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High-Risk Pregnancy
If you had shortening/funneling the 1st time around and are pg again
tell me about your experience.
My cervix was 2.7 and funneled at 25 weeks and I was put on strict bedrest. My ob didn't consider a cerclage because of the risk at that point. The measurements varied between 2.8 and 1.1 for the remainder of my ultrasounds which lasted until 36 weeks. At that point he said that if I got pregnant again some of the possibilities might include progesterone shots at the beginning, and obviously bedrest in the next pregnancy if the numbers were down. Then my son was born at 39w2d, It was a success story!
My doctor has always said that there is little data to support that bedrest is effective but there's really no way to study that, since its not like they can put a group on bedrest and a comparison group NOT on bedrest. He said did bedrest work for me? We'll never know. Was he too conservative last time? He also didn't know but he also said he would rather have been safe than sorry.
But he did say that since my son was born full term (at a healthy 8 lbs 10 oz!) he will probably be less conservative the next time around because statistically, I have a smaller chance of having a pre-term baby.
So he's not going to do progesterone shots in the beginning since there was no history of pre-term labor, he's going to monitor with biweekly ultrasounds again (after a certain point, I can't remember when it starts, but I almost wonder if that point would be past the point of a cerclage) and if the numbers start going around the 2.5ish mark he'll do FfN tests.
If the FfN is negative, he'd most likely send me back to work rather than jump right to bedrest. We haven't talked about cutoffs for numbers (as in, let's say its a negative ffn, but really shortened) so I think he's just going to take each measurement as we go.
Anyone have a similar situation?
I just get nervous. I trust my doctor but my hospital does not have a NICU.
This discussion has been closed.
Re: If you had shortening/funneling the 1st time around and are pg again
Mine was done at home, strict, but that brings up another point. I asked my doctor at what point would he put someone on hospital bedrest for shortening, like what number? I remember a lot of ladies on this board the first time around being on hospital bedrest. He said he wouldn't really send me to the hospital for shortening because they wouldn't do anything different than had I been at home. As in, there would be no different monitoring, etc. I had a lot of contractions....but none of them were strong enough to change my cervix, so maybe my situation was unique. There was no need for meds or continuous monitoring contractions for me.
I had cervical shortening and funneling that started at around 19-20 weeks. I was placed on bedrest and started progesterone pills. I was also contracting (I have a family history of having PTL).
I was on bedrest for 17 weeks and had my son at 37 weeks. My cervix varied from 1.5-3 the entire time, sometimes with a funnel, sometimes not. I was admitted to the hospital a few times too and they started me on procardia at around 30 weeks because I kept contracting.
I am TTC #2 right now with my doctor's approval....we are going to do the progesterone after the 1st trimester and we will play it by ear with the bedrest. I am a nurse so it's not like my job is low intensity and I do not have the option to sit down during the shift all the time.
I have a feeling that I will end up on bedrest again for the majority of my pregnancy but I will do whatever I need to so I have a healthy full term baby.
Since you had your baby at 39 + days than you probably can stay at work for longer and avoid bedrest as long as you stay in touch with your OB and get frequent cervical ultrasounds. My OB said since Jack came so soon after stopping the meds and the bedrest he really thinks bedrest saved my baby from coming very early.
Good luck and although I don't want to join you ladies I really hope I get a BFP soon!
I don't think my situation is very similar but I wanted to share my experience and hope it offers some information to you.
With my 1st pregnancy, there was no issue with my cervix or anything (went full-term with a full time job).
Then during my 2nd, I lost my child at 23 weeks to chorioamnionitis. Following this, at the beginning of my third pregnancy the new docs and peri. I consulted with highly recommended a cerclage since they weren't certain whether my cervix opened first and let the bad guys in or if I had the bad guys in there which caused me to dilate. In any event, after talking with my previous doc (who handled the 1st two pregnancies before I moved) she told me if I were under her care that she would just monitor me closely (but did not necessarily say that she would have me get a cerclage).
So, I decided to have the cerclage at 12 weeks. Then after bi-weekly monitoring lo and behold my cervix began to shorten. It went from maybe 3cm down to 0.5cm with funneling from say 14 weeks to about 21 weeks. At that appointment after getting that measurement, the peri. tells me that I have to be admitted to the hospital (mind you I didn't know that I should have been bedresting up to this point). I stayed there for 6 weeks until I got past the "danger zone" and went to do home bedrest from 28 weeks. My CL had stabilized during my stay... hadn't gotten any worse nor better... another reason why they were fine to let me go.
So that's how I got to stay in the high-risk unit last pregnancy. Personally though, I think another influence for the peri to decide to send me there was b/c I was taking care of my then 2 year old and saw that I was not able to do strict bed-rest (my toddler at the time was there with me at every appointment).
I've come to the conclusion (after reading countless experiences) that cerclage and bed-rest of some form is the way to maximize a desired result. I wouldn't necessarily say that the two need to go together BUT it just seems that one is rarely seen without the other when it comes to cervical insufficiency.
You could also get more opinions from other docs as well like I did.
Me again.
Congrats on your pregnancy BTW. I have to ask though, if you don't mind. Your ticker says 3 weeks... how were you able to find out so early? Curious!
And I think I remember your username from the time I frequently visited this board during my pregnancy last year (my delivery was at the end of May 2009).
Hello.
Hey Buggles! I remember you too. Congrats!
I was charting and took dollar tree tests everyday from about 8 DPO and got a faint line at 11 dpo, but didn't trust it until 12 dpo!
This is my first PG and I'm being monitored b/c of a short cervix. It was 4cm at 20 weeks, 3.0 at 24 weeks, 2.8 at 26 weeks and stayed that way at 28 weeks. I got back Wed to checked again. So far I've had no funneling but my cervix is dynamic so it changes as they watch it. I was also was put on progesterone shots at 24 weeks as a precaution to stop contractions if by chance I got any...and pelvic rest
I'm not sure what number they will put me on bedrest but at 2.8 and no funneling they haven't. My sister went into pre term labor last year at 33 weeks so they are watching me closely b/c of that....they said it could just be the way my cervix is and just b/c it's short doesn't mean it's not strong.
Fingers crossed that it's the same on Wed
We are pretty similar.
With pregnancy #1 my cervix was 2.8 and funneled at 22 weeks and down to 1.8 and VERY funneled by 30 weeks when they stopped measuring. I was never on strict bed rest but on modified bed rest. Never had a cerclage or anything like that. I went on to deliver my DD at 35w4d due to pPROM. LIKELY the pPROM was a result of my cervix but I didn't have PTL or anything like that.
This time I started 17P shots at 16 weeks and had bi-weekly cervical scans until 31 weeks. My cervix was much more cooperative (4.5cm at the 20 week anatomy scan and never got below 2.5cm during the measurements. The funneling didn't really start until 29 weeks and it was VERY slight). I haven't been on bedrest but have been on pelvic rest (that was lifted at 31 weeks). I was also put on Procardia when I started getting more and more contractions at 30ish weeks. I was on that until 35 weeks.
I am currently 37w2d and still pregnant. My cervix is READY (I was 4cm dilated and 80% effaced at my last OB appt. at 36 weeks) but nothing to report. I'm guessing it could happen now or 3 weeks from now. Who knows?
One other thing I did aside from 17P, Procardia, and bi-weekly screening was I took a Vitamin C supplement the whole pregnancy. Apparently vitamin C helps to naturally strengthen the amniotic sac. And for people with funneled/shortened cervixes our amniotic sac has more stress (it rubs on the funnel) and our chances of pPROM are higher. I figured it couldn't hurt! Worst case is that I was doing nothing to my amniotic sac but would prevent more colds and illnesses
. I haven't been sick!
That's interesting about the Vitamin C..how much do you take? My peri suggested Omega 3's b/c some studies show it strengthens the cervix. I'm taking 1000mg 3 times a day... he said the worse case scenario is I'm reducing my risk of heart problems and making LO smart
I lost my first pregnancy at 18 weeks due to incompetent cervix. At my 18 week ultrasound I was dilated 3cm and effaced. I was so effaced that a rescue transvaginal cerclage wasn't an option for me. The drs also felt that bedrest probably wouldn't do me any good at that point. My water broke that night and I had a D&E the next day.
After doing much research on incompetent cervix and what can be done to prevent it, I decided to get a transabdominal cerclage. I met with my high risk dr and he wanted to do p17 shots and biweekly ultrasounds, and if my cervix showed any change, put in a rescue transvaginal cerclage. A rescue transvaginal cerclage has a low success rate, because it's sometimes placed when it's too late. Another option would be to put in a preventative transvaginal cerclage around 12-13 weeks. This type of cerclage gets removed at 36 weeks to allow for labor naturally. It has a 60-70% success rate, with 40% of those babies being born premature. I wasn't comfortable with those statistics at all so I did tons of research on the transabdominal cerclage. The transvaginal cerclage is placed lower on the cervix, so there is still room for the cervix to shorten, funnel, etc., causing the cerclage to fail. The transabdominal cerclage is placed at the top of the cervix, and doesn't allow for any changes in the cervix. This type of cerclage is put in either pre-pregnancy or around 10-12 weeks in pregnancy. It has a 97% success rate. Since it's permanent it requires a c-section delivery. I had this type of cerclage placed at 11 weeks. This surgery isn't done by a lot of drs so it's not widely known about. The dr that placed mine told me I should have a completely normal pregnancy and won't need to be considered high risk. After my surgery the dr did an ultrasound showed me that the bottom part of my cervix is already open so if I would have gotten the transvaginal cerclage it most likely would have failed and I would have another late loss. I'm so glad I decided to get the abdominal one!
If you want more information on this, check out www.abbyloopers.org and https://health.groups.yahoo.com/group/Abbyloopers/. The yahoo group is a great source of information, with tons of women who have had the surgery done, and files of information...list of drs that perform the surgery, frequently asked questions answered by the most well known drs that perform this, etc.
Sorry this is so long but it's something I feel strongly about and am trying to educate other women on!
PM if you have any questions.
SweetieD21 I'm so sorry about your loss. Your info was really helpful, thank you for sharing.
My OB gave me some options, we could do nothing (which would mean monitoring biweekly or more often beginning at 14 weeks rather than 16 like we talked about before)
or he felt it wouldnt hurt to see what a specialist thinks.That's kind of what I wanted anyway so I'm glad he mentioned it before I had to. He said to let him know after our first ultrasound at 7 weeks so I just have to figure out where I want to go.