Short Cervix (1.5)- Bed Rest Needed?

HLee75

I was told this board might have more people that would give me advice... Hope so

... I am looking for some insight - based on the below should my dr. be recommending bed rest? Since she isn't should I be looking for a second opinion and how do I go about doing that?

At my 20 week appointment my cervix was 1.7 - at that point I didn't even know that they measured these things! I was told that since I had a previous full term birth and was not having contractions that I could continue to work, but to be rather restful at home (no sex, no lifting). I started taking progesterone nightly and mortin every 6 hours.

21 and 22 weeks measued 3.0 - I was thinking positive thoughts ;  at 23- I dropped to 2.5 and started having serious pelvic pain; at 24 dropped to 2.0. I stayed at 2.0 for the 25th and 26th visit (although one measurment was 1.5, but she discounted it as tech error);

at the 27th visit (Monday) I was officially averaging 1.5 with measurements as low as 1.2. My Fetal Fibronectin tests have been negative.

I am not on bed rest - still just suppose to not walk and stand for long periods of time. I havve a lot of pelvic pain when I sit and stand, but don't think I have had any contractions.

Should I be on bed rest? Am I not getting good advice from my doctor who is saying to continue work and just take it easy at home?

I want what's best for the baby and having a preterm birth that could be prevented or at least delayed by laying in bed sounds better to me.

BermudaBride07

I would say get a second opinion.

 My cervix went to 1.7 at 26 weeks and I was put on bedrest at home for 4 days. It was the same at the next check so I was able to go back to work and take it easy. The following week it went down to about 1.2 and I was sent home on strict bedrest for a week.  I went back a week later and it was between .7 and 1 and was sent directly to the hospital. I couldn't even go home to pack a bag. I've been here for 3.5 weeks now and my cervix is holding steady at 1 so hospital bedrest really works. You think you can do it at home but if you have a cervix that changes a lot, which it sounds like yours does, the hospital bedrest really has benefits. Not to mention they monitor you constantly for contractions and you may be having them and not even know it!

I wish you all the best!!

cbkittner

I would definitely get a second opinion.

With my first, when I measured 1.3cm at 28 weeks I was put on bed rest at home, by 31 weeks I was dilated, and almost delivered.  They kept me on hospital bed rest until 34 weeks, and baby was in the NICU for two weeks.

This second time they are being very cautious and I'm on home bed rest going on 12 weeks for shortened cervix again.  Another four to go!

Good luck!

Temp984666312503071

There are lots of mixed opinions regarding short cervix and bed rest.  Some doctors put patients on bed rest immediately, others don't. 

In my first pregnancy my cervix was 2.8 at 22 weeks and got shorter from there.  At 22 weeks I was put on pelvic rest, exercise restriction, and "light duty" (work but no long days, walks, etc).  At 30 weeks I was 1.5 and funneling so I got betamethazone shots and told to keep doing the same thing (light duty).  At 35 weeks I was taken off of restrictions.  My water broke at 35w4d and I had my daughter.  I have NO idea if the pPROM was cervix related but I suspect it probably was. 

This pregnancy I started taking 17-P shots at 16 weeks.  At 20 weeks my cervix was 4.5+.  Since then it has fluctuated between 3.5 and 2.8.  At my last appt this past Monday it measured between 3 and 3.5 with a small dynamic funnel.  Because of the funnel I am on pelvic rest and exercise restriction.  I also recieved a course of betamethazone last week as a precaution (mostly due to my DD being born early).

I have never been on total bed rest.  My MFM has three perinatologists and none of them think that bed rest is (or was) warranted for my particular cervix issues.  But i have seen on this board where women are admitted to the hospital for cervix measurements in the 2-3 range.  So I think that care really really varies.

I know I'm not much help.  I do think there is some value to a second opinion if you are nervous.  I feel comfortable because my Peri, his two partners, and my OB all agree that I don't need full bed rest.  And luckily (knock on wood) the 17-P seems to be doing a pretty good job keeping my cervix in a good place this time. 

HLee75

Thank you. Your information is really helpful.

Do you happen to know why P-17 was used vs other forms - my Dr has me taking nightly progesterone sepositories...

My first son was IVF so I took the progesterone through to my 12 or 16 week and didn't seem to have a cervix issue at all. This time I had 3 failed IVF's and then miracle baby the first month we decided to take a break from IVF! So I didn't take the progesterone... I really regret that, but I didn't know the benefits.

Also, on the Steroide shot... my doctor said they wouldn't give that to me unless my FFN test was positive or I was having contracts 6 times or more an hour. and that they would only do one treatment... does this seem conservative or normal? Should I look to request the shot if I get close to 30 or 31 weeks to make sure the she get's to the 32 week of development? It just seems that others are getting the shot and they still aren't considering it... she did say if I hit 1.0 cm she would consider giving it to me then, but I hate the idea of waiting till things are REALLY BAD to help her keep cooking! 

Temp984666312503071

I personally requested the betamethazone based on my history.  My Peri said that he understood my fears and I had the series done last week (he wanted them done between 29 and 31 weeks).  My OB thought it was overkill but agreed to go along with it.  Maybe I have a pushover Peri?  My daughter was pPROM (born 12 hours after my water broke) so I didn't want to wait for contractions because if that happened again I probably wouldn't have the 48 hours I would need to get them steroids into my system. 

As for 17-P vs. suppositories...  I honestly don't know the major difference.  I was on Prometrium from week 5-12 because of low progesterone.  Then I wasn't on anything for 4 weeks before starting the shot.  I believe that most doctors agree that the shot is the most efficient way to get progesterone into the system.  But I know that some REs don't require the progesterone shots (and do suppositories for IVF cycles) so maybe the jury is out on how much better (if at all) 17-P is to supps.  I would ask the question next time you see the doctor.

tlcondon

I had a short cervix measuring at 2.0 at my 18w appt. I was put on modified bed rest:  working from home, laid back in recliner.. No pelvic activity. I also started the progesterone shots then. BUT, mine is due to a LEEP procedure I had done last year. I also have a history of PTL from my DD. I have been on modified bed rest ever since.. My OB said he is going to go ahead and do a steroid shot, just in case. I go back for a follow up this morning.