IC Check during Late First/Early Second Trimester

laineashton29 · July 2014

Hi all. I am a little more than 11 weeks pregnant and due to a cone biopsy of the cervix 4 years ago, my doc told me I will need specialized U/S to determine if I have IC. For anyone who has had IC during pregnancy, when did they first begin watching your cervix? I have been doing research and I cannot find the ideal time to begin having these scans to determine if bed rest or cerclage is necessary? Ive had a lot of back pain recently, as well as more pressure down below, but I assume this is normal this early on. I haven't heard of any miscarriages around this 11-12 week make due to IC, since baby isn't very big at this point, (seems to be closer to 20+ weeks) but want to make sure I start my scans early to prevent loss if necessary. Any advice or experience with this is welcome!

amtay825 · July 2014

You should definitely start now, if you're 11 weeks. A preventative cerclage could be placed soon if needed. You'd like to try to avoid having to do an emergency cerclage, as sometimes they aren't as effective. This pregnancy, I've been being monitored since 9 weeks by my MFM (specialist). He placed the preventative cerclage at 13 weeks because of my history. With my son, I was also being monitored early but had other complications that prevented me from having the cerclage until 16 weeks. At this point, my cervix was virtually gone and didn't take. I ended up being on bedrest from 9 weeks until I delivered at 36 weeks; with a ton of other issues to deal with.

The sooner the better with this type of thing. Always best to prevent something if possible, than have to deal with an emergency situation. Are you currently seeing a specialist; or just your OB?

suitern · July 2014

I wasn't a candidate for a cerclage, but my high risk Dr. did cervical scans starting at 12 weeks every 2 weeks to watch my cervix for a baseline number since it shortened at 24 weeks with my previous pregnancy. I graduated from cervical scans at 28 weeks...but of course it was the week after that I ended up in L&D with cervical changes from contractions! Good luck, it is good your DR. is being proactive early!

laineashton · July 2014

Thank you ladies! They called me today to schedule, and at first wanted to see me Sept 8th, but that would put me near 20 weeks, so I said, no! They rescheduled for next week, so I will be just over 12 weeks then, thankfully!

laineashton · July 2014

amtay825 said:

You should definitely start now, if you're 11 weeks. A preventative cerclage could be placed soon if needed. You'd like to try to avoid having to do an emergency cerclage, as sometimes they aren't as effective. This pregnancy, I've been being monitored since 9 weeks by my MFM (specialist). He placed the preventative cerclage at 13 weeks because of my history. With my son, I was also being monitored early but had other complications that prevented me from having the cerclage until 16 weeks. At this point, my cervix was virtually gone and didn't take. I ended up being on bedrest from 9 weeks until I delivered at 36 weeks; with a ton of other issues to deal with.
The sooner the better with this type of thing. Always best to prevent something if possible, than have to deal with an emergency situation. Are you currently seeing a specialist; or just your OB?

laineashton · July 2014

AMTAY825, I am only seeing my OB at this point...not sure if/when they move to a specialist? They do have me going to a different hospital for the cervix scan though.

This is baby #2 for me...first baby was before the coneization of my cervix, so I had no issues. I guess my concern is that since this is baby #2 and things seem to grow faster, I dont want to wait on the scans, and be too late to prevent miscarriage.

MinaE01 · July 2014

I also had a cold cone biopsy (about 8 years ago). They didn't do any additional cervical length checks. DS1 was born at 32w3d due to PTL. OB didn't know what caused me to go into labor so early, but she didn't suspect IC. When I was pregnant with DS2, I they checked my cervix at my NT scan at 12 weeks. Next, I had my first MFM appt. at 16 weeks. He checked my cervix again at the anatomy scan at 20w and since nothing had changed, he released me. My OB continued to check every 3-4 weeks. There were absolutely no changes until 33 weeks when I began to dilate. DS2 stayed in until 36w.

laineashton29 · July 2014

That's great to hear! Thanks for the input!

AnonnAni · July 2014

You'll probably be moved to a specialist by 16 weeks and from there if not before there would be cervical length checks reguarly (i do bi-weekly). Do you know if they will do suppositories for you or shots? (I personally prefer shots to the suppositories I've had both and had no response to the suppositories but no changes while on the shots and hoping for the same result this time around)

laineashton29 · July 2014

I don't know what their plan is. They are checking me for the first time in one week, and I asked what protocol was for next steps and the nurse at my regular doctor said they would probably see me every 4 weeks after the first check, but if they know I had the coneization done, I am wondering why they don't want to do weekly or bi-weekly scans? I guess if my cervix looks good next week maybe they would wait? I would rather be cautious and do bi-weekly scans either way just in case. They mentioned the surgery to stitch it closed but we don't know if I will need that or not. As for shots or suppositories, I don't know what they will do. I wish I had a better idea!

AnonnAni · July 2014

@laineashton29 YOU are in charge of your care... Your baby has no voice at the moment but everything affects that little life, so you have to have the voice for you both right now
That being said If they are suggesting the need for a cerclage then ask why they are not then monitoring the situation more closely as oppossed to every 4 weeks. Ask for bi-weekly ultrasounds even if to only 24 weeks (at which point you cervix naturally begins to shorten) if you feel you need that or if their explaination does not feel right to you.
Ask why they deem a cerclage as a possible neccesary action but not suppositories or 17P shots..
And if you feel 4 weeks is to far to wait call back and schedule a closer appointment.. Your appointments and care are suggestions and if they are not giving all of the information you need, you have to speak on it. You always have a say, do NOT take a back seat to the care you feel you want/need.
Not saying go in like a raging "B" but it is your right to be as proactive in getting the answers you feel you need as neccessary. Part of a healthy pregnancy is limited stress, how can you be less stressed if you allow the people that are supposed to be helping you to not give you all the information you need? You dont need the worry so explain just that, that you need definitve knowledge on a set plan, and now since you know a few options find out why they weren't presented to you and then go from there on a plan that you feel comfortable with.
Also you can request to see a Maternal Fetal Medicine Specialist if you feel your OB isn't giving you the care you need, which they are not all qualified to do, and you shold ask if your OB can... For instance I see a high risk OB, BUT she is still not qaulified to handle my IC issues that has to be deferred to my MFM so you may need to see someone else in conjunction with you OB.

laineashton29 · July 2014

Thank you @AnonnAni‌! I do plan to talk more with them when I see them. I'll see my OB this coming Monday and have the scan of my cervix on Tuesday. I have no problem telling them I want bi-weekly scans. I don't like feeling in the dark. My main concern was that I wanted to make sure they started monitoring me early in case I do wind up needing something else for my cervix.

AnonnAni · July 2014

Since your 11 or 12 weeks they may not start any "real" monitoring till 16ish weeks if you haven't had a loss due to IC :-( .. some do an early baseline so they would first look there to see where your starting from. IC is still new research and treatment wise and prior to 2010 they didn't treat it AT ALL. So some OB's are in the dark about how and how much to monitor. I'd suggest asking for a MFM as well. Even if you only do a consult with them at least you'd have an idea of what someone that specializes in dealing with your issue would do. But again OB's and MFM deal with totally different things so your OB may not be qualified to manage you solely.

caden1206 · July 2014

I was checked from 13 weeks on, but that is bc i had a cerclage put in.

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