Cervical dilation question

CNYBride05 · June 2013

When I 1st presented to L&D at 22w with contrax, a digital exam determined that I was 1cm dilated. 6w later, via transvag u/s, they said I was about 2cm. Today, at 30w, MFM said I'm a fingertip, not even 1cm. I know it's all subjective, and depends how hard one is pushing on the cervix, but has anyone heard of this happening? I mean, I'd be thrilled to be less dilated, especially as we begin to discuss discharge from the hospital back to home bed rest in the next few weeks, but I'm also worried about different docs with different assessments and don't want to be cavalier about the health/strength of my cervix...

E&RMommy · June 2013

Cervix is dynamic. When you were contracting it's possible it was 1 cm dilated and now with time and bedrest it's not as open. The difference between 1 cm and fingertip is not much and very common for different people to say that.

Also a transvaginal ultrasound cannot say you're 2 cm dilated. Was it that your cervical length was 2 cm?? Dilation really can't be assessed at all with ultrasound; only really effacement.

Good luck and hope you make it home!!

CNYBride05 · June 2013

Nope, not 2cm long, 2cm dilated. I know, I questioned it too. I'm funneling a lot and with fundal pressure, they could see my cervix opening further and thus estimated the 2cm dilation. This dilation assessment is definitely not an exact science

. My cervix is about 0.1-0.7cm long depending on fundal pressure, contrax, and again, who is measuring.

MrsCaseyK · June 2013

I've heard of a lot if people regressing in dilation over 2 cm on the "baby center" bed rest and incompetent cervix boards. So I'd say its very possible. Glad to hear you're doing so well and congrats on thirty weeks.

E&RMommy · June 2013

So that was your funnel width more than likely. Again it's just an estimate on ultrasound. I've watched dozens of ultrasounds where it funnels down and literally relaxes all while watching. A manual exam may still reveal it's closed. Once a patient is 2-3 cm dilated it's really tough to go backwards.

The digital exam by your perinatologist is the best gauge at this point.

NantucketSunset · June 2013

Hi CNYBride - I was told the same thing as what E&RMommy is saying - that you can only measure external dilation (dilation facing the v canal) via manual exam; u/s, even transv, can only measure internal cervical funneling (facing the uterus). I had a Dr use the term dilation as well after an u/s but when I followed up I was told the Dr meant internal. Also yes bc the manual exam is subjective you can get different opinions re dilation e.g. fingertip vs 1cm. It sounds like you are doing great

CNYBride05 · June 2013

Yeah, I see what people are saying. I don't want to argue about it, but did ask them to explain further and they were talking about the external dilation (again, roughly, not exact). The funnel is significant, but I guess all will be re-evaluated in a few weeks to decide if discharge is in the cards. N sometimes I wish it was just 1 consistent doc instead of doc of the day

Thank you for your thoughts and well wishes . I'm pleased to at least not be dilated further!

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