Incompetent Cervix - stitch/cerclage - threatened labour

[kateqpr]

Hi everyone!!

Well, Larockera has had her baby! Just saw her update on facebook and two beautiful photos of Xanthe - full head of hair and looking very cute. Well done LR!! You've been an inspiration. I hope your csection went smoothly and you're up and about, cuddling and staring at your little one very soon.

Bookfish - glad the nagging pain has stopping in your side. If it's any consolation, i had have numerous twinges and pains that are quite sharp, last for a few hours / days, then invariably when i go to hospital, they disappear. Most annoying in one way, as theres nothing the doctor's can see, only me feeling a pain. But i remember from my last pregnancy, i had numerous pains, but none were ever anything other than normal pregnancy pains. Its so hard to trust that though when you have other high risk worries, or IC, or indeed, pregnancy after a loss. Hopefully your scan next week will reassure you. And do talk to your doctor about your worries about your scar. I'm so sure they will be able to reassure rather than scare you. Try and eliminate your worries by asking questions, otherwise you will weigh yourself down with so many things in your head, when bed rest etc, is hard enough mentally as it is!

Liven - I have had lots of cervix twinges and pains. I had a time last week when she was really poking my cervix with something, and it felt like sharp electric shock pains in me. Not nice at all. But then she moved and the pain went, so was nothing to worry about. I'm sure yours is the same!

Helen - glad you're enjoying your 'sod the lot of them' weekend! Life is too short to let work effect the time you have with your family. I hope you'r feeling more positive this week, able to handle any crap thrown your way!

Jimmy - hello my love. Such such good news you've been upgraded to a suite (ha ha!). Well, a room without three other pairs of eye and ears observing your every up and down. Last thing you need. And so sorry i missed your worries these last few days. Hopefully your temperature is now behaving itself and you're celebrating being 25 weeks today (wey hey!). When i was banged up inside, i studied my temp and blood pressure studiously. Not a lot else to do really other than worry. And yup, my temp was up for one reading. Then down four hours later. NO idea why - the human body is a mysterious thing.

I shall pop in to see you tomorrow at 3ish. I'll text you in the morning and you can give me a list of goodies to bring in. Looking forward to it!

I've been getting increasingly uncomfortable these last few days. It feels like her head is really low, as if i lean forward, or God forbid try and pick something up off the floor, i get a really heavy sharp pain right in my pubic bone. Plus i'm feeling breathless, and the my hips and thighs are so sore. AND i am so so tired. It's horrible - i feel permanently jet lagged, but with no glamorous trip to show for it. It's raining outside, so me and Poppy are stuck in doors after a trip out jumping in puddles. Even that little excursion tired me out. I feel pathetic!

Our night away was so so lovely! I felt normal again for 24 hours. I even had a cocktail (well, a fake mojito, but it made me feel a bit tipsy, even without alcohol!). The hotel was beautiful. We just ordered room service, watched a couple of films in bed, read the papers, ate a ridiculously posh dinner, then back to bed for more reading and snoozing. Perfect.

Right - best go. I have a chicken and leek pie to make. Fun fun fun!

XX

 

[book.fish2011]

Bookfish- just a quick one as I'm in the car, but the lady I covered for maternity leave and eventually replaced had twins after a singleton full term pregnancy, that was delivered by c-section after failed ventouse. She had her twins by elective section at 38 weeks. She was 5 feet nothing, exactly the same as me, and her twins caused her mobility issues (sciatica) and she had to have her hernia repaired after delivery, but she had no problems with anything like uterine rupture. Hope that helps! X

Thank you Helen, that's sweet of you to write a reply while in the car.

Do you by any chance know the gap between pregnancies of this woman?

Good to know you are my company in 'height'

 

[book.fish2011]

Congatulations to LR!!!!! Waiting for her to come here with Xanthe's pix. So happy for her!!!!!!!!
Kate and Christiana- yes yes yes. The pain while bubs is kicking own there is exactly that. Electric shocks. I think they are trying to fit somewhere in my little body. Poor things. Only if momma could carry them as long as she possibly can and bring them home safe and healthy!

Chris & JJ - congratulations for progressing to week 25.

Kate- your secret night sounds yummy. so did you fly out to an exotic location somewhere? And how did your dh take the surprise?? All that must have been so romantic.

 

[JimmyJam]

Hi All,

Thanks for your tips re: temps. Mine is normal gain today it might just be the dodgy aircon in my room ... Freezing one minute, scorchio the next ... Just glad it's nomal today.

Liven I feel baby kicking my cervix too sometimes, it does freak me when it's that low but I think it's quite common ...

I am feeling heavy & stretched today, I think the poly has returned with a vengeance & will probably have to have a second amnioreduction this week more risks - aaargh, I wish it would just go away ...

Bf lovely I hope yr inurance comes through good, you so have enough to deal with already.

Hope everyone 's okay today, otherwise, Helen you've recuperated & Lizzie is as lovely as ever. Kate you Domestic Goddess, you are always baking!!!

Please, please let the poly go away ...

Love to you all.

Jj xx

 

[JimmyJam]

Ps - Kate, verily looking fwd to hearing about yr exciting night away. Sos you're pooped hon & hope you feel better xx

Yayayay LaRock has done it! Go Girlfriend! Whoop! Whoop! Xx

 

[HelenGee]

Bookfish- there was a 2 and a half year gap between the pregnancies. However, I'm sure from the advice I've read that it's recommended to leave a year between pregnancies, so that the body can heal. I too was worried about uterine rupture, but I worry about everything! Mention it to your doc so they can reassure and monitor you x

 

[HelenGee]

CONGRATS la Rock! Xxxxx

 

[Violinnem]

Hi ladies. I'm really sorry to gate crash your party in here, I'm just looking for some reassurance and thought this'd be the most suitable thread to ask in.

After a LLETZ last March to remove 1cm3 of CIN3 I'm being monitored throughout this pregnancy to check my cervical length is holding up. I'm 23 weeks today and have had 3 internal scans so far measuring:
18+5 = 3.4cm
20+5 = 3.3cm
22+5 = 2.7cm
Apparently there's no funnelling yet so that's encouraging, but I've read in various places that this doesn't necessarily matter and cervical shortening even without funnelling is still cause for concern.
My OB is still being really relaxed about it all. She has scheduled me in for 2 more scans at 25wks and again at 26+5 so I suppose for the NHS that's fairly good? Still, she's not recommended reduced movement, not standing/walking around for long periods etc., none of that. Everything I've read online says that a cervical length of less than 3cm increases the risk of labour before 36-37 weeks sixfold and anything below c.2-2.5cm requires bedrest. I'm a music teacher in a very busy secondary school and I'm trying to teach sitting down where I can but at times it's impossible. Plus, because the schools on a big campus it involves trekking from one end to the other fairly regularly, so generally day to day the activity levels clock up.

Is my OB being too relaxed about this? ANY info is most welcome! You all appear to be experienced in these matters, and lovely, both of which are very helpful! x

 

[HelenGee]

Hi Violinnem and welcome!

Your cervical length at this stage is good, the doc I saw said anything around 20 weeks at 25mm is borderline. This is what I was at 19 weeks, a week later I was suddenly down to 13mm with funneling. This all happened a few crucial weeks earlier than your brilliant 23 weeks. It sounds to me as if your doctor is being proactive and is taking great, cautious care of you, which is half the battle in the nhs with ic. Ic usually is an issue during weeks 18-23, when the weight of the baby increases pressure on a weak cervix, but the baby is not mature enough to survive. If there were to be any significant changes, you most likely would have seen them by now. If ic is an issue your doc is ready to catch it in time.

Honestly, I would have faith in your doctor. That said, however, I know how ridiculous secondary teaching is at the moment And how very few people realise just how much you are expected to run from one place to another and be on your feet for so long. Even doctors don't quite understand....so it is worth spelling out to your doctor that you are concerned by the amount of time you are expected to be on your feet, especially as you are being monitored for ic. Explain a typical day with all the daft stuff you have to do, moving books, chasing after students who haven't done this, that and the other, break/lunch duties and then ask what they would advise. They may be able your provide your school with some guidance for supporting you during pregnancy, and suggest that you do not have to do duties etc as you are being monitored for a risk of pre-term delivery. It's scary I know, but I wish I'd done it. I beat myself up for months over the fact that I worked for 2 days of the new term, prior to my stitch. I could feel my cervix giving out, but felt powerless to act without a doctor's consent. My school is an especially ruthless one unfortunately, and I was having to lug books around whilst pregnant. They still haven't learnt, the idiots.

Good luck and keep us posted x

 

[chistiana]

Jimmy- firstly let me say YAYAYAYYAYAYYA for the 25 weeks and secondly that i am keeping everythig xed for stupid poly to stay far far away!xo

Violin- although i m no expert in ic really, i would agree with helen...your cervical length sounds a lot better than many of us in here and trully with you beig on your feet all the time it could just be that the baby was putting some extra pressure at that point. But even if it s not 27mm is ok i think! Try to keep off your feet when you re not at school and of course do mention it to both your doc as well as your school to try to avoid as much of the standing and trekking as possible! Welcome to this thread, it s been a life savior for all
Of us!!

Larockera-congratulations hun, off to log in to fb, cant wait for that pic!!

 

[lizziedripping]

Hi ladies.

Bf - uterine rupture is rare, and is mainly a risk during labour when it is contracting and baby is being pushed out. The risk of your uterus stretching and being over-distended is much less to do with height, and more to do with baby size with lots of smaller women carrying 10Ib + babies with not trouble at all.

Realistically your babies will be on average 5/6Ibs each, making a total of around 16Ibs including placentas and water. Your uterus is more than capable of stretching to,accommodate this weight without increasing the risk of rupture hun. Scar rupture happens for a whole host of reasons which no one can predict, but is the result of much more than simply carrying twins.

In an ideal world every woman would wait two yrs between pregnancies to give their body the optimum chance to recover, but this is more about replenishing iron reserves, nutrition and general health than scar healing. In reality, most women have babies within two yrs, and most of them and their babies are absolutely fine.

A section scar is nicely healed within 6mths sweet, so you are not at any great risk for rupture even tho you are carrying two

Liven - sharp pains in the cervix are totally normal. My twin A was breech throughout the pregnancy and constantly had his feet low down, kicking me in the bladder and cervix. At night I would actually cry out with the pain, it was excruciating. It doesn't mean that your cervix isn't supporting the baby, or that baby is low down and preparing to deliver, it just means that your uterus and abdomen have limited space, and the baby will squash into any available space from down low in the pubic area to high up under the ribs.

From 20wks the baby moves up and out of the pelvis, into the abdomen and is supported more by the hips, so women often get some some respite from this feeling until again at 30wks+, when baby is so big that they are kicked and punched every which way, including in the cervix lol. X

 

[lizziedripping]

Hi violinem, and welcome to the thread

In itself, 2.7 at 22wks is not too bad, though on the shorter side of normal. After Leetz, the cervix is physiologically shorter than average at its starting point before pregnancy, but this is very different to it being weak. It could be that your cervix is short but strong, and is measuring 2.7 because it started off shorter than an average cervix. Add back the 1.3cms you lost due to the procedure, and you'd have a 4cm cervix at this stage.

All cervixes shorten as pregnancy progresses, this is normal. At 20wks it should be above 3.5, and have plenty of 'room for manoeuvre' for the remaining 20wks of pregnancy. A weak cervix shortens rapidly after 16wks and effectively 'gives way' by 22wks as the uterus expands. A short but strong cervix can actually look shorter than average, but still be capable of holding up under the weight of the growing baby (tho it is uterine expansion and growth which affects the cervix rather than baby weight). It might actually get down to as low as 2mms, but remain closed for the duration.

Because yours is still above 2.5 at 22wks, I'd be inclined to think that it is short rather than incompetent, and this is supported by the fact that it has not yet funneled (another alarm bell for IC). If it were incompetent, it would typically have looked like this at 18wks, rapidly shortened and begun to funnel by this stage. Yours hasn't shortened by much over a relatively long period of time. I notice too that yours has been more or less around 3 for the last 4/5wks. It could be that it changes daily, and if it were to be scanned more regularly, it might go up or down by a few mms day by day anyway. Each scan can vary by a few mms depending on baby position and the sonographer doing it. Around 3 might just be normal for you hun.

All this said, there is no absolute way of knowing which camp you fall into. There is always the possibility that if a cervix looks short on scan, it is weak and showing the first signs of incompetence ( shortening comes before funneling). If it were, then it is not badly incompetent because it is still reasonably long for 22wks, and you're almost past the point where it is a huge problem.

It is true that statistically a short cervix early on in pregnancy can be a sign of possible ptl later on, but this isn't necessarily true for a lady with IC. Ptl is often a seperate issue not precipitated necessarily by a shorter cervix, and a short cervix caused because it is incompetent is not necessarily a precursor for ptl either hun. The causes of ptl are many and complex Vio, and if the two always went hand in, then many of the ladies here (myself included) would have delivered before 30wks, with or without a stitch - remembering of course that a stitch cannot prevent ptl.

The signs are that you have a short rather than weak cervix, but I can't say definitively either way. One thing I can say with certainty tho, is that despite the reason behind your shorter cervix, you should be taking things more easily. If it is just short but strong, then it could still be argued that you like any other pregnant woman are doing far too much running around, which in itself could cause it shorten further at stage where it shouldn't be short. You have less 'length to play with', and should be more careful than most chick. If it is short because it is showing incompetence then it speaks for itself that you should be resting more with feet up.

I was never officially told to rest by my consultant hun despite having a hideously weak, floppy cervix as early as 12wks! I didn't move anyway just to be on the safe side. I know it's probably impossible to leave work altogether, but it might be worth looking at how you might cut back on physical exertion and perhaps ask for more support from your consultant. Maybe suggest to her that you are feeling the strain and need to reduce your hours? Failing that, try to spend less time on your feet and get the Doctors backing for at least that much.

I don't want to be alarmist hun, but at the same time I do want to stress the need to play it safe as a precaution. Your consultant is at least giving you regular scans, but these are pretty fruitless if they are not acted upon (sole reason for their inception).

At this stage you are ambiguous. You are presenting with a short cervix relatively late, have no funneling and are almost through the danger zone for IC, so there is no obvious and immedite cause for alarm. That said, I have seen too many ladies ignored and fobbed by too many clinicians to simply do the same, and if you can, why not err on the side of caution - the 'prize' in this case is way too valuable not to my darlin'.

Hope that has helped - it's late and I fear I may have droned on a touch too long fFilter what you need and abandon The rest lol

 

[Nurse1980]

Hi ladies,

Just looking for a bit of advice. I am worried about my cervix. I had laser treatment in 2002 for CIN2.

In 2007 I had silver nitrate for cervical erosion and had cyrotherapy twice last year for cervical erosion.

I mentioned it to my midwife and she brushed it off and didn't even write it in my pregnancy notes.

Any advice?

 

[JimmyJam]

Morning Ladies,

A very warm welcome to both Violin & Nurse. This thread is a total godsend, the ladies on it are so articulate & generous with their knowledge, I hope you'll both stick around as the support it provides is invaluable.

Violin, I really can't add anything to what the Fantastic Lizzie has already said, other than that she has supported many, many women through this condition & that I trust her advice implicitly. I totally understand how tough it must be juggling a high-pressure teaching job with a diagnosis of a shortening cervix & you just need to be aware to take it as easy as possible. It sounds like your clinic are on the ball which is important. Hang with us , Violin, & get the emotional support the NHs can't provide.

Nurse there are other more experienced ladies on this thread who have been through this & come out the other side (I'm only 25 weeks & have additional 'issues') but what I would say is that you sould insist on monitoring for cervical length & not take no for an answer - even if it's just for peace of mind. It's atrocious that women have to go through mid-trimester losses before the medical community pays attention & the only way to deal with it is to be pushy & not to let them fob you off. Ask to see a different midwife, make an appointment with your GP, if necessary see a private consltant for a referral if you can stretch to it. The alternative just isn't worth it.

Christiana - 25+1 yay-ay-ay! Bloody hell girlfriend, we're in for the long stretch Eh? ... Roll on twenty eight weeks!!!

Bookfish sweets, how're you feeling today? Any news? Thinking of you always hon.

Helen - hope you have a better week this week than last - keep us posted gorgeous & don't let the buggers get you down

Liven - where are you now hon? How far along I mean? How you feeling? You seem so close! It'll be you next after LaRock, I think you're next up ...

Olgie - is it wonderful to be @ home. Totes jelz. I hope you are enjoying it!

Lovely Lizzie - you're just, well ... lovely! Have a wonderful week you fabulous lady.

Katie-pop I shall hopefully see you later.

I have a TV! Whoop! Whoop! It's only the size of an ipad but just having the news on in the background so makes my four walls feel less lonely ...

Have a great day ladies, all of you wherever you are.

Much Love, Jj xx

 

[chistiana]

Jimmy-WOOOOHOOOOO say that twice!!!!!i really cant believe it, weeks are going y, we re in it for the long run for sure, yayyaayya!!! So glad you got your tv babe, before you know it you wont need it anyway but for now it s food company!!!!when s your next check??

Nurse- i m really clueless about your condition but i ll echo jimmy and say push for more monitoring...rather safe than sorry...welcome btw, i wish you a happy and healthy full term pg!!

Update from me: had a scan at my docs today, baby is fine, apparently movin just fine but for some strange reason (i am totally insensitive????) i cant feel her! She was flippig around during the scan but i didnt feel a thing!! Everythig measures on date exept from her belly which is a week behind but doc said this just means she ll be a small baby..suits me as i have bu and not enough space anyway!!! That's all from me!! Hope everyone s having a great day!!live to ya all!

 

[Mommy's Angel]

Coming to see if we have any baby updates or pics. Congrats!

 

[lizziedripping]

Lovely ladies, good evening

Nurse, because of the cryosurgery it would be wise to have your cervical length checked because sometimes it can cause it to shorten. However, tho women like you might have shorter cervixes, cryotherapy is seldom a cause of incompetence and most go on to carry their babies to term despite it. As I said in my long, waffly message to Violin a few posts back, a short cervix caused by cervical surgery is not usually a weak one. Cervical incompetence is a complex condition caused more typically by trauma which weakens the muscle, rather than surgery which shortens it.

I'd still get a tvu tho to check where your cl starting point is. It never hurts to be forewarned and subsequently cautious if need be

C and JJ - yey for reaching another milestone! Not to be sniffed at. You can now tick off the weeks as they happen, and be increasingly relieved at the prospect of reaching 30wks. It's just around the corner now girls I know that for you JJ there are additional concerns beyond reaching a good gestation, but even IF there is a problem with lo, every extra week in utero can only be a good thing for him or her xx

Hope your meet up with Kate went well JJ - I'm very jealous. It must be a bit strange tho to meet someone from a forum - a bit like a blind date lol xxx

Bf and Olga, you both ok? Xxx

 

[HelenGee]

Hey JJ, how's the tv tonight then? X

 

[Violinnem]

Hi ladies, just a quick one as it's been an evening of report writing and I need to head off to bed. Not had time to write a length reply, but just wanted to pop and say THANK YOU for the wealth of support, advice and information you've giving me It's MUCH appreciated. Thank you again, and I'll be back soon to update/reply properly xxx

 

[JimmyJam]

Morning All!

Snakes & Ladders ... We avoided another serpent today, my 2nd set of chromosomes came back clear ... Doesn't men everything's defo alright but it 's a process of elimination & am v pleased. Let's see what clinic throws up tmrw ... 25+2 & counting ... Eh Christiana?

Helen - TV is awesome thanks & have even had an upgrade! Matt arrived last night with a 12" flat screen to replace the portable travel kit his ma had bought. It plugs in to the hospital aerial thingy so I now have all the freeview channels AND a DVD player! Whoop whoop!

Lizzie Kate popped in yesterday with a fantastic goodie bag of mags & treats. It was really fab to catch up - I still think we should all arrange a date in London some time in the future so we can all meet up,... Yoo-hoo Kate! Hope you're good today? xx

Still think poly is coming back but figured it would. Want to get as far as I can before another amnio ...

Hope everyone has a good day.

Lol JimmyJam xx