STMs - Any experience with short cervix with your 1st??

SwtAnana

Hey ladies,

Didn't think there was an appropriate thread for this that would garner enough attention from moms on their 2+ pregnancies.....this is certainly not a silly question so it doesn't belong in that thread.

I just came back from an early anatomy scan (18+3) and they noted that my cervix is on the short side at 2.5cm.  Ideally they want it closer to 3 with 3 being the average. The perinatologist told me that the biggest predictor of preterm labor is prior preterm labor and since this is my first, I don't have that history to draw from. I do have one aunt and cousin (her daughter) who have a history of preterm labor with late losses but no one else in my huge family does.  For now, he said that there's nothing to do but to just watch it and to come back in 4 weeks for another check.  He said that even if it shortened to 2.3cm, that the most they'd do is place me on progesterone and continue to watch.  

I think he could sense how skeptical I was of this "watch and wait" technique because he pulled out a flowchart from their professional society with guidelines on what to do with a short cervix and it basically supported what he said and only advocated immediate intervention if it got down to 2.  I guess I"m in the grey zone.

So my question to you ladies who are doing this for the second+ time is: Do you have any experience with this? How did things progress and did you need any interventions? Were you able to deliver at term?? 

Trying not to freak out about this but after trying for a while, this is our very much so wanted IVF baby (not to say non-IVF babies aren't wanted....just wanted to put some perspective on how getting this far hasn't been a walk in the park and subsequent pregnancies likely won't be either). I appreciate any insight you ladies may have!

ac1259

I'd definitely keep on top of it, if anything is feeling abnormal or you feel like you're having contractions or anything call right away. I have cervical checks at 16 and 24 weeks because of preterm labor history but I've never had cervical shortening before my water broke. At a certain point they could put in a cerclage (basically sewing the cervix shut) and do bedrest but beyond that the progesterone injections are usually the go to for preterm labor. I'd probably take it fairly easy if I were you until that next check

ChocolateIsLife

I don't have any experience but wanted to send hugs to you! I hope you can find peace of mind during the wait, even though I can imagine how difficult that is.

aprilsarahjune

Though my story doesn't really relate well to yours, I would second the advice to stay on top of it.  Ask for more frequent u/s, if only to measure your cervix.  At one point, I was going to an MFM (maternal fetal medicine) every other week to have it measured.  Treatment recommendations have also changed a lot in the last 5 years (as I just learned at my appointment yesterday), so I am glad that he was willing to show you evidence that he is recommending the current standard.

ETA a more direct response: For my 2011 twin pregnancy, I had a shortened cervix as well as serious braxton hicks contractions in early second trimester and throughout.  I took procardia (which doesn't sound like a regular treatment anymore) and was put on bed rest.  I delivered at 33 weeks.  For my 2013 singleton pregnancy, my cervix measured fine at my 20 week u/s, we did not measure again and did no interventions, and I delivered when my water broke at 37 weeks.  This time we are going to do interventions because those 2 pregnancies looked at together show that I might have a problem.  Going to do progesterone injectibles weekly and then hopefully get my cervix measured regularly.

SwtAnana

@ac1259 I am also seeing MFM due to high blood pressure so that's where I had my scan today.  I see my regular OB in about 1.5 weeks so I'm going to ask her to check my cervix for obvious signs of effacement, dilating, funneling etc. The perinatologist did mention that they now recommend progesterone and have learned that in someone without a history of PTL, a cerclage at this stage has the potential to be more harmful than helpful...especially since I'm technically still "normal".  Thanks for your insight!

@ChocolateIsLife Thank you for the encouragement!  I had to stop myself multiple times from bursting into tears on my way home 

@aprilsarahjune I'm also happy that he could show me that they were staying up to date on evidence based medicine.  I definitely don't want an unnecessary procedure that could end up hurting more than helping. I've been pulling up random stories on the net and it's hard to relate to most of them because like you said, treatment recommendations have changed recently.  Depending on what my OB sees, I may request that they move my next ultrasound appointment up....or I'd just be willing to pay out of pocket to go somewhere else.  Already spent thousands of dollars on IVF....a bit more money for piece of mind is totally worth it to me.

kmornelas29

My husbands cousin had it with both pregnancies. She was on complete bedrest both times due to increase chance of early labor. Second she did but the stopped it. They said next time they would have to sew her closed until 37 weeks and then they would open it. 

SwtAnana

For anyone else who may have read this or later finds out that they may be dealing with a short cervix or increased risk for PTL, my incessant googling allowed me to stumble onto a great website.  Keepemcookin.com has tons of info and a great community of people dealing with this specific problem.

I thank you ladies again for taking the time to reply and help ease my mind  

dumbledoredies

@SwtAnana thank you for the link! I had surgery on my cervix a few years back to remove dysplasia and so this is a concern for me (and my doctor). She did a pap smear at my 10w appointment. I have my anatomy scan at 19w and then she is checking my cervix again at 21w and 23w. If it's looking good I won't need to get it checked anymore but if it's shortening or what not then we will take further action to prevent preterm labor but it's definitely something that had worried me.

I would request something similar if it's going to stress you out. At first my doctor said we might not check my cervix regularly and I was going to request that she do it anyway to ease my anxiety. She ended up deciding on her own that we should check it so it was nice that I didn't have to convince her..

Good luck to you! 

SwtAnana

@dumbledoredies Thanks for sharing! I like that your doc is checking you every 2 weeks. Although I've read a few stories of people going back for check-ups in 4 week intervals, most seem to follow up more often and it just made me so uncomfortable to wait so long. I ended up emailing the MFM office and asking them to move my appointment up. I hope you find out that you won't have much use for the link!

I've been reading stories of women who have gone close to term without a cerclage/much bedrest for encouragement. I work full time and it requires that I'm on my feet a lot....although I have short term disability insurance it would really throw my job for a loop if I suddenly had to be on bedrest for weeks at a time.

The night before my AS I was on overnight call and definitely overdid it...hoping that my next check is way better.

Britt&Max2010

This is pregnancy/baby #3 for me and I have been watched each time for cervical shortening.  It was found accidentally with my first and I was put on progesterone suppositories and things stabilized.  I did deliver her early, but it had nothing to do with my cervix.  I developed severe preeclampsia and abrupted while in labor at 30w6d.  My daughter is now 5 and doing great.  With baby #2 they watched my cervix and I did the vaginal suppositories again.  While I was short, I was stable.  Delivered at 37w6days with daughter #2.  Same thing this go around.  I was measured at 2.7cm at 16w and had a follow-up a few days later to make a plan and was back to 3cm.  I had also started the suppositories in that time.  I have checks every two weeks and will be on progesterone until 37 weeks.  Talk to your doctor about the suppositories, studies show they are very effective and have helped me stay stable in the past.  Good luck mama!

SwtAnana

@britt&max2010

thank you for your reassuring story!!!! My high-risk doc mentioned it as a possibility if things didn't stabilize.

I've successfully been able to move my appointment up 2 weeks. I don't know why my office was being so resistant about moving it. The woman I spoke to said that it appeared as if I was having a contraction with the measurement and that that played a role in my measurement. 

I was warned I'll likely have to pay out of pocket for the ultrasound but I'm ok with that. These things can change quickly and I rather know if I'm rapidly changing sooner rather than later....especially since I'm going out of town for a big exam the weekend of my original rescan date. That's not the time I want to try reorganizing/canceling flights and a hotel stay! 

KAK37

I won't give the long story but I have a really funky cervix. With my daughter (10 years ago) they did a cerclage and bedrest for a shortened cervix.

This time my cervix hasn't really shortened but we have been taking precautionary measures. Also my cervix measures about 2.6cm my doctor says that can be within the normal range.

 I have been seeing my high risk specialist every 2 week since the beginning of my 3rd month and I've been taking progesterone suppositories since about the beginning of my 4th month. 

So far everything is looking great! I potentially have my last specialist appointment at the end of the month. Oh and no bedrest this time so far! Hallelujah!!

I say all this to say a shortened cervix and no bedrest appears to be possible.