long-Kind of upset... wondering if I am over-reacting (LEEPs, cervical length, etc)

NewlyWeds13

So-- my regular OBGYN has been treating me for the past 4 years.   She knows that 10 years ago, I had a LEEP.   I have had no pap or cervix issues for the past 10 years.

When i got pregnant, she did not mention anything about watching me more closely or high risk or not running or no-sex, nothing.

Well-- I elected to do a NT scan so had to go the high risk doctor for it (that is this practice's normal procedure).

thankfully the NT scan was wonderful.   At it, the ultrasound tech noticed in my records that I had had a LEEP 10 yrs ago, she mentioned it to the high risk doctor when he came in to explain the NT results.    The doctor said, oh-- yes, let's have her come in at 16 weeks to start cervical length measurements so i can get a baseline then.

So... I called my regular OBGYN and told her office this and they said, ok, I can go if I want.  they don't really see a big risk of this given my history, but is fine to go if I want.

Well-- I go there this week (as I am about to be 16 weeks) and between then and now and I have done way more research and found that if you have had a LEEP, even one that you might want to consider geting a preventative cerelage (but has to be done before 14 weeks from what I understand).   Well-- I was never given that option.

My husband and i have a babymoon planned for when I am 23 weeks (again, I had no idea that i had any increased chance of being high risk when we planned this at 11 weeks since none of my doctors said anything).

So... would you be upset about this?   what can I even do about it now?

I am obviously just hoping and praying that everything will be fine and this will end up not even being a problem, but I just can not stop thinking about it and the more I think about it, the more angry I get. 

I think it is ridiculous that a doctor would not mention this (or even the high risk one that instead of monitoring, giving me the option of preventative curtlege).

I am super risk adverse and would have definately done a preventative procedure if the option was given to me.

I have been running as well and I am not sure if I should stop (regular doctor says no reason, but now I do not trust her).

Am I over-reacting?

miaomi

First off, stop worrying so much!  I know that's so much easier said then done.  :-) I can answer your question pretty well for you.  I've had 3 LEEP procedures.  They don't worry or place you at high-risk unless you've had more than 2.  I had my cervix measured at 16wks and 20wks and was doing ok.  Here's to hoping it stays strong!  I don't have the cerclage and didn't need one.  I also wasn't given the option to have one since I don't need it.  It's kinda like, why complecate things if you don't need to. 

If I were you I'd go and have my cervix measured at 16wks.  It's completly painless and easy to do.  This will ease your fears.  If your cervix is at all short or they are concerned they will go from there.  I don't think your doc was being irresponsible at all in not telling you anything.  Like I said, unless you've had more than 2 LEEPs, they don't really do anything different.

I'm now at 28wks and my cervix is still doing good.  I wouldn't see any problem with you going on a babymoon at 23 wks, even if you have a cerclage.  My SIL had a cerclage and carried untill 37wks without any major issues. 

That being said, I understand your fears.  It's always scary to think that you might not be able to carry your baby to term or that there is something wrong with you.  Please feel free to contact me if you have any questions or need any support.  Good Luck and please give me an update when you find out your cervix measurements!!

NewlyWeds13

Miaomi- thanks so much for the support and perspective.   that makes me feel better that she was not being irresponsible for not suggesting this if other doctors say only a higher risk if more than 2 LEEPs.

I will post my cervix measurements when I get them. I go this Wednesday at 4:45 PM:)  

I think I am just nervous and upset and more emotional than I usually am:)   Hoping and praying I will have the same results as you and not have any cervical length issues!   Good luck to you as well.  

KYmama9286

I dont have any experience w/ this but I can relate to feeling frustrated about having dr's not take your concerns seriously--I always felt silly asking questions, being persistent about things that seemed "high risk" to me but Ive noticed that OB's and midwives try their best to be the least "alarmist" as possible (if that makes sense) they act like nothing is a big deal b/c they dont want you to worry unneccesarily

Sometimes its nice just to have a dr or midwive validate that you are completely justified in having concerns instead of trying to act like nothing is happening as to not alarm you--because Ive found regardless of what they say (whether they say to worry or not) I worry--its normal, its your child for goodness sake

Just try to stay optimistic and in the moment- take things day by day and just keep in mind nothing has happened yet, so try not to worry. T&P for good measurements on Wed!

Laxbugg1410

I had the LEEP procedure 5 years ago (while living in a different city) and the Dr never said ANYTHING about an incompetent cervix being a risk after the procedure so I was pretty surprised when my OB brought it up. That said, he said at our first meeting that he would like to put in a preventive cerclage and that he was very aggressive about cerclages (some dr's are not) and had had great luck with them. I also wanted to minimize my risk of bed rest, which the cerclage does. But I think Dr's have different opinions on the procedure and the need for it. Some figure that you can just go on bed rest and will be fine.

My recommendation is that you talk to your dr about the LEEP that you had and how deep it was and how much it has healed. If it wasn't too deep, it may not even be an issue. But be sure to voice your concern and that you weren't given this option.

Then again, it's nice to get an ultrasound and see the baby every 4 weeks.  

As for the babymoon, I wouldn't worry about it--1. My OB said that the biggest risk for shortening is at 28-32 weeks AND 2. Even if you got a cerclage, there's no guarantee you wouldn't have shortening at 23 weeks. I'll be 28 weeks when we go on our babymoon (knock on wood), but DH and I are both aware that it might not happen. I've also got work trips scheduled for my 29th and 34th weeks, but of course those will depend on my ability to travel.

 Good luck! You might want to re-post on the High Risk board.

wingedbride

I have had two LEEP procedures and my OB knew my history and referred me to a perinatologist at my first pregnancy appointment at 8 weeks for a length check. Based on my measurements over the coarse of 2 checks, we decided to have a preventative cerclage placed at 14 weeks. My H and I are very conservative and non risk takers. My perinatologist is also somewhat conservative but said that since my measurement was borderline, he would leave it up to us. he did say that if I was carrying multiples or if this pregnancy was difficult to achieve due to infertility that he would place to cerclage no questions asked. That was all my H and I needed to hear. Even though we did not struggle with infertility, we were not willing to risk the chance of my cervix shortening and causing problems.

I know we went the conservative route, but I am happy with our decision and we both felt it was the right one for us.

So I guess, I am saying, you need to also feel comfortable with the decision you. And you have to feel that your doctor is a partner in this decision making, because that is the person you are trusting all of this medical information with.

BeccaLandes

I don't think you need to worry.  Even after a LEEP, you should be fine.  I also had a LEEP, and now twins, and am having some shortening of my cervix, but I don't know that it's related to the LEEP.  I have done some research and seen that it isn't "standard of care" to do preventive cerclages in a first pregnancy after one LEEP.  I know my SIL, who is now 24w with her first, had a LEEP about 1.5 years ago, and she has not had a cerclage or any special monitoring during her pregnancy and is doing just fine, working and traveling, etc.  You should be totally fine for your trip at 23 weeks.

Dec31stBride

All of my research said it was a concern if the LEEP was within the past 2 yrs (I think - def not 10!)

I'd had one about 4 yrs before my 1st pg and my OB/GYN said no worries - but they did measure my cervix at the big u/s.

My recent experience (1st time speaking with the high-risk dr) left me feeling that these doc are so used to prescribing extra tests and monitoring by nature of what they do. Hopefully everything looks good when you get the 1st measurement. You should be fine. Good luck! 

yellow_grace

I am not pregnant but am TTC. My history includes a LEEP as well as a few other surgeries to my cervix, which is, at non-pregnant baseline, very short. We met with high-risk docs at 2 different academic medical centers. My DH is an internal medicine doctor, and I am a critical care RN, so we did a lot of research before the meetings and got 2 opinions.

 It is not standard to do a intervention on any woman who has not demonstrated a cervical incompetence or failure. You are not "at risk" until you have had 2 LEEPs, or a "complicated" LEEP (ie-did not heal, etc.) There is no research that proves that pregnancy is prolonged with any intervention... and even the research that is out there shows a correlation that is not necessarily a strong correlation.

 If we become pregnant, given my extensive history of cervical interventions in the past 3 years, we will have frequent cervical length monitoring, but we will not have any invasive interventions. We believe the risks outweigh the benefits (in my case) for invasive interventions.

I hope everything works out for you!