Multiples

Cervical checks

Both my OB and my MFM have said that with twin pregnancies they typically recommend getting cervical checks done every other week.... and of course regular growth checks every 4 weeks. They have said that the every other week cervical checks should start at 20 weeks (I am 22 now) ...... the thing is, there is no way I can go in every other week at this point..... My parents are my only source of child care to watch my son and they will not be available for any appointments until the beginning of October. Not to mention when I was pregnant with my singleton it was thought that the best course of action was to keep stuff out of my girly bits, and I can't help but think that that should also apply for twins unless one is bleeding or having issues. Anyone not doing every other week checks this early by their own choice or have a doctor who doesn't do it yet?
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Re: Cervical checks

  • I have an appointment tomorrow (21w) but I have not had any manual cervical checks and honestly, I don't expect to until about 30w or so (although I honestly don't know). I will start seeing my OB every 2 weeks after tomorrows appointment - prior to that, it was every 3 weeks and I get an ultrasound at each to measure hb and growth since she doesn't use a doppler with a twin pregnancy. The sonographer also tries to get a shot of my cervix, if she can't see it going the abdominal route, then she has to use the wand (they are checking for cervical length and can tell if it is closed via ultrasound). Beginning at 30w, my appointments will be weekly.

    If I'm told differently tomorrow regarding cervical checks, I'll up-date the post.
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  • After 20w, my very experienced OB did a check every other week.  Every other time it was via us.  They're not just checking to see if it's closed, they're checking for thinning, ripening, and funneling - all signs of ptl.  
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  • I am 29w6d with triplets and my MFM only checked my cervix at 20 weeks, said they don't check again to 32 weeks unless there is a problem or I ask to have it checked.
  • All of my cervical measurements (outside of one at 12 weeks after a bleeding scare) were taken via u/s until I was somewhere around 32ish weeks, but all OBs/MFMs are comfortable with different approaches. Can you take your son with you to your appointments?

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  • I have been getting mine checked every 4 weeks by my MFM. I would refuse to allow manual checks, they are l done via transvaginal ultrasounds as it is. It has been over 3.5 the whole time (I am 33 weeks now) but if for some reason I were showing signs of softening, shortening, funneling, etc. I would go in every week. Every 2 weeks seem a little aggressive, maybe you can compromise at every 3-4 weeks unless and issue pops up? I know scheduling it seems difficult, but PTL is absolutely nothing brush off in a multiple pregnancy and your cerivx may be the first sign somethign is happening.
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  • My MFM checked mine via u/s at the anatomy scan and hasn't mentioned doing any further checks, especially not manually. They may take a quick peak during my monthly growth scans, but unless there is a specific concern, they aren't going to look closely at it. I read somewhere recently (I think it was a position statement from SOGC) that routine cervical checks aren't helpful in preventing PTL. 

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  • I'm 32 weeks and have never had any manual cervical checks. Maybe they've checked via ultrasound and I just haven't realized but no one has mentioned them to me.
  • I'm almost 22 weeks and mine has been checked about every 4 weeks since the first trimester via ultrasound.  
  • I didn't get my cervical checked until I was 35 weeks and that was only because I was having signs of preterm labor!
  • I went through my entire twin pregnancy with only one cervical check at 20 weeks. I did however have multiple ultrasounds and NSTs so I was either at the MFM or OB frequently.

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  • My OB does not do manual checks he does them with U/s. I have had them check it externally and internally through U/s since our a/s at 20 weeks. They also checked it during each appointment at the MFM during our fetal echo.  My OB does it more for awareness, not prevention of PTL. I will say it is one of my biggest fears that my cervix would just open up and the babies would fall out. (Yes I know it doesn't happen that way) But I have constantly had sharp pains, tightness, and heavy pressure feeling down there so I'm a bit paranoid about it.
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  • Are you sure she didn't mean checking the length of your cervix by ultrasound? I began that every 2 weeks starting around 20. It is different than the doctor checking your cervix with her fingers to determine dilation.

    In my opinion, the bimonthly (and I switched to weekly at 28 weeks) internal ultrasounds are so incredibly important - they saved by babies or at the very least have them a chance to be healthier and stronger.

    I had an awesome pregnancy. I was active and felt 100% but my ultrasounds showed that my cervix was rapidly shortening. There was absolutely no reason to suspect it. At 28 weeks, it became so short that I had to go on immediate bedrest and get steroids. Thank god for the ultrasounds because we would not had known to do it otherwise.

    Twin pregnancy is high risk. You really have to take into consideration your doctor's advice. Ask if you can bring your son or your husband might have to take some time off.

    D & L are here at 34 weeks 4 days by vaginal and breech delivery on 11/19/2013
    Two healthy boys weighing 4 lbs 15 ozs and 4 lbs 5 ozs.  Only 6 days in the NICU and getting bigger, stronger and cuter every day! 
  • Thanks ladies, for your experiences. My husband just started a new job so him taking off isn't going to be smiled upon, especially not that often. My OB and MFM allow you to bring children to appointments.... however, my son is...... spirited, shall we say. He is a challenge and a half, doesn't listen, high energy, fast, gets into stuff, kind of lad that doesn't respond to any kind of disciplin that gets thrown at him. If I took him with me it would be a nightmare of trying to keep him out of cabinets, drawers, and from pushing buttons and things. Especially as my MFM keeps one waiting forever.... I waited over an hour to even be seen last time. It's kind of a no win situation that I don't know what exactly to do about. At my A/s they said my cervix was locked up tight as Fort Knox (20w 4d), I wasn't able to make an appointment with them again until I'm at week 25 and 4 days.... my husband is taking off of work that day because that is also when I am doing the one hour glucose test.... I guess I am just hoping that once a month will be enough. : / I just can see how I will be able to do every other week.
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  • OK, just be careful and if you can find alternate child care arrangements, try.  My cervix was perfect until all of a sudden, it wasn't.  No reason to live in fear, but just be very conscious!

    Good Luck!

    D & L are here at 34 weeks 4 days by vaginal and breech delivery on 11/19/2013
    Two healthy boys weighing 4 lbs 15 ozs and 4 lbs 5 ozs.  Only 6 days in the NICU and getting bigger, stronger and cuter every day! 
  • I had one via u/s around 23 weeks. I had a check with fingers this week at 28, but i had been having a lot of bh. He said he would check every apt from now on and I'm going every 2 weeks now.
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