Cervix question

Jen0204 · November 2011

I had an appointment with my MFM yesterday. 2 weeks ago (at 26 weeks) I was put on strict bed rest because my cervix was down to 2cm. My FFN came back negative so they didn't make me go to the hospital. Yesterday the girls measured right on track as far as how many days they are, and one was 2 lbs 10 oz and the other is 2 lbs 13 oz (7% difference, so they said that's good). However, my cervix was down to 1 cm and while he said I'm not dilated at all, he said it's starting to open up inside. He didn't seem at all worried, though. I asked him if that was something to be concerned about and his response was that if I was 32 weeks they wouldn't even be checking my cervix length. My mom said to him "but she's not 32 weeks, she's 28 weeks" and he said again that later in pregnancy they don't even check.

Has anyone else been in a similar situation? He started me on prometrium 2 weeks ago so I had hoped with that and the bed rest my cervix would at least stay the same. When he did the FFN swab fluid came out with it and he was worried that my water could be breaking but he had me walk around and use the restroom and there was no excess fluid so he sent me home and said to continue my bed rest. My mom was with me (H started a new job, so he can't make all of the appointments) and she is freaking out, but I'm trying hard not to. I figure if they were at all worried then they'd admit me, especially since they know I live an hour from the hospital. Yesterday's FFN came back negative as well. My plan is to just relax all weekend and call if I feel/see anything abnormal, but my mom wants me to call my OB and head to the hospital to have them check me out (but I see them next week anyway).

Sorry for the long post, but my MFM said that cervix issues are common with twins, so I was hoping that others might have some advice.

TaylorandMel · November 2011

I don't really have any experience with this because I am behind you--I'm 20 weeks. I just had my 20 week US and my cervix was 3.3 cm. They said that the babies are really happy as long as it is above 3. However, reading online it seems like a lot of peoples are above 4 at this point. So, I like you, have been worrying if I'm heading in a bad direction. I've been on bedrest since 6 weeks due to bleeding, so hopefully the bed rest will prevent mine from furthering along.

What was your measurement at 20 weeks? Were you working up until this past appointment when they put you on bed rest?

E&RMommy · November 2011

Twin cervical lengths do thin faster than singletons but not that fast. I think a negative fFN is good but you also need a cervical length of 2.5 cm or longer in addition to the fFN to be completely reassured. I'm really surprised your MFM is being that cavalier.

I feel that my bedrest completely saved my kids from being born early. I made it to 36 weeks and delivered from pre-e.

Hang in there and let us know what your doc says.

Waiting4Fred · November 2011

E&RMommy:
Twin cervical lengths do thin faster than singletons but not that fast. I think a negative fFN is good but you also need a cervical length of 2.5 cm or longer in addition to the fFN to be completely reassured. I'm really surprised your MFM is being that cavalier.

I feel that my bedrest completely saved my kids from being born early. I made it to 36 weeks and delivered from pre-e.

Hang in there and let us know what your doc says.

I tend to agree that your MFM is being pretty nonchalant. Yes, at 32 weeks when they check the length of you cervix it matters a lot less, but like your mom pointed out, your a MONTH behind that. I am almost 34 weeks, and I am down to 2, but before that I had always fluctuated between 3.02 (at like 18 weeks... I freaked out, but the next time it was higher) and 3.75. I have always considered 1cm to be a big issue. You said this was your MFM... are you seeing an OB too? What does he say?

Kimmy08 · November 2011

I would get a second opinion. At 20 weeks, my cervix was over 3cm and at my MFM appointment at 22wks5days, it had dropped to a 0.8 with funneling. I am not sure if it was because I was contracting and in PTL, but it was enough for me to be on strict hospital bedrest for the next ten weeks. They didn't even want me sitting up to eat, because of the pressure it would cause on my cervix.

Like I said, I would defnitely get a second opinion. If my doctors weren't so proactive, my girls wouldn't be here right now. (But I was only 22 weeks).

Good luck and I hope you have some full term babies!

kafunder · November 2011

I agree with the others--you need a second opinion. My cervix started shortening at 22w and I was put on home bedrest. When my cervix dropped from 2.2 to around 1.9-2.0 at 28w, they admitted me to the hospital without batting an eye and said I'd likely be there until I delivered. I did 4 weeks in the hospital on bedrest, and they only let me leave at 32w when the checked me and my cervix was still 2.0 and under the condition that I continue strict bedrest at home. I was on strict BR at home for another 3w until 35w, and then they let me off b/c I was still at 2.0. I delivered at 36w4d due to high BP. If it hadn't been for the BP, I think I would have lasted another week or so. Like E&RMommy, I credit keeping my babies in for so long to spending that month in the hospital and having such proactive, conservative dr's.

Good luck!

akaMrsL · November 2011

I would definitely get a second opinion! Your MFM seems a little too relaxed to me. I ended up in the hospital for 10 weeks when my cervix was at 1.8. I had already been on strict bed rest for 5 weeks prior to that. I also had a lot of braxton hicks. Probably NOT the best option but you could always "pretend to feel" tightening of your stomach and go to the ER :-)

Jen0204 · November 2011

At either 22 weeks my cervix was measuring at 4cm, so it shortened a lot by my 26 week appointment and then even more at my 28 week appointment. Another doctor from my OB's practice called out my FFN results (because they work closely with the MFM and he was gone by the time the results came in) and I asked her if 1 cm was normal at this point and she said it's something to be concernd about but the FFN is negative, I'm not contracting, and the MFM has me on bed rest so she's not worried. My regular

OB sent me to the hospital for a NST a couple of weeks ago (the hospital is right across the street from their practice and they prefer to use the hospital for NST for twins) and she wanted to start me on medication to help the girls lungs in case I go into labor but at the hospital they called my MFM and he said no so they didn't do it. The OB practice seems to defer to him on everything.

At my 26 week appointment when they put me on bed rest he made the same comment about how if I were 32 weeks this wouldn't be a concern and another doctor who was in the room said "but she's not, so why would you say that?" and he said it was to show that certain things are normal later in pregnancy. Obviously later on it's normal for my body to progress towards labor, but not now!

I have an appointment with my OB on Monday so based on what you guys are all saying I think I'll really push her for answers and tell her that I'm not very comfortable with how the MFM is handling things. I certainly don't want to be in the hospital at all, especially for the holidays, but if that's where I need to be to make sure that my girls stay put as long as possible then I need to be in there. Especially with the fact that a simple cotton swab caused horrible pain and leaking fluid, I just don't think he's being cautious enough.

Jen0204 · November 2011

I think I have funneling, too. It looked like it on the internal u/s and he said that my inner cervix was down to 1cm and starting to open, but nothing was open on my outer cervix. I have no idea what that means since I've never heard anyone mention inner versus outer cervix before.

ams8099 · November 2011

I would get a second opinion. I am surprised your MFM is being nonchalant.

At 24 weeks my cervix was at 2 cm and I was put on modified bedrest. At that point I had weekly cervical checks and FFNs every two weeks. At 27 weeks my cervix was down to 1 cm with lots of funneling and I was admitted immediately. I went on a terb pump (sp) to relax my uterus and spent two weeks in the hospital.

At 29 weeks I was released and was on strict bed rest until I delivered at 35 weeks. My last cervical check was at 34 weeks and my last FFN was at 33 weeks.

GAbride2006 · November 2011

I am at 32 weeks with my twins. At 26 weeks I was having some lower abdominal pain so they had me give a urine specimen and it came back that I had protein and blood in my urine. They then checked me and I was dilated 2 cm. They put me in the hospital and started pumping me full of antibiotics and fluid. 24 hours later they did a FFN test and it was positive. I was in full freak out mode. They told me I was likely to deliver within 2 weeks and started me on steroid shots. They even had NICU come down to talk with my husband and I so we would know what to expect. They told me at that point the babies had a good chance of survival but we would be looking at a long NICU stay and possible long term problems. We have prayed like crazy. I was in the hospital from Wed-Sat and they released me to strict bed rest, that is where I am still. They tell me if I can make 34 weeks we can breathe a sigh of relief. They did a vaginal US too while I was hospitalized and my cervix was shortened. Just take it easy and I think you will be fine. The drs are so shocked I am where I am. A negative FFN is a great thing, means you won't be delivering within the next 2 weeks. I wish you the best!

Jen0204 · November 2011

GAbride2006:
I am at 32 weeks with my twins. At 26 weeks I was having some lower abdominal pain so they had me give a urine specimen and it came back that I had protein and blood in my urine. They then checked me and I was dilated 2 cm. They put me in the hospital and started pumping me full of antibiotics and fluid. 24 hours later they did a FFN test and it was positive. I was in full freak out mode. They told me I was likely to deliver within 2 weeks and started me on steroid shots. They even had NICU come down to talk with my husband and I so we would know what to expect. They told me at that point the babies had a good chance of survival but we would be looking at a long NICU stay and possible long term problems. We have prayed like crazy. I was in the hospital from Wed-Sat and they released me to strict bed rest, that is where I am still. They tell me if I can make 34 weeks we can breathe a sigh of relief. They did a vaginal US too while I was hospitalized and my cervix was shortened. Just take it easy and I think you will be fine. The drs are so shocked I am where I am. A negative FFN is a great thing, means you won't be delivering within the next 2 weeks. I wish you the best!

Thanks, that makes me feel better. I certainly don't want to be in the hospital, but I want to do everything possible to keep these girls inside as long as I can. I just wish that the doctor was answering my questions and better about explaining why he isn't concerned. Hopefully tomorrow my OB can clear up some of my questions and make me feel a little more reassured. I'm so glad that you've been able to surprise the doctors and keep yours in for longer then they thought! Just 2 more weeks until you can relax a little

AmyJoy728 · November 2011

TaylorandMel:
I don't really have any experience with this because I am behind you--I'm 20 weeks. I just had my 20 week US and my cervix was 3.3 cm. They said that the babies are really happy as long as it is above 3. However, reading online it seems like a lot of peoples are above 4 at this point. So, I like you, have been worrying if I'm heading in a bad direction. I've been on bedrest since 6 weeks due to bleeding, so hopefully the bed rest will prevent mine from furthering along.
What was your measurement at 20 weeks? Were you working up until this past appointment when they put you on bed rest?

FWIW, At my 19 wk appt I was at 4.5 (was 3.5 at my 17 wk). My MFM said it wasn't something to worry about and didn't put my on bed rest. I've been trying to cut down on my activities, so that hopefully at my 21 wk appt my cervix it isn't bed rest worthy.

Jen0204 · November 2011

AmyJoy728:
TaylorandMel:
I don't really have any experience with this because I am behind you--I'm 20 weeks. I just had my 20 week US and my cervix was 3.3 cm. They said that the babies are really happy as long as it is above 3. However, reading online it seems like a lot of peoples are above 4 at this point. So, I like you, have been worrying if I'm heading in a bad direction. I've been on bedrest since 6 weeks due to bleeding, so hopefully the bed rest will prevent mine from furthering along.
What was your measurement at 20 weeks? Were you working up until this past appointment when they put you on bed rest?
FWIW, At my 19 wk appt I was at 4.5 (was 3.5 at my 17 wk). My MFM said it wasn't something to worry about and didn't put my on bed rest. I've been trying to cut down on my activities, so that hopefully at my 21 wk appt my cervix it isn't bed rest worthy.

4.5 is excellent, though, that's why your MFM said it's nothing to be worried about. I'm sure your cervix will be great at your next appointment since it got longer Good luck! And to the poster who you quoted, I've heard that anywhere between 3 and 4 is considered good.

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