back again last night and had my cervix checked again--last one was at 21 weeks. It had been about 12 days since the last check: I'm still at 2.9cm right now, 'no funneling and strong' said the docs. They said it was nothing to worry about right now--I'm now at 23 weeks but I was a bit bummed, I had hoped this number would go up but one of the twins again had their little head on my cervix. 

The reason I went in was because I was having these little twinges--almost pin-prick like sensations coming from deep in my vaginal canal--maybe even my cervix area. Has anyone experienced this? I feared it may be related to my cervical measurement but the docs said no. They it's likely just ligament pain.. still that seems odd to me, I thought that pain was more in the belly area, not deeper in the vagina. any thoughts? My next cervical check is in a week so hopefully I won't go down again.


----------



## SquirrelGirl

Yep, been there with this too. I was also told ligament pain. There are the major ligaments on the sides of your stomach that most people talk about, but there are other ligaments all over the place and some attach to the vagina.

One time I was walking and suddenly felt like I was being stabbed in the hooha a couple times. It was extraordinarily painful. I thought for sure it was an MC. Had an emergency appointment, they checked everything out and said it was ligament pain. I've since had many of those little tiny pricking/stabbing type pains that aren't any where near as bad, but still noticeable, which sounds like what you're describing.


----------



## CaliGirl35

I get those same pains!! I also get pain in my pelvic bone when I am walking, or go to stand up?? Anyone else experience this?
At my last Dr. appt. I was 17w2d and my cervix measured 3.7 he told me as long as it stays above 3.0 then no worries, but if it goes below thats when bed rest comes in??? :shrug: That seems like its still a high number at that point to then consider bed rest?!


----------



## curiouscat6

Cali,
I kind of agree.. my fetal maternal specialist said bedrest comes in once you get around 2.5... or before if there's any funneling.. I'd ask him why.


----------



## CaliGirl35

I'm going to at my next appt next friday..


----------



## lizziedripping

Hi Cali. Its less about the length and more about the overall rate at which a cervix shortens. 3 is ok, but if it was 4 2wks ago but shortened to 3 in that time then there might be cause for concern. It could indicate a struggling cervix which has the potential to shorten again in the next 2wks. Because twins cause so much more cervical pressure than a singleton, it is important to have as much cervical length to 'play with' as possible, especially early on.

Dropping below 3 isn't catastrophic but is cause for concern, and it's wise to act before it drops too low and 'salvage' any cervix to get you through the pregnancy.Rest has been shown to help a weak cervix regain length, so it's totally worth it hun.

All that said, there are some women with naturally short cervixes which are otherwise strong and remain firmly closed despite being on the shorter side of normal. It's hard to say which are and which aren't so operating caution is always the way to go. 

Most twin ladies would do well to take things easy regardless of cervical length, but when it is looking shorter then it's best to play it safe and rest when you can. If yours were to drop below 3 in the next few weeks, take rest atleast until you have seen how yours is behaving over several weeks xxx

Ps - pain in your pelvic bone on standing is definitely spd (separation of pubic bone) Cali. It's harmless but gets quite painful as you progress. Hot water bottle in the eveings worked for me hun.


----------



## lizziedripping

Curious - the twinges you describe in your cervix were, for me, normal throughout the twin pregnancy and got steadily worse as it progressed. I did have a cervical stitch in place, so can't say how much it was related to that, but I certainly didn't shorten significantly, nor did I go into early labour so for me it wasn't a sinister sign. 

It felt like I was being internally pinched and at times took my breath away. On reflection it was probably just my breech baby kicking me low down in my bladder and cervix. Goes with the 'twin territory' lol. 

IC generally causes intense feelings of vaginal pressure and a sensation of bulging. I had this too with the twins and, as it turns out, it was prolapse rather than stitch related (terrifying at the time tho), so again it probably indicates the strain of carrying two rather than a failing cervix. 

It's hard to distinguish the two in twin pregnancy, but at 2.7 your cervix is still holding up quite well, and it's unlikely your physical symptoms are indicative of anything more than normal pregnancy aches and pains at this stage x


----------



## CaliGirl35

Thank Lizzie! That make total sense! As for the spd.... is that normal this early? I have been having braxton hicks too, which from what I see is normal this early with twins, I will mention it to the Dr. anyway... I have been having them for a few weeks and the lightbulb just went off that thats what they are!! :dohh:


----------



## lizziedripping

Hi Cali - once you realise that nothing is 'normal' in a twin pregnancy, then you relax a whole lot more lol. Our bodies really weren't designed to carry 2, so they protest often and in the most bizarre fashion.

All these additional symptoms frightened me and convinced me I wouldn't make 30wks, let alone 38! Needless to say I did despite the stitch, bh from 15wks, over distended uterus and relentless pelvic pain and pressure. It is possible hun, but learn to listen to your body. Take it as a sign to rest a little more than you otherwise would have, and you'll be fine :)

Get in touch if you have any more concerns at all xxx


----------



## heyyady

I had those horrid vaginal pains also- at times it was like being poked with a big needle way up there- it would make me yelp and tear up :( I don't remember having that at all with my singleton pregnancies, but then they were 16 an 20 years ago so maybe I've just forgotten? :shrug:


----------



## CaliGirl35

Lizzie- Lol! I am starting to realize that nothing is normal in the twin pregnancy!! Its crazy..sometime I feel like I'm being a wimp, then I think... hello you got TWO in there!!:haha:

Heyyady- I have had those sharp pains too... and to be honest, I don't remember/ didn't have any of this from when I was pregnant with my daughter.. but like you that was 17 years ago! She will be 17 in a month! Crazy how fast time flies... Makes me sad that she is so grown up already when just "yesterday" she was my little baby :cry:


----------



## heyyady

I hear ya- my son will be 20 next week- it's just not possible! :shrug: And it is a whole new ballgame in the baby world from when our kids were babies! I was on a serious learning curve for a while! lol

Where are you in Northern California? We're in sonoma county


----------



## virginialove

Hi Ladies,

I am 16 weeks with twins. My doctor today told me that my cervix is low short @2.7cm. She put me on bed rest for 1 week and will remeasure me next week and see if it's improved. I was not a candidate for the stitch because it was too low or something and it did not have enough tissue to stitch together. Anyhow, she inserted this plastic diaphragm like apparatus called a pessary (spelling??) into my vagina to give my cervix and uterus more support. I have to wear the pessary all through my pregnancy. Also, I was put on prometrium suppositories twice a day to strength my uterus. Hope that helps. Please pray for me!!! I will give you ladies an update next week with my next appointment.


----------

