short, funneling cervix ~ negative fFN

Temp984666312503071

Hi girls,

I have been seeing a perinatologist this whole pregnancy because I was originally expecting twins, lost one at the end of 1st tri, and was being watched to make sure it "vanished" without incident.

At my 16 week u/s my cervix looked "normal".

At my 22 week anatomy scan my cervix looked short.  They did a t/v ultrasound and it was 2.8cm - no funneling.

At 23 weeks the t/v ultrasound showed it at 3cm - no funneling.

Yesterday things had taken at turn for the worst.  My cervix was funneling and the closed portion was measuring 2cm.  The peri did a fFN and it came back negative.  I have no signs or history of pre-term labor and no risk factors for IC.

Right now my peri isn't that worried.  He thinks I have a "dynamic" cervix and that it needs to be monitored bi-weekly with bi-weekly fFN tests.  He said that bed rest isn't indicated yet and that he wants me to just do "modified" bed rest (go to work, come home, lay down as much as possible, no lifting, no sex). 

First, he doesn't think it is incompetent cervix because of how far along I am.  I guess most cases of IC come up at 20ish weeks?  He says that if I were going to lose the baby due to IC it would have happened already.  And since the fFN test was negative, I am not in pre-term labor.

So what the heck?  I FEEL fine... no pressure, no discharge, no spotting.  I have a feeling that if my pregnancy hadn't been labeled "high risk" due to the vanishing twin that I would be none the wiser about my cervix.  Most people don't get t/v ultrasounds of their cervix at their anatomy scan - it is common practice for them.

So I guess my question is, have any of you had a similar incident with such a non-chalant response?  My peri says that if at a future appointment things look much worse or I get a +fFN test that they will give me steroid shots to mature the baby's lungs and oral medication to stop contractions.  But that right now water and rest are the best medicine.  I am anxiety prone as it is so this is scaring me . 

atmarques

Wow, your story sounds very familiar.  I have been with a MFM doctor for this pregnancy because I deliverd my son at 25 weeks.  They have no Idea why I went into labor with him, so she has been watching me for EVERYTHING. 

I was having bi weekly T/V ultrasounds begining at week 18.  My cervix was always long and closed.  When I went in last week for my final ultrasound it was funneling down to 1.1cm.  It literally looked like a small tornado in the middle of my cervix.  The doc checked me as well and said it was "non-threatening" but sent me for monitoring, gave me steriods and sent me home on bed rest.  I like you, do not feel any different.  No pressure, discharge, contractions etc.

I was already on my doctors version of "pelvic rest"  (which sounds like your docor's verion of modified bes rest) since week 14.  She told me that everything could be just fine but she is oaraniod and would rather be safe than sorry.  She did not do a FFN test as she does not fully agree with their use, from what she explained negative means negative but positive could just mean maybe and she does not want to cause me any unnecessary stress.

I know it is hard not to worry, but rest and hydration are the best medicine.  From what the doc told me, without contrations not much should change.  I am going in to be checked today, so we will see if this week has brought any changes.

 

Good luck! 

 

 

2BWEDN2007

It sounds like you definitely have a dynamic cervix. I do as well along with an IC.

The one thing I would caution you about is your doctors claim that you can't have an IC because you didn't have any problems before/around 20 weeks. My issues didn't start until between 21.5 and 22 weeks and I ended up shortening from 2.5 cm to 1.8 cm in 10 days. Shortly after that I had a positive fFN test, started funneling and was admitted to the hospital. I gave birth at 24w5d. It is possible to have an IC and just hold out longer than most.

Definitely follow-up with those bi-weekly cervical length checks and fFN tests. It is still WAY too early to have your baby and there could be many complications especially if you don't receive steroid shots in time (I did thankfully). I didn't feel anything until it was too late (was already 5 cm dilated and bag of waters had come down in my vagina) so make sure you keep up with the monitoring *just in case*.

Temp984666312503071

Thanks 2BWed... Question... is fFN a good indicator of pre-term birth with IC?  I know it is for pre-term labor (contractions, dilation, etc) but with IC, is it possible to have a negative test and then have the baby anyway?  I guess I am worried I will be that .5% that still deliver even with a negative fFN.  And wondering if that statistic applies to patients with IC.

Don't worry, I will be going to the doctor.  I had my scan yesterday and go again a week from Thursday.  And you are right, it is WAYYYY too early for this baby to make an appearance.

Did you have any cramping, discharge, bleeding, etc when you dilated to 5 and ended up giving birth?

2BWEDN2007

It was my first baby and I didn't really know what I was feeling at the time, but looking back, the cramps I had were, in fact, contractions. I only had three contractions total (between 2:30 and 4 AM) before they checked me and I was 5 cm. It happened so fast and the doctors think I was probably in labor the day before I gave birth and just didn't feel anything. Other than that no discharge, no bleeding, etc. I had lost my mucous plug the day I went in for the fFN test 10 days prior so I knew I was funneling. Other than that no signs of labor.

Like the prior poster said the fFN test can be very unreliable with a positive result. They say if the result is positive that means you have a chance of delivering in the next two weeks and I delivered 10 days later. With me it was dead on! I was trying to explain it to my family and to make more sense to them I compared it to a lie detector test. You can have one done, but it is inadmissible in court and the fFN test can be positive, but it doesn't mean you will go into labor.

JenLynn11

Hi! I have a very similar experience to yours...Im an OB sonographer who liked having her coworkers scan her baby every couple of weeks for fun..well, one fun day at 26 weeks exactly, we took a look at my cervix and found that it was short (1.5 cm) and dynamic.  I was sent to L&D but wasnt having contractions.  Ive been taking procardia and progesterone (I recommend the shots because suppositories are uncomfortable and require pads...but anyway).....Ive been on bedrest for almost 10 weeks now, going a little crazy...but he stayed in there so far! 

I can tell you that 2.0 is when our doctors become concerned, and with you having dynamic changes, I believe they would be concerned where I work and maybe change your work schedule.  However, I have found that each doctor has thier own level of when to be concerned and the older doctors usually have a higher threshold for concern lol...I personally would take it easy, Im guessing that if you are a school counselor (I think is what I read in your profile) that you have to walk around and get up and down quite a bit during the day maybe you might want to see about being checked again in 1 week or something, I dont know.....who is your doctor or group in Maryland, we get a lot of referrals from different doctors where I work?  Im not going to say where I work lol, but I will tell you if Ive heard of them and if Id be trusting....only my two cents though  

You are right though, my doctor said its best to take precautions when these things happen becaues even though you normally would not have had a scan after your anatomy, you could have either carried to term and never known, or gone into PTL...so its best to just be cautious...I myself wonder how many women walk around with a cervix like mine and carry to term without knowing! haha, we shall see after these 10 weeks how much longer he stays in there though   best wishes.....

Temp984666312503071

JenLynn,

I see Dr. Sweeny and Dr. Weinbaum in Annapolis (MFM of Annapolis).  They come highly recommended and I definitely trust them but would love to hear your feedback.  My job is basically what I make of it. In light of this I do not get up and down very often at all.  Just when I need to pee or refill my water bottle.  The kids come to me and I haven't been doing any classroom visits - just using the phone/intercom to get the kids .  I leave every day at 2:40 and go home and to the couch.  So I am "in bed" from 3PM-6AM every day. 

I am getting another scan and fFN test a week from today.  I have heard about progesterone and will ask about that next time.  I hear you on the shots - this baby is an IVF baby so I have done PIO shots and suppositories.  I prefer the shots too because of the mess that suppos leave.  They would put me on procardia if I was contracting or the fFN was + but until then they are going to hold off.  Same with steroid shots for baby's lungs.

In your experience, how long do they scan the cervix (to how many weeks?).  Are you still getting checked at 35 weeks?  Let me know how things go!!  I appreciate your help!

 

JenLynn11

Sweetheart18,

I hear mixed things about Sweeny, but most of the bad things are more on a personal level than medical.  They are pretty big in Annapolis so they must be doing something right!  I worked a little with one of the doctors who recently left there, and Id trust him, so usually they are all similar in a group I think. 

Thats good that you dont have to get up and down a lot.  Id just try and keep it to a minimum as much as possible.  Your cervix measured at the upper limit of normal, and mine was a half a centimeter shorter than that, so that could be the difference in why I couldnt work, plus, I have to get up and down and walk around a lot.  Id still be cautious and really follow the other restrictions with the dynamic changes though.  We take that pretty seriously where I work when it is dynamic but that could just be them being overly cautious. 

Congratulations on a successful IVF pregnancy .  Yeah, I tried the suppositories for the 30 day prescription and was like, please give me the injections for the next 30 days haha...I just ran out and have to do suppositories again because I only need 1 weeks worth and they cant do that in the injection form so ugh, starting tonight Ill be grouchy haha.  Yeah, I was told that not all doctors are big on procardia but the one in my group that I see and the one who sent me to L&D were big fans of it, so I guess they all use it differently.  Its a pain too though because you take it every 6 hours and I continually forget and then cant remember if I took it or not and its just a mess haha.

Where I work we do sono's on your cervix up until 32 weeks...but again, some doctors are more lenient than others so some may not have a patient come back after 30 weeks for a sono and will just rely on the manual exam.  Generally, people with cervical problems come every 2 weeks for a check unless they are overly anxious and can get the doctor to order them weekly......Ive had mine checked by sono every two weeks starting with the day I went to L&D and had my last one at 32 weeks.  My OB checked manually my first visit back after L&D which was like a few days later, and then she checked it again at 30 weeks and once more at 32 because she was goign to let me go back to desk duty at work, but  I was 1 cm dilated and 90% effaced so ...here I lie still LOL...last visit she said that at 36 weeks I can stop taking the progesterone and procardia, I believe she will check me again and hopefully I can go back to work because Im  usuing up all of my FMLA which really sucks!

So take it REALLY easy, you have a long way to go and you dont want to end up on bedrest at home--Its horrible!!! haha, sometimes I just want to cry because I am so tired of being on the couch, in fact, one day I did haha.  But once I got to  32 weeks a lot of the doctors I saw who I work with seemed to feel like I was at a good point...you just dont want baby to come too early and have to see it in the NICU you know!   Make sure your husband understands that you are going to need assistance with a lot, like cleaning, grocery shopping, cooking and all, you dont want to put any more pressure on your cervix than need be....Best wishes!  Let me know how things go!