Short cervix 20 weeks...Advice Plz

[elijah4]

I'm going to try and make my long story as short as possible. A bit of history... I have had three premature babies first born at 31 weeks, second had pre eclampsia and delivered at 33 weeks, third had GD and went into labor at 31 weeks with placental abruption. My youngest son just passed away 1/28/11 from the swine flu. I got pregnant again right away, Maybe not the smartest thing to do but people do weird things when grieving.

Now Im pregnant just 5 months after delivering my last baby. I see a perinatologist and at 20 weeks my CL dropped from 3.5cm to 2.5 cm. The Dr said to wait a week and if more shortening happens then we will place a stich to hold him in. The following week, after a week of bedrest, my cervix was great at 4cm. Then last tue, 22 week, I went in for another CL and it has dropped to 2 cm. Baby is measuring 1lb 7oz but the dr said if I deliver before 24 weeks they will not do ne thing and just let him pass To top that off they say Im too far along for a stich now.

I have been on vaginal suppositories since 16 weeks but I guess its just now working, Does anyone have any advice or stories they can share with me. Im so afraid of losing another child. I want to do what ever I can to save my baby. Is there any hope that I will continue to carry for another month or two when the baby will be have a better chance?

Also they did a Ffn test last tue and it came back negative which is good but dr said it cant rule out incompetent cervix and me still loosing the baby.

 

[JaydensMommy1]

Rest rest rest!! I'm a nurse and you need to be laying down as much as possible!! Standing causes pressure on cervix therefore can dilate or shorten it. Please, stay off your feet! I know it's hard with little ones- but it is the best. It obviously helped before.

Drink water- dehydration causes contractions and can worsen. No orgasm which can do the same- be safe and go on pelvic rest- no sex, I know it sucks but don't do anything to irritate cervix

I am so sorry for your loss how are you holding up?

 

[Semanthia]

Stay in bed!! Let your friends and family help you. I was on bed rest with my last pregnancy when they found out I was 2 cm dilated, I stayed 2cm dilated for 3 weeks. Do not let them do pelvic exams! If there is nothing they are going to do for you then they need to leave things alone. I know you aren't dilated yet but if you do dilate then them performing pelvic exams or transvaginal ultrasounds will increase the risk of popping your membranes and the possibility of an infection. I am not trying to scare you. When I was 2 cm dilated my doctor wouldn't do anything and continued to perform pelvic exams just to "see what it looked like" and I ended up going into labor because of chorioamnionitis (which is when normal vaginal bacteria gets into amniotic sac. It eventually weakens the lining of the sac causing the membranes to rupture).
Wait... You are 20 weeks? I thought they could do an emergent cerclage until 24 weeks or something like that as long as you are a not dilated over 4cm. Maybe you could go talk to a different doctor? Just to see if another doctor says the same thing. I really regret not seeing another doctor for many reasons.
I am praying for you and stay positive!! I hope this doesn't make you feel worse, I just want to give you any advice I think I might be about to offer. FX things go well for you.

 

[elijah4]

Thank you for the fast response and advice. I am 23 weeks today. I have been on bed rest since 20 weeks and will continue for as long as I have to. I have been very blessed to have many friends and family help out when hubby is at work. Because of my history my perinatologist has had me on pelvic rest and no lifting since 16 weeks but its worth it. Last tue when I went to see my perinatologist he called in another perinatologist for their opinion on the stich who also agreed the stich is more of a risk for me since I have an irritable uterus. They told me doing the stich may irritate my cervix and uterus too much and cause me to go into labor. But that dr was from the same clinic so maybe a bifferent perinatologist from a different clinic would think otherewise.

As for no pelvic exams I was wondering if putting in a vag suppository every night if that can cause problems. I do get weekly TV ultrasounds to check CL and also the Ffn test which they have to use the speculum and place the qtip right under my cervix, every two weeks. Should I have them stop all this? Is this going to cause more problems then good.

I am happy I only have one week till I hit viability but I also know the outcome could still be pretty grim at that stage.

As for holding up... everyday is different. It will be 6 months since my Elijah went to heaven on the 28th. It doesnt get any easier and the pain is still there but I am blessed that he sent me down a ray of hope from heaven. I think the pregnancy is helping me with the grieving process but I must say grieving and pregnancy emotions can be pretty intense at times. We are naming this baby Zion rae meaning (zion)-highest point or heaven and rae as in my rae of light from Elijah I'm just taking it day by day and trying to stay as positive as I can. Knowing I have an angel watching over us helps a bunch too.

 

[Semanthia]

Thank you for the fast response and advice. I am 23 weeks today. I have been on bed rest since 20 weeks and will continue for as long as I have to. I have been very blessed to have many friends and family help out when hubby is at work. Because of my history my perinatologist has had me on pelvic rest and no lifting since 16 weeks but its worth it. Last tue when I went to see my perinatologist he called in another perinatologist for their opinion on the stich who also agreed the stich is more of a risk for me since I have an irritable uterus. They told me doing the stich may irritate my cervix and uterus too much and cause me to go into labor. But that dr was from the same clinic so maybe a bifferent perinatologist from a different clinic would think otherewise.

As for no pelvic exams I was wondering if putting in a vag suppository every night if that can cause problems. I do get weekly TV ultrasounds to check CL and also the Ffn test which they have to use the speculum and place the qtip right under my cervix, every two weeks. Should I have them stop all this? Is this going to cause more problems then good.

I am happy I only have one week till I hit viability but I also know the outcome could still be pretty grim at that stage.

As for holding up... everyday is different. It will be 6 months since my Elijah went to heaven on the 28th. It doesnt get any easier and the pain is still there but I am blessed that he sent me down a ray of hope from heaven. I think the pregnancy is helping me with the grieving process but I must say grieving and pregnancy emotions can be pretty intense at times. We are naming this baby Zion rae meaning (zion)-highest point or heaven and rae as in my rae of light from Elijah I'm just taking it day by day and trying to stay as positive as I can. Knowing I have an angel watching over us helps a bunch too.

I wouldn't worry about the pelvic exams and what not as long as you are not dilated. When you start to dilate I would have them stop. Your doctor knows best. I think it might be nice for you to see how quickly your cervix is shorting. If it isn't shortening very quickly it might be a relief for you to know that. Good luck! I am praying for you!
Very meaningful and special name by the way.

 

[JaydensMommy1]

Semanthia- I read your blog- charlotte was beautiful. So sorry for your loss and congrats on your BFP. Sending you warm wishes.

 

[elijah4]

I went to the perinatologist today and got pretty good news. My cervix hasnt gotten any shorter and has stayed at 2 cm. He is going to continue to follow me weekly and continue bedrest. If my cervix gets any shorter by next week then they are going to give me the steroid shots just in case. Thank you for your support! Each week is a great step and I hope to make it many many more. 5 more days and I hit viability

 

[jules22]

Hey hun, I've been in the same boat as you for a shortned cervix. Are you contracting at all? That was my problem mostly, I would contract and they would be 5 minutes apart and totally painful. They started at 20 weeks and continued until I gave birth at 36 weeks. My cervix kept shortening but once I was put on bed rest it settled for a few weeks until I went into labor at 27 weeks. They started giving me procardia/niphetapine which is a calcium blocker that helps stop contractions. (totally experimental) and that stopped them. I'll keep you in my thoughts! Every day is a gift, keep on resting!

 

[elijah4]

I have been contracting but its hard to tell when its irritability or real contractions. The Dr said if the contraction lasts more then 30sec it is a real contraction. But with my second pregnancy I had contractions every 5-10 mins and was in the hospital for over a month before they released me because those werent changing my cervix. Its so hard to tell when I should call my dr and get checked out and when not to worry. My peri wants me to call with any contractions that last more then an hr but then I would be calling everyday and my dr is already getting irritated with me.

 

[jules22]

I used to go into triage every other day, I felt like they were getting annoyed with me too. They finally said they couldn't do anything until I hit 24 weeks. So I just ignored it and finally said, "YOU need to check my cervix, do a vaginal ultrasound." Finally at 24 weeks they checked it and discovered it was shortened and then started paying attention to me.

 

[elijah4]

So I was happy to reach viability yesterday until I went to my drs appt today. She did a Ffn test and it came back positive. I was sent over to the perinatologists office to have a TV cervical length done. At first it looked good at 2.6 cm but then I had a contraction and on the screen you could see my cervix shrink away. It dropped down to 1.2 cm durring a contraction. They sent me to L&D and admitted me. When they hooked me up to the toco monitor it showed I was contracting every 3-5 mins. They gave me an IV with fluids and magnesium (yuck) and gave me one shot of steroids (ouch). Now the contractions have tappered off and I pray they stay away. I guess the dr just wants to get the second dose of steroids in but I want to keep baby in for another 2 months. 24 weeks is just too soon. I dont want to loose another baby and 50% survival rate just isnt good enough. I NEED to hold him in for a few more weeks at the least.

 

[jennwitt]

Hi there - just wanted to send hugs to you! I am right behind you w/my first pg ever. We did 4 perfect IVF's 15 years ago and have adopted five kiddos (13yog, 13yog, 10yob, 6yob, 4yob). We completely forgot about TTC as life has been very full! I have 1 fallopian tube and got pg spontaneously this spring. Found out on April 1st ;-)

I have had complications from the beginning....big fibroids found at my first u/s at 8 weeks....The biggest one is sitting right on top of my anterior placenta and they believe has caused 3 episodes of major bleeding (at 18, 20 and 22 weeks). I will be at 24 weeks THIS FRIDAY! Can't wait!

I am also at a perinatologist and have had many u/s with them. My cervical length is all over the place too - from 25 to 32 to 37, then down to 28 last Tuesday....grr! I have my next u/s next Tues. Like you, they said they couldn't/wouldn't do too much for baby before 24 weeks. I will be soooooooo relieved to get to Friday!!! Only 3 more days!!!!

I will be thinking of you today in the hospital - the peri said one of these times that I come in (after 24 weeks), they may put me in to keep a close eye on me (and I guess start on steroids?).

Keep us updated and I am hoping your LO will stay put for many more weeks!!!!

 

[Semanthia]

Were you getting the p17 injections? I'm just curious. I would get the other steroid shot for sure so that if baby comes early he will have the best chance. I am hoping for the best for you. Another two months would be awesome and the steroid will def. Still be helpful in two months. My sister had her first at 30 weeks and got a steroid shot the week before and It helped his stay in the nice stay shorter. Good luck!

 

[elijah4]

Two full more days and your at viability, that is great!
I don't do the 17-p shots but the vag suppositories. I did the shots last time and this time we are trying a more direct method although it doesnt seem to be helping any.
I got my second shot of steroids today and I will be getting off the magnesium tomorrow I just hope things stay calmed down when they stop it. They are planing on starting me on procardia (nifedapine) to keep me contractions in check. They also did another TV ultrasound today to see if I had any cervical changes from lastnight and my cervix measured 1.2 cm Not being dynamic today though and my perinatologist said it looks stable? Not sure how he sees it as stable but okay... Ill go with that. He is looking at things very positivly... He said I might be able to go home next week if I do well on the procardia. He also doesnt think I will pop anytime soon like my OB thinks. He said the positive Ffn means nothing. I think I would feel alot better if that test came back negative but Im going to think positive and hope and pray for the best. My goal... make it to next week appointment... that will make me 25 weeks 2 days. Then maybe 26 then 28. I just want to get out of this scary zone! Its so nerve wracking!!

 

[RainbowGift]

I was put on bedrest at 23 weeks, due to a short cervix. By the time they checked me at 25 weeks, I had no cervix left and was contracting and dilating. I was transported to a hospital in a bigger city and had the mag etc. All the risks and scary stats were discussed with me, as they were pretty sure I was going to deliver that night or the next day.

Well, I was in that hospital for a month. No drugs after the first two or three days. Went to my mother's house after a month and held them in FOR ANOTHER MONTH!!!! No drugs, no stitch, no cervical length, open cervix!!
My water broke at just about 33 weeks and my babies were great weights and did wonderfully. Had to stay in NICU for a while, but no major problems.

I stayed down for EVERYTHING except bathroom. I ate without even propping myself up. It was a depressing, scary time so I wanted to write to you and tell you I know how you are feeling and it is possible you could go that far or ALL THE WAY!!!

 

[calypso]

I am sorry you are going through this. I just posted a brief overview of my pregnancy on another thread here. I can copy/paste if you don't see it.

I always say I must have huge ulcers from all the stress this has caused. It's all for the best cause though.

Good luck!

 

[jennwitt]

Very encouraging, RainbowGift! What a hard time, but I am so happy for you that all turned out so well - that is inspiring to me!

 

[jocelyn062410]

My name is Jesica I'm 19 yeras old and sadly I know exactly what your going through. Last January I found out I was pregnant I was only 18 then everything was going fine I was gonna have the baby girl I had always dreamed of (Jocelyn Elaine). My boyfriendc and I were so happy and then I went in for a normal antaomy ultrasound at 20 or 21 weeks and found out I had started dialating I was 1 cm and they rushed me to Pittsburgh where they stabalized me and sent mehome on meds to keep me from contracting and dialating. However 2 weeks later I went into labor and lost my baby girl :'(. I was unaware at how much I had really wanted to be a mother. It rore my heart to shreds and I went into a sevre depression. This had all happened in June and I didn't want to try again as soon as my boyfriend had because I felt like I might be replacing her but he finally talked me into in in October and we were unsuccessful until Feburary. And now I'm in the same boat again only this time the doctor told me I have a short cerix and everything was going fine until yesterday when my cervix got slightly smaller and I was put on bedrest but so far that is everything I'm not contracting or dialiting and I'm farther along than last time I'm now 23 weeks and 4 days. I'm nearly certain that this time around will be better but I want more but I don't think I can keep goin through this and think I should get my tubes tied after this one no matter the outcome. Highest hopes.

 

[jennwitt]

elijah4 - I am right behind you...here's what has happened since yesterday....I went for a regular peri visit...2 weeks ago, my cervix was at 2.8, not great, but still okay. Yesterday, after prob 90% rest the last two weeks, as soon as she did the tvu/s, I said, "where's my cervix?" It measured at .94!! aaaahhhh! Head of the clinic sent me straight to the hospital. Highest level peri here at highest level hospital decided this morning to put in a stitch as a last ditch effort, even though I'm so far along. I had been advised to not do the stitch since 19 weeks, b/c I had 3 episodes of major bleeding between 19 and 22 weeks. He wanted to get his eyes on my cervix this morning and it showed at 1.6. He said we entered the gray area of doing the stitch and possible irritating my non-contracting uterus/cervix. In the end, he decided to leave me perfectly alone. Right after that I got the news that my ffn from yesterday (my 1st ffn) was positive - ick!! Good news I am laying very still here in bed, drinking lots.....I am approved for twice a day pool therapy, but I think I am going to wait until my next u/s on Mon. I have no contractions, closed cervix......babe is measuring 2 weeks ahead and now I've had 2 shots of steroids ;-) how are you doing??? praying for these babies to stay put!! Oh, BTW, tihs is my fourth boy also - 3 others adopted ;-)

 

[elijah4]

Jocelyn: I'm really sorry for your loss. I know how hard it is and that NO baby will ever replace your little girl no matter what. There are a lot of women who choose to not have ne more children after incompetent cervix and preemie babies but there are things the DR can do next time which might help and you might even be able to carry to term too. Hey you might even with this one. If you choose to have another you could always ask for a stich to keep your cervix from shortening and progesterone supsitories or injections also help too. Good news is your at viability in a few days and then you can have other milestones to meet. 26 weeks, 28 weeks then really anything after that is just great! Keep us updated.

Jenn: .94 yikes... That would be scary. But you not contracting or opening which is great and having the steroid shots on board is great too. Hopefully we can be like rainbowGift and still make it to 33 weeks or more. It is nice to know it can happen. I had a pos ffn and my perinatologist said its nothing to worry about. He is going to do another one on tue cause I guess there are a lot of false pos and it can go back to neg.

I have had a nice little ride the last week. On Sat I started having contractions every 5 mins and my back was killing me. I have had back pain on and off for the last 5 weeks. They wouldnt give me any pain killers, couldnt hop in the shower or bath to relieve the pain and they made me lay in the bed wwithout sitting up. After a few hrs I told them I think Im passing a kidney stone again and they just wouldnt listen. Then I went to the bathroom and a 4mm stone came out after the most horrible pain. After that the contractions stopped and just irritability but no contractions on Sunday... well a few here and there but nothing like the week before. My doc was on vacation and when she came back she was upset that they never called her and that they wouldnt give me any pain meds, It was just horrid! They think I have more stones cause my back is still hurting now and then and thats what happens when you have stones.

Everything went good after that and I saw my perinatologist on tue and my cervix is stable at 1.2 cm. He said I could either stay in the hospital or go home on strict bedrest. I jumped at going home But on my way home from the hospital I had to fill my script for procardia and my insurance wouldnt pay for it and the pharmacy wouldnt give it to me cause it was for an off market reason and I am pregnant. I had to have my dr call over there and make them give it to me. I was so worried that I would start contracting again without the meds. Then when I got home all my progesterone suppositories melted from the heat! I couldnt believe my bad luck. I know if you stop the progesterone it can throw you into labor from the jrop in progesterone but there was nothing I could do because the compounding pharmacy was closed. I made it through the night a bit scared but all was good and the compounding pharmacy got me a refill the next day. Thankfully everything has been good since. I go back to see my dr on monday and perinatologist and ultrasound on tue. I'm staying positive and keeping my fingers crossed for stable cervix and to keep going for many more weeks.