Can a cervix start thinning/dialating without a sign?

[Emaya]

Hi all!

I'm expecting triplets and am just starting week 26. Had the cervix checked in week 22, and it looked good (5.5 cm and closed).

If I haven't been having any contractions, and haven't felt anything in particular around that area, how often should it be checked? I ask, because it doesn't seem to be part of the general check-up/ultrasound I'm getting every two weeks. 

Can the thing start to thin out and dialate without giving me any sensory indication?

When I asked for a cervical check last time, the specialist said that there wasn't any reason to do so, and we could wait another couple of weeks. She mentioned that there's a slight risk involved with putting the ultrasound wand up against the cervix. I forgot to ask her what that risk was -- do any of you know what she was talking about?

 

Thank you, mamas!

[daisie31]

Mine did, twice:(.  My first pg, I thought I was just having BH, they were painless contractions that came and went.  I mentioned it to my Dr and he checked me, I was over 50% effaced so was put on bedrest at 28 weeks.  I delivered that baby at 38 wks after 10 wks of strict home bedrest.  My twin pg was very similar.  I had a positive ffn at 27 weeks and a shortened cervix, maybe 2.8 or so.  Bedrest again and delivered them at 36 weeks.  Both times I was active and thought nothing was wrong.  I am suprised that they aren't measuring your cervix regularly.  Are they going to do ffns?  I had ffns every 2 wks starting at 24 wks I think, was on progesterone starting at 16 weeks and had weekly cervical length checks starting at 28 weeks (with the twins).  I didn't go to a peri because my OB felt she could manage me (she did, very well) and the peri is 90 minutes away.

Dena

[Emaya]

Thanks for your reply daisie. I'm not sure what a ffns is - some kind of scan? I'm having an ultrasound every two weeks to check for fetal growth, twin transfusion syndrome, etc. They check my urine and blood pressure too, and I check in with the peri on how I'm feeling/doing. 

[Amanda Leigh]

Mine did as well. I was 3cm and 80% at 28 weeks and got to 5cm and 95% by 34 weeks. I was contracting but didn't feel anything. They were able to measure cervical length on an abdominal ultrasound. My OB didn't want transvaginal ultrasounds because any disruption to the cervix can release prostaglandins which can cause further dilation. Good Luck!

[jgallagher66]

I've had this happen twice. Both times happened at around 24 weeks. The first time I had a little blood tinged discharge. It was so little I almost didn't even mention it. I just had a little blood when I wiped which I had been told was normal and could happen after intercourse or a pelvic exam or any variety of reasons. Still it just worried me so I mentioned it to my doctor. He had me come in just to make sure and sent me for ultrasound. My cervix is was dilating and I had contractions on the monitor even though I wasn't feeling a thing. This was my 4th pregnancy so I thought I would know if I was having contractions or not! I ended up in full blown labor which they were able to stop with mag and then on hospital bedrest. By the time I was 28 weeks I was 5 cm dilated and I never felt a thing. We were very fortunate to be able to keep her inside until 32 weeks.

I'm having similar issues with this pregnancy. My cervix is thinning and shortening and I'm just not feeling it. I'm on bedrest again.

Also BTW, a ffn is a fetal fibronectin test. Here's a link for more info. It's just a swab that can help predict if preterm labor is likely to occur in the next couple of weeks:

http://www.marchofdimes.com/pregnancy/pretermlabor_fetalfibronectin.html

Since you're carrying triplets, you might want to talk to your dr. about preterm labor and what you should be doing to prevent it, but generally they only do ffn on women that are showing signs of preterm labor which may include a short cervix so my experience has been that they do the ultrasound first.

Good luck with your babies.

[Emaya]

Amanda - I didn't know they could measure cervical length with an abdominal exam. I'll ask about that on Tuesday. Seems like the easiest and safest way to go.

Jgallagher, thanks you too for the information on the fetal fibronectin test. I'll ask my peri on Tuesday. My specialist has talked to me about preterm labor and how to avoid it, but it's hard to know how easy to take it when I can't feel anything at all associated with labor or even BH contractions. 

Thank you for the replies.

[APToddlerMama]

Mine did twice too.  With my first (preterm at 35 weeks) I had no pain before transition when I was like 8=9 cm dilated. I'm hospitalized right now with my second preterm labor and have been since 29 weeks.  I had months of painless BH contractions but had demanded the FFN every two weeks and luckily, the FFN caught it, followed by a cervical length check.  There are some women I know who have contractions that are so mild that they don't even feel them, but the monitors at the hospitals can pick them up and they can cause cervical change.  The abdominal cervical lengths can be done, but they are not nearly as accurate as the transvaginal ones.  However, if you have a number of 3cm or over, you're pretty much doing great even on an abdominal.  I would truly demand either FFN or cervical lengths or both given your situation.  You do not want preterm babies.  They took me on a NICU tour a couple of days ago and it just about ripped my heart out.   

[lesliesara63]

My MFM has your cervical length checked every two weeks at the growth u/s. Mine had been 3.9 for many weeks. I always (even in singleton pregnancies) had a lot of BH so I was concerned. At 28w my cervix had shortened to 1cm earning me 5 weeks in the hospital. Once in the hospital I still had tons of BH even on procardia and my cervix did not shorten more. Since you are having triplets, I would take resting very seriously. I would still go for maybe one errand in the morning, stay in bed 2-3 hrs in the afternoon, get up to give the kids dinner & back down on the couch for the evening at the point you are now. I probably should have done even less in hind sight. Bedrest at home would have been so much better than in the hospital. Ultimately the girls were born at 32.6 and had the best case scenario for NICU time that there could be. All three came home after 27 days.

[Emaya]

Thank you for your input, Leslie! I hope all is well with you and your girls - glad to hear that you are all home. I had my cervix checked the week I wrote the original post (week 26), and it was at 4 cm and hard. I figure I'll have it checked again this week and then again a month later. I don't want to fiddle around too much in there as any infection or stimulation can get things going unnecesarily. I'm pretty much doing what you wrote - resting for much of the day, and taking on one easy task per day. My PSD is so bad now, I can't get around too much anyway. Week 30 now, and keeping my fingers (and legs) crossed!

[lesliesara63]

Originally Posted by lesliesara63 

My MFM has your cervical length checked every two weeks at the growth u/s. Mine had been 3.9 for many weeks. I always (even in singleton pregnancies) had a lot of BH so I was concerned. At 28w my cervix had shortened to 1cm earning me 5 weeks in the hospital. Once in the hospital I still had tons of BH even on procardia and my cervix did not shorten more. Since you are having triplets, I would take resting very seriously. I would still go for maybe one errand in the morning, stay in bed 2-3 hrs in the afternoon, get up to give the kids dinner & back down on the couch for the evening at the point you are now. I probably should have done even less in hind sight. Bedrest at home would have been so much better than in the hospital. Ultimately the girls were born at 32.6 and had the best case scenario for NICU time that there could be. All three came home after 27 days.

That should have said I was not concerned b/c I always had lots of BH. It was hard to know when to take things seriously. When my water broke I knew lol! I'm glad things are going well. 30 weeks is fantastic & hopefully you can bake for a few more weeks. I have friends that just had GGG at 30 w and there is a big difference in the health of their babies vs mine at 32.6 The only other thing I should mention is that you should try to make some special time for your older dd while you can. I really wish that I had stayed home from the NICU one day before the babies came home in order to do something special. I always spent a lot of time with them but its different now & a lot harder for me to give them one on one attention. Please come back and update when the babies come if you can.

[Emaya]

Checked the cervix yesterday - a whopping 6 cm long, hard and closed. The peri checked it twice because she couldn't believe it. She' said, *ok, this is not normal, but I don't suppose it's anything to be worried about." We scheduled a c-section for the first days in January (I'd be 37+4), but she said I'll be begging for a cesarean before then. I scoffed -- I have tons of room to grow (I'm a very tall woman) and of course I want to cook these kids as long as possible -- but last night in the middle of another uncomfortable and sleepless night I felt a little worried about how I can manage the next 6 weeks physically. I can hardly walk because of the PSD now, and I'm only 30 weeks. Things are looking brighter this morning. One day at a time. I've got a crazy super cervix and I'm going to take advantage of that to have three 3kg babies in January 

Leslie, solid advice on taking care of my older girl now. I've been haning out with her exclusively between 4-7p.m. each day (no cooking, no phone calls, no visits), and we're having a lot of fun. In Sweden, where I live, the parents live in the NICU with the babies (or rather, the babies live in the same suite with the parents in the hospital) to have 24-hour access to feeding/pumping/kangaroo care, etc. So that makes me especially intent on spending tons of time with her now in case I'm absent for a month. Of course, she can visit us there (her grandparents, who she adores, will be staying at our house with her) and dad can come home and stay with her too. But it's going to be a huge change. Also, we get a helper from the government when the babies come home for 20 hours a week, so we thought we'd continue with my mom/daughter afternoons afer babies come and have helper take care of babies for a few hours a day. Dad also gets paid paternity leave, so the other alternative is that he and I trade off baby/big girl time and helper does dinner/laundry/cleaning stuff. I'm so glad this (triplets) happened to me in Sweden... You must have a similar experience in Canada with social help and quality health care at no/little cost. Just the thought of sending 4 kids to college in the US at the same time is frightening. Thank goodness for free education the whole way in Sweden. Thank goodness I fell in love with a Swede!

I will definitely come and update when babies come. And I will be on the lookout for your updates to see how you are doing with young triplets!