Question about incompetent cervix

jap618 · September 2014

Hey ladies. So I don't want to create problems but I also don't want to ignore my history. I've had 3 D&C's and a hysteroscopy in the past 2 years. Now that I'm in my 2nd tri I brought up to my doctor that I'm concerned about my increase chance of IC due to so many procedures. She told me that I'm not at any increased risk and not to worry about it. This isn't one of the 2 doctors that has been along side me the entire time so I don't fully trust her. Should I just drop it or should I bring it up again at my next appointment (which is with one of my 2 doctors that I'm most comfortable with)? I'll be 18 weeks at my next appointment and will have just had my anatomy scan. Thoughts?

Thanks ladies

pblge · September 2014

[Redacted]

Not to do a dirty delete, but I got an email from a mod about this post (!!). I thought I was being reassuring, but turned out I was just wrong. Didn't mean any harm by it, sorry!

jap618 · September 2014

pblge said:

FWIW. I've never heard that theory before in my life, and infertility patients have all kinds of cervical manipulation. In the past year, I've had my cervix dilated and "messed with" eight times, and I don't think that's particularly high. I really don't think there's an association. Is there some particular reason you do?

No but a quick google search does have D&C's as a risk factor for IC.

jap618 · September 2014

eme520 said:

Omg you are in 2nd tri?!?!?! :x =D> The nice thing about your anatomy scan is they will have done a cervical length and that can be objective evidence. Either it will support your concern or reassure you. No matter what the concern you should always bring it up.

YES! I'm still in disbelief

Thank you for letting me know that the AS will check my cervical length. No need to bring it up an hour later then

Thanks love, how are you doing?!

buggirl72 · September 2014

pblge said:

FWIW. I've never heard that theory before in my life, and infertility patients have all kinds of cervical manipulation. In the past year, I've had my cervix dilated and "messed with" eight times, and I don't think that's particularly high. I really don't think there's an association. Is there some particular reason you do?

***lurking***

I don't know if you are a doctor but please don't discount someone's concerns based on what you have heard or not heard. I simple Google search shows that the American Pregnancy Association does consider a D&C as a previous trauma that can weaken the cervix and make IC a risk. There are even attorneys who specialize in this area of malpractice.

JAP was also a member of TTCAL for quite awhile with someone who had IC and was told by their doctor that they should avoid certain procedures that would dilate the cervix because it could cause damage and weaken the cervix. I'm willing to guess she remembers discussions about the topic.

JAP, congrats on 2nd tri! Please don't ever let a doctor discount your concerns. The AS will let you see just how long your cervix is but, if I was in your shoes, I would contact your regular doctors that know you and discuss your concerns with them. Never feel like you cannot be the squeaky wheel. They know everything you have been through and want you to bring that rainbow home. If they are not concerned, they should be able to explain to you why in a way that makes you feel comfortable.

pblge · September 2014

jap618 said:

pblge said:

FWIW. I've never heard that theory before in my life, and infertility patients have all kinds of cervical manipulation. In the past year, I've had my cervix dilated and "messed with" eight times, and I don't think that's particularly high. I really don't think there's an association. Is there some particular reason you do?

No but a quick google search does have D&C's as a risk factor for IC.

I see, sorry!

ETA: @buggirl72, yes I was just commenting as you wrote that.

Samuelismomma · September 2014

I didn't know this but I had ds 6 wks early so they put cerclage in, and I've had two D&C 'S this yr and scope to. I would bring it up if I were you.good luck! Congrats on 2nd trimester!

footprint · September 2014

I know nothing about IC, but I feel very strongly that no matter the validity (and I believe that you have an absolutely valid concern) of your concern, you have the right to ask questions again and again until you get an answer that satisfies your worries. A good doctor, I believe, would want you to be comfortable with the answer s/he (or her/his agent) give you. I would rather be a pain-in-the-ass patient that is comfortable with my care than a nervous wreck that goes along to get along.

I had a hard time advocating for myself when my son was born - it was a pre-term, emergency c and I wasn't ready. I'm trying very hard to be a better advocate this time around. I hope that you get an answer that helps you feel better as you move through your second trimester!

luciddreamer106 · September 2014

I would bring it up again with one of the doctors you've worked with more. You 'll know your cervical length from the a/s, but I think it'll help ease your mind to get their opinion. Don't be afraid to push for what you need.

jap618 · September 2014

@buggirl72‌ thanks love! I ♡ you!!!

PinkCamino · September 2014

after my loss the first thing they asked me was whether I'd had a d&c.

My MFM says there is a correlation and as a result I would absolutely push the issue. Better safe than sorry in my opinion.

KMW08 · September 2014

I agree to push & get more info, especially if you're concerned.

That being said, my ob wasn't terribly concerned. It is true that your cervix was measured during the a/s, the us tech showed me mine & my remnant of a septum, but I had asked something so I think that's why she showed me.

bunnybun4 · September 2014

lurking:

I was so paranoid about mine last pregnancy because a stupid nurse commented on how "short" mine was when I was having laminaria inserted for my D&E...after that my OB always (even in first tri) would show me how long mine was on the ultrasound and then do a manual check too just to make me feel better. couldn't hurt to ask....and it's an easy thing for them to do!

carlsonbaby2014 · September 2014

Just want to pop in with some love and ((((hugs)))) for you @jap618!!! Congrats on being in your second trimester and so close to your A/S!!! They did a full look at my cervix at the A/S and said everything looked great there, so I didn't feel the need to bring it up, but certainly do whatever you need to do to get the information and peace of mind you need.

peggels24 · September 2014

I would definitely bring it up to the doctor that you are comfortable with - it can't hurt.

I was concerned about my the length of my cervix as well because I had a LEEP and a D&C/D&E. When I first went to my OB for this pregnancy, he commented that they would watch my cervix. Then at my 18 week visit, I asked what he meant by that. He told me that they would measure my cervix at my a/s (which is at the hospital in MFM). They did and I was told it was great. Then because the tech had some issues getting some pictures - she called the "doctor" in. The doctor there (the on-call MFM) took a look at everything and told me that he wants to see me every 3 weeks to make sure that nothing changes. So I now I see him in addition to my OB.

TL;DR? They decided at the a/s to follow-up on my cervix length without my OB even saying anything.

mpiemont · September 2014

If you have the concern, definitely bring it up! I know it can be intimidating in the dr's office but it's worth it for your peace of mind.

(I had a cone biopsy (sort of like a LEEP) about 5 years before becoming pregnant with my 1st. I had my cervix checked at 12weeks, 16weeks, and 20weeks and all the measurements were fine. With my 2nd, they weren't concerned at all about it because I'd already carried a baby to term once. But now after having a D&C and with my history of a cone biopsy (even though it was 9 years ago), I will definitely be bringing it up to my OB.)

nikkitaplin · September 2014

jap618 said:

eme520 said:

Omg you are in 2nd tri?!?!?! :x =D> The nice thing about your anatomy scan is they will have done a cervical length and that can be objective evidence. Either it will support your concern or reassure you. No matter what the concern you should always bring it up.

YES! I'm still in disbelief Thank you for letting me know that the AS will check my cervical length. No need to bring it up an hour later then Thanks love, how are you doing?!

I could be wrong but I don't think they check cervical length unless ordered by the doctor. It's a little different than the normal u/s. I have IC and had a cerclage placed at 13 weeks. At my 20 week scan last week, I asked the tech if they were going to check the cervical length. She said the doctor didn't order it so she didn't know. I pretty much begged just to reassure myself the stitch was still doing it's job. She decided to do it and then talk to my dr after (u/s is done in office so I'm sure the relationship is present to know what the doctor has done in the past). I can give you details of how it's done if you don't know....I've had my length checked a few times.

OP-as for what causes it...I have done a TON of research on it because we lost a pregnancy last august at 18 weeks. I had no prior concerns or worries. Two full term pregnancies before the one we lost. My doctor said sometimes....it just happens. So don't think that just because you had "a" "b" and "c" done, you have IC although it is something to bring up to someone that is going to listen and talk to you about it instead of blow it off. Good luck.

sgio7485 · September 2014

I would definitely ask. It will put your mind more at ease. They do measure the cervix as part of the A/S and my tech and doctor did comment on it and let me know mine was fine, so hopefully that can offer you some reassurance. Congrats on 2nd tri!

jap618 · September 2014

Thank you ladies ♡ I'll wait until my a/s and if they say it's fine I will have the reassurance I need (hopefully). I definitely don't want to be creating problems :-)

jess123456 · September 2014

I have also had three d & e's and a hysteroscopy and I worried about the same thing. I have had many ultrasounds due to loss history and at each one they check my cervical length. Now at 31 weeks it hasn't been an issue yet but if you are concerned, definitely ask your doctor. My doctor adds that into what the ultrasound tech should look for but I always ask at each ultrasound too. Thinking positive thoughts for your a/s.