Incompetent Cervix - stitch/cerclage - threatened labour

[HearMyPrayers]

Jumping in here I'm 21+6 and was diagnosed with a really short cervix @ 0.6cm at 20+1. I'm on 200mg preogesterone daily and was told a cerlage at the short of a length was too risky as the water bag could break and it poses more chance of infection as well. I had a follow up ultrasound this past Tuesday and small increase to 0.9cm. No dilation cervix is still closed and firm.

Bedrest is so very hard, mentally more than anything. Especially at this time of year when there is so much festive things going on. But I will do whatever it takes to bring my baby boy here safely.

 

[kirstybumx3]

Hi ladies. I've just found out I'm pregnant with my second child. My first was premature and there was question of incompetent cervix last time so I was just wondering what might happen this time, does anyone know?
I had an appt at my doctors this Saturday and she booked me an emergency appointment with the midwife this Tuesday and I don't know what to expect. Is there any way they can find out if I actually do have incompetent cervix or will it just be a game of wait and see? I am so anxious and really hope they take my worries seriously.

 

[klabro]

Thanks Kat!

Congratulations on a good cervical length and a boy Twinklie! So glad to hear

Welcome hearmyprayers- Hang in there with the bedrest! There are many ladies here who have been in your situation and will be able to offer great moral support to get through, keep cooking that baby

Kirsty-why did they think you had an incompetent cervix last time? Was cervical shortening detected on ultrasound and at what week? I see from your signature you delivered at 32 weeks so from my experience they wont give you a diagnosis of IC based on that. Usually you will not be "diagnosed" with an incompetent cervix until you've had one or more second trimester losses or more than one pregnancy that results in cervical changes characteristic of IC. Most likely they will end up recommending weekly progesterone shots and weekly or bi-weekly cervical length scans to check for any shortening unless you have a very proactive doctor (they are definitely out there). Keep us updated on your appointment. Congratulations on your pregnancy!!

 

[kirstybumx3]

Thanks very much. Yes I was sent for a scan at 26 weeks just because I was measuring 6 weeks ahead so they wanted to check for excess fluid but found that all normal and checked cervix length then and found it to be shorter than expected so I was sent for another scan at 29 weeks and I was starting to dilate, they scheduled me for another at 32 but that's when I had him. I'd been in hospital at 31 weeks with full blown contractions and by then I was 2cm dilated but they managed to stop the contractions with a drip and sent me home on bed rest until it started again a few days later and I was already 4-5cm so had to deliver. I didn't really ask questions at the time as I didn't get chance, then forgot all about it after Rio was born. Hopefully it'll be something my midwife will know all about but my care will be with a different mw and a different hospital this time around.

 

[klabro]

Kirsty-I'd say based on the contractions etc. they might lean towards treating you with pre term labor rather than IC. You really could just have a proactive doctor that will recommend doing a cerclage just to be safe though. Progesterone injections are supposed to help keep your uterus calm. Do you know what the cervical length was when they said it was shorter than expected?

 

[Twinklie12]

Welcome hearmyprayers... bed rest does sound mentally exhausting. I hope you are finding ways to keep yourself distracted. We'll be thinking of you as you keep that baby in!

And welcome kirstybum! Just make sure they are measuring your cervix and keeping an eye on things, ask a lot of questions and push your concerns to be sure they are heard. Good luck!

 

[kirstybumx3]

I don't but could probably ask my midwife to find out from my notes as they definitely told me at the scan. Hopefully they'll just monitor me more closely then. Thank you.

 

[lindsayms05]

Sorry for my post and run! What a busy time of year now. I had my TAC placed on 11/14 and all went well. I am now in my first tww and hoping and praying I get my BFP for Christmas. I'll try to read up on what is happening with everyone when I have a few minutes. Good luck to all.

 

[klabro]

Well ladies, not great news for me today at my 24 week check. My length dropped to being between a 2.2-2.8 the length was varying depending on how she measured. Basically since I am 24 weeks they don't recommend doing any follow up length checks, don't recommend any further progesterone because I am already on the shots and the MFM clinic is releasing me back to regular OB care. UGH.

 

[Twinklie12]

Oh Klabro I'm sorry that's got you down. I still think you have plenty of length, it's really not TOO short. Keep taking it easy and I bet things will all be fine. I'm sure that isn't reassuring at all but we're all thinking of you and cheering you on to keep cooking that baby!

 

[tcinks]

Well ladies, not great news for me today at my 24 week check. My length dropped to being between a 2.2-2.8 the length was varying depending on how she measured. Basically since I am 24 weeks they don't recommend doing any follow up length checks, don't recommend any further progesterone because I am already on the shots and the MFM clinic is releasing me back to regular OB care. UGH.

I'm surprised they're releasing you with your length continuing to drop :/ I mean no, it isn't a terrible length, but the fact that it dropped so much would be concerning for me too. I'm sorry. Do you think your normal ob will continue to check your length.

 

[klabro]

Thanks ladies, I'm pretty anxious. I'm surprised they are releasing me at this gestation as well. Basically from what they are telling me it isn't going to get any longer at this point and they aren't going to change my treatment plan because they do not recommend bed rest so it will just end up causing me more stress to continue being monitored (not true). She told me that if my length was under 2cm they would possibly recommend vaginal progesterone but at this length they would only add progesterone shots if I wasn't already getting them. Also said, that at my length there is still a good chance for me to deliver at term. Although they did add the growth scan for baby at 30-31 so I'm sure that means that they know an earlier delivery is likely.

 

[chistiana]

Klabro I am sorry this is so stressful hun...it isn't a bad leangth considering ic is only considered an issue for the next 4 weeks but I know how you must feel. Can you put yourself on bed rest for the next 4 weeks??

Hearmyprayers hi. Sorry you ve found yourself in this situation. I was there too back in 2012.. I did 5 months of strict bed rest with only toilet breaks..initially it was extremely hard especially as I had an 18 month old baby to care for (well I couldn't care for !) but in a way I got used to it and it you ask me now I might even say I miss it sometimes. I watched a lot of tv series, finished my dissertation, read a billion books and slept a lot! The day I got up to go but my son his bday present ( he was turning 2 that day) I actually gave him his sister as an early present!! It's tough but you ll get there. We re here to chat

Kirsty if you feel like you want to be proactive you could ask for a cerclage although at that gestation I agree it's more to do with preterm labor. My first was born at 38+4, my second at 35+2 and my third at 39+3 so I guess you never know how it might turn out!

 

[klabro]

Chistiana- I would love too, unfortunately we have zero family here and my husband works 24 hour shifts every 3rd day. So on days when he is home I do as little as I possibly can, but on days when he works I have to take my DD to school or whatever class she has that day. When I'm home I'm laying and taking it as easy as possible. I'm not going out grocery shopping or anything like that so if I am up and around it is usually for less than an hour at a time. I'll be 25 weeks Saturday so I'm trying my best to be positive that I only have a little more than 3 weeks until I hit that 28 week mark. The MFM just seemed so completely unconcerned with me getting that far.

 

[klabro]

Well update, I've been scheduled to be checked in 2 weeks. I decided to call the MFM clinic back today to ask some more questions and I talked to the doctor who treated me when I lost the twins. She is the same one who didn't want to do a cercalge but agreed to weekly checks. Anyways, she said that given my history she would have scheduled me for one more check because if my cervix has drastically shortened in those 2 weeks they would absolutely change the treatment plan to include steroid shots, etc. I'll be just shy of 27 weeks at that check.

 

[Pinkfairy2]

Klabro do you have a stitch? My length was between 20-26 at 24 weeks with a stitch and they were also unconcerned. I'm 28 weeks now. Had a growth scan yesterday which had been booked for weeks since the stitch was in so now I'm wondering if like you say, they're expecting an ear,y delivery. I've another growth scan at 33 weeks (should be 32 but due to xmas....). They have said their plan is to remove stitch at 37 weeks. Yesterday she checked cervix abdominally and it was closed with no funnelling. She said she's not concerned and as your doctor said, there's not much more she could do so no point interfering up there any more.

One thing I am wondering about if anyone knows anything about is that my cervix has always been quite curved. It was very curved at twenty four weeks but yesterday was very straight. I'm wondering if this is a bad sigh that it's starting to shorten etc? Does anyone know?

Can't remember the name of the lady who had previous baby at thirty two weeks but similar to me. I had PPROM at 31+2 and then went into labour at 31+5. I'd had my cervix monitored from 16-22 weeks due to lletz treatment and it was short (2.5-2.7) though did remain stable at that with no funnelling. No action was taken and they wouldn't even give me progesterone. I am pretty sure they said my cervix was shut when my waters went. This time I was monitored with CL scans from 16 weeks. It was reported my length dropped 1cm beyeeen 16-18 weeks though I doubt the initial 16 week measurements accuracy if I'm honest. The stitch was done at 18+3 and I've put myself on progesterone (interestingly I'd been on progesterone until 16 weeks due to it being a FET and then came off it which is when the supposed drop happened) but my doctor doesn't know I'm on it because she doesn't agree with it's use. I was also on bedrest after the stitch. Not entirely full but pretty much. At 24'weeks I began getting up a bit more and then gradually more and more. I'm very very very anxious about this. I still lie down most of day but can take a trip to a shop if I'm driven and don't walk about too much. I don't know if this is OK or not and I feel every day that the baby could come.

There was no warning of my waters going before, everything had been fine, though I'd bled from 8-17 weeks. I'm petrified the same thing is going to happen again.

That was a big ramble and what I meant to say is make sure you are checked regularly for CL and a stitch put in if it drops. Ask for progesterone pessaries too as I really believe they help.

 

[tcinks]

Klabro, I'm glad they're doing one more check!

 

[Twinklie12]

Klabro, so glad they are going to check you again! Sorry for all this stress. Let us know how it goes!!!

My next check is 12/13 and they will be able to check transvaginal by then, but they did say they might check abdominal and only check transvaginal if it looked short on the ab scan... so hmmm....

 

[klabro]

Thanks ladies! Yes, they still don't recommend any bedrest for me. I am taking it really easy though. I'd say I'm up for less than an hour Basically just saying that they'll offer steroids etc. depending on the length. I go on the 20th so just under 2 weeks now. I'm hoping for at least a stable length.

PinkFairy-I do not have a cerclage.

Twinklie-Hoping for a good length for you!

 

[HopingCarter]

Hi Ladies, I too have a cerclage, YAYYY!! I got it put in Friday morning 12/2 which coincidentally was the same day I lost my last princess at 13w. Doing much better than expected though, which is suprising. It was nothing like I thought it would be after reading other posts and watching others' videos. I thought it was going to be weeks and weeks worth of pain and bleeding and discharge, but nope. Completely opposite. It's so nice to see everyone here who has had a cerclage is doing well and it's holding up for them. I go back for my follow up on 12/9 and then I will get checked every 2 weeks and if at 21 weeks there is no change/shortening/funneling, they will change it to every 4 weeks.
I do have a question though, has any one here who's had a cerclage placed, also taking the p shots WITHOUT having progesterone issues? My sisters' both had them and they swore by them, that if they hadn't got the shots they believe they would've had pre-term labors with all of their kids. Now, albeit, they didn't get cerclages because they didn't need them, but the very fact that the shots help prevent pre-term labor is what has me interested. I just want to know what chances I have of getting the shots, for that reason alone, since my progesterone level is pretty good, just as another line of caution??