[momof1sofar]

At my regular check-up today, I mentioned to my OB that I've been having pretty bad pelvic pain (for months really) and lots of BH (for a couple of weeks). She checked my cervix and said it felt fine, but since the u/s tech was there anyway she had him check the length via transvaginal u/s. He said I measured around 2cm - DH thinks he said 2.5 at one point.

My OB said we could try a cerclage, and my immediate reaction was no. I had a negative impression of the procedure based on previous things I'd read casually. She said she didn't think they were particularly effective and there are risks, so she wouldn't really recommend it.

I'm to be checked again in a week. I'm doing research online, and have found studies both supporting and opposing cerclage. I carried my one previous pregnancy to term, although I did walk around 75% effaced for weeks. So I don't think I qualify as high risk. I just feel so lost as to what to do to give this baby girl the best chance at staying put.

I'd love to hear from folks who have similar experiences. Thank you...
Missy

 

[alegna]

Unless you had a measurement of your cervix before your pregancy, you can't be sure it's really shortened (from what I've read there is quite a variation in length between women) From my reading there also isn't a lot to show that cerclage improves outcome. I know that some obs swear by them.

I wouldn't do it. But I wouldn't be with an ob or have internal check or the u/s either

-Angela

 

[flyingspaghettimama]

Hi,

I had the same thing around 20 weeks (along with pretty intense contractions). I agree with the previous poster, you can't know *for sure* without a base measurement. However, I was referred out to a high-risk OBGYN who took an extremely conservative approach (weekly checkups to see if there was any additional change). They did cerclage as a last resort; there's something else before that (I don't remember what). For me, they saw me a few times and kicked me back out to the midwives as being "normal" - apparently I was just meant to walk around with a changing cervix. yay! I think many times, the perinatologists tend to overreact less. The OB I saw (in the emergency room with contractions and pelvic pressure) told me I was probably going to go into labor in the next week. So you might see if you can refer out to a conservative-approach perinatologist who sees LOTS of other high-risk women.

There is also the Fetal Fibronectin Test, which your doctor should know about, to see if labor is actually imminent and if any of this is even pertinent. http://www.lvpa.com/articles/fibronectin.htm. It's like a pap, very noninvasive compared to the fun of internal ultrasound.

Cerclage is a pretty drastic last option, in my very non-medical opinion. It's a good sign that she did not recommend it. Checking you by ultrasound might just be the reassurance you need, it's all my midwives/OBs needed. But the FFN test might negate all the ultrasounds...

 

[pamamidwife]

Quote:

Originally Posted by alegna Unless you had a measurement of your cervix before your pregancy, you can't be sure it's really shortened (from what I've read there is quite a variation in length between women) From my reading there also isn't a lot to show that cerclage improves outcome. I know that some obs swear by them. I wouldn't do it. But I wouldn't be with an ob or have internal check or the u/s either -Angela

 

[hadleys_mom]

I was in a similar situation 19 months ago when my DD was born. I was 23 weeks and my cervix was measuring at 2.1CM. I don't recall having contractions but was put on the Mag. We opted not to have the emergency cerclage and 6 days later my DD was born at 1 pound, 6 ounces. She spent 110 days in the NICU and is very healthy today but blind. I"m currently 29 weeks pregnant with #2 and had the cerclage placed at 14 weeks. I was originally measuring 4CM before the cerclage and have slowly shortened to 2.1CM with a good bit of funneling.

Having gone through the hell of the NICU and not being able to touch my baby for a week or hold her for a month or breast feed her for 2 months, I was happy to be as aggressive as needed with this pregnancy. The research didn't show that the cerclage was always helpful but I wasn't about to pass up something that could give my baby even another week inside. I've also been on bedrest for the last 10 weeks with four of those in the hospital during those critical 21-26 weeks, even though the research showed that bedrest isn't always effective in reducing PTL.

Watching how my cervix has changed over the last 15 weeks, I feel pretty confident the cerclage and bedrest has helped me not have another extremely premature baby.

You are in a tough place, I still don't know if I would have any emergency cerclage but I would without a doubt put myself on strict bedrest.

I wish for you a long and healthy pregnancy,

 

[cuqui]

With DD #2, I had a short cervix (discovered via ultrasound) and funneling, after 17.5 weeks of strict bedrest (10 in hospital), no cerclage, dd was born at 38 weeks full term.

This time around I went to the best of the best, Yale. They did not think I should be classed High Risk nor did they feel a cerclage was going to help. (Good thing because I did not want one, you have to get either a spinal or an epidural for the procedure and I just could not do that).

I am now at 25 weeks and although I have had some strong braxton hicks, there is no change to my cervix.

BTW, it turns out the u/s was wrong, what was thought to be 'funneling' was a cyst. I probably just had a short cervix, all the interventions that followed are probably what caused me to have preterm labor and dilate my cervix to 5cm at 26 weeks (when I was hospitalized).

My advice, lay low, there are a lot of risk associated with the cerclage (besides the drugs) stay positive, eat a diet high in leafy greens (this advice from my naturalpath whom believes you can strenghten your cervix via diet).

Good luck!

 

[~Megan~]

unless you know what you were earlier in pregnancy you can't know if 2cm is normal for you or not. Like the length of fingers, the cervix length is different for every woman.

 

[caligirl]

I just wanted to wish you well.
This exact thing was my worst fear with this pregnancy, although I had no reason for it to be. I have no risk factors and my cervix has always measured fine. It is an irrational fear.

This past November a neighbor and good friend of mine lost her son after he lived a week in the NICU. He was born at 26 weeks and had a really rough time while he was alive. They decided not to persue any more treatment and he passed away in her arms comfortable on morphine.

She had not seen this coming. She carried her first born to term with no complications. She just awoke in the middle of the night bleeding quite heavily. Went via ambulance to the hospital where she discovered she was already 3-4cm dialated and nothing much could be done. Like I said she had no BH's, no abdominal pain, nothing to forwarn her this may be coming. Her cervix at the 20wk level 2 was perfectly fine.

Had she had a warning or a prior U/S showing a shortening cervix she would have done the cerclage.

Like PP say, you have no idea what your cervix was prior to you getting pregnant.

Although I have had a tough time with this pregnancy (dealing with the fear that the same thing was going to happen to me since I found out I was pregnant 2 days before her son passed.) If I was in you situation I wouldn't jump right into a cercalge either. Another friend of mine has a "short cervix" and just did close monitoring checks and U/S's every 2 weeks and she is at 34 weeks already now with no complications.

Maybe see a specialist and see what they say. It is true they seem to be a little more relaxed about these things.

Please keep us posted and best wishes with your pregnancy.

 

[sarahloughmiller]

I had a cerclage put in a few weeks ago. I am having twins and my cervix was short, open a little and very soft at 24 weeks. It was not an easy decision and I had to make it right then not really knowing anything about it. It is impossible to know what your cervix naturally would be or if the cerclage will help at all. I have read some things that say they do nothing and some that say they do help. I am not one to do things that normally, but I was really worried so I did it. My dh's aunt gave birth to twins at 5 months and they did not live so that was probably part of why I did it. I am sorry I was probably not much help, but I do understand how you are feeling. Do keep in mind that you are not really supposed to get one after about 24 weeks because it gets more risky for the baby & there are always risks to doing things like this. Good luck keeping that baby in there.

 

[mama2gracie]

i did not read all the posts, but i just wanted to add that you might pm mommy2be. she lost her first baby at 20 weeks and had a cerclage with her second and he was born full term. she was on bedrest for the last half of her pregnancy, so she had a lot of time to research things online - she knows more about cerclages and the like than anyone i know!

just a thought...

 

[momof1sofar]

Thank you so much for all of your responses! I especially appreciated those who shared their similar experiences. It really helped me get through the last couple of days of bedrest.

I saw a perinatologist today and he did a transvaginal u/s. My cervix measured 3.2cm! The tech before had done a translabial u/s, which apparently is nowhere near as accurate.

: So the doc today confirmed that my pain is from pelvic separation and should have no impact on my pregnancy. Woo-hoo!

Thank you again for all of your support, I appreciate it so much.

Missy

 

[hadleys_mom]

Congratulations! What wonderful news. I'm sure you're relieved.

Enjoy the rest of your pregnancy,

 

[SimplyMama]

What great news! I am so happy for you & your family!

 

[mamahammer]

Just wanted to add my agreement that the only way to truly measure a cervix is via transvaginal ultrasound. Abdominal ultrasound is nowhere near is effective! I had a cerclage placed this time around at 13 weeks, due to preterm labor at 30 weeks with my son, followed by 7 weeks of strict bedrest, an already compromised cervix and a previous cervical tear. Truly, you can't know what your cervix is doing unless you have your own cervical measurements to compare it to. I know that my cervix started out at 3.5 cms this time, and is now (at 30 weeks) 2 cm and very, very soft.

So glad you got good news from this new dr! Here's to a long, healthy pregnancy

 

[Boobiemama]

Glad to hear the good news!