Anyone from Canada with short cervix?

[shikha001]

Hi,

I have been following the other thread with incompetent/short cervix but I want to get some advice from ladies in Canada about the treatment and the follow ups.

About me: this is my second pregnancy. First was fairly uncomplicated until the end when the doctors thought I had pre-eclampsia and I was induced just short of 37 weeks. But it did not work and my numbers were back to normal after 2 days. Then I was induced again at 38 weeks and 3 days. After 2 days of being in labor, I did not dilate and had a caesarean. DD was born healthy, no complications.

Now with my second pregnancy, everything seems to be going ok until 20 week ultrasound. Baby was looking good but I had short cervix of 2.1cm. They asked me to take it easy at home and see the doctor. I am a SAHM. I saw my gyno at 21 weeks and had another ultrasound. Cervix length went down to 1.7cm. I was put on bed rest. I could use the bathroom and have shower but no cooking, no cleaning. Be a couch potato, I was told. Also, I started prometrium 200mg every night.

At 23 weeks, length was 2cm. According to my doctor, she was happy with the length as it has not decreased and it is considered stable. I was not going to get more ultrasounds as there is no point, doctor told me. Stay on bed rest and continue with prometrium.

Next appointment was at 27 weeks. No ultrasound but she checked the cervix manually and said that it is still closed. Continue with bed rest. I will be on bed rest at least until 34 weeks. And I will have another ultrasound at 32 weeks to check on the baby.

I was never given an option of cerclage.

My question: Is this normal? No more ultrasounds. I keep reading how everyone else is getting the cervix length checked every 2 weeks. And for me, it is not offered. My doctor is a high risk doctor as I have type II diabetes. And she is very good. Plus she knows my history as I had the same doctor with my first pregnancy.

So I am curious about treatment in Canada as it seems to be very different from the USA and the UK. May be because it is all paid by taxes and considered to be "free". Any thoughts are welcome.

Today I am 28 weeks.

Thanks for reading.

 

[lovenoel]

Hi there, I'm in the US but wanted to share what my high-risk OB said - I had a check at 28 weeks this week and she gave me the option of having one more or being done. I chose to have one more check next Friday, but she told me that doctors in Europe generally stop checking cervical length at 24 weeks because they don't do cerclages past that point anyway. I thought it was interesting to hear...maybe it's similar in Canada?

 

[sprite30]

I'm in the us as well and just got my 24 week check and was told no cerclage was needed and that they will look at my cervix 2 more times but measurements were just for there information as their aren't many studies to show that the length matters at this point which is why they won't do a cerclage. The mfm said that they will do whatever they can to prevent preterm birth and give baby steroids if needed but if labor happens it happens and babies chance of survival now are very high.

I was told they don't do cerclage so past 24 weeks because the risks of infection and the risk of the surgeon rupturing your membranes are far greater then just leaving well enough alone.

I don't think your care in canada is too far off from what I've experienced, and if I had told my mfm that I was going on vacation I couldn't come back until 27 weeks I think he would have been fine with that. I think that 23 week appt and being at 2 cm then was the magic number for you.

 

[shikha001]

I understand the line of reasoning but I have never came across anyone on the internet who was not offered more length checks. Even if it is for more information. So, I thought may be it is unique in Canada.

 

[CrunchyJenny]

Hi Shikha, I'm not sure I have answers for your situation but I'll share mine and maybe it will shed some light. I have a history of preterm labour likely due to an incompetent cervix. At my 12 week US my cervix measured a normal length and my mfm doctor implied she wanted to take the "wait and see" approach. I told her I'd rather do a preventative cerclage because of my history and thankfully she is allowing it. I'll be getting the cerclage in a week. I expected to be monitered every 2 weeks after that but she said my next US would be at 18 weeks. I asked her why and she said that the stitch is in place and there's no more that they could do at that stage of the pregnancy. I believe they will be monitoring me every 2 weeks after the anatomy scan and possibly putting me on progesterone if my cervix is shortening. I think your dr's reasoning for not doing more length checks for you at this point in your pregnancy is that they can't do a cerclage at this stage anyway. I think the most they can do is give you the progesterone to keep the cervix closed, which I think you said they're already doing. It's not great for your peace of mind but it probably has something to do with the cost of it.