Incomplete cervix

[Loula]

OK so this is a concern that i have due to so many surgeries. My OB however does not think it will be an issue.

I have had 10 D&C in the last 7 years and have bleed with this pg even up to today.

I guess i would like to know if there are any signs or symptoms? i feel heavier 'down there' and feel like i need to pass wind all the time but nothing comes out.

[crumpet]

im not sure if this helps but i have incompetant cervix which basically means i cant carry a bub full term, or even long enough for it to survive.....

i had no symptoms except that on US they picked up it was shortening early....

at 21 weeks it had shortened to much and waters then buldged out of my cervix and i was 3 cm dialted.....

ive googled incomplete cervix and nothing came up except references to incompetant cervix.....
speak to ur OB and find out exactly what the go is coz if ur anything like me u will need a stitch put in to get u close to term.

also try and find out the lenght of ur cervix......
when i had my 12w scan they said it was 2.5cm which is short, not generally short enough for the stitch but short enough that it needs to be monitored!

[Loula]

Thank you crumpet,

The sono ady said at my 12 week scan that it looked within range but some Drs will check again around 15 weeks.

My OB is understanding of my anixety however says that it is rare. However with my history i feel i need to be concerned.

[Mildez]

Loula the greatest risk of incompetant or incomplete cervix is having had a history of prior (especially multiple) late miscarriages or second trimester labour/birth. Multiple D&Cs could increase your risk but not by much and it also increases the risk of scar tissue which generally will keeps the cervix shut not make it open under pressure. The other thing that can increase your risk is having multiple LLETZ procedures (which is where they take a small bit of cervix to get rid of cancerous or pre-cancerous cells usually caused by HPV) even still the risk of this happening (unless it has before is very low)
As for knowing it might happen usually unless diagnosed on ultrasound that the cervix is shortening and or funnelling then there is no warning it is going to happen until labour starts or membranes rupture. At this stage I would agree with your Obby that the risk is low of this happening. An ultrasound at 15weeks like you said your having and then the usual morphology scan at 18-20weeks should show the cervix been shorter then what is considered normal if this was going to be a problem. Also you can have a shortened cervix at one of these scans and go onto deliver at term so its not always accurate at diagnosing who is going to go into labour and who isn't.
Have they been able to diagnose why you are bleeding or where its coming from?

[Loula]

Thanks Emmy. I have a subchronic heamorrage which they believe is causing the bleeding (worse on activity) i am not as concerned about this now that bleeding is spootting.

I guess i dont want to have to wait till i loose my baby due to a weak cervix to get it dx IYKWIM? It has been a long 7 years to get here.

Your post has given me some reasurrance

Thank you

[crumpet]

I guess i dont want to have to wait till i loose my baby due to a weak cervix to get it dx IYKWIM? It has been a long 7 years to get here.

unfortunatly for me it was to late and i did loose my bub, which is why id be making sure u speak to ur OB again to make sure ur measurments are looking ok, but even then it can look fine one week and ***** can hit the fan then next, which is what happened to us.....

at 21 weeks my cervix looked ok, it had shortened but my OB didnt feel any need for concern which was fine and then before we knew it i was in hopsital on bed rest trying to get another few weeks.....

as mentioned above having mutliple D&C's can weaken the cervix as can an laser proceedures and terminations, but also there is a very small percentage of ppl who are born with a congenitally weak cervix, unfortunatly im one of these ppl and we had to learn the hard way....

my OB said my cervix is in the state he would expect to see of a patient who has had a lot of treatments or D&C's, but ive had none, well now ive had to have one D&C after my little man was delivered.....

for ur own sake id be requesting more scans to monitor things and making sure ur OB knows how conderned u are!

[Visitor9]

A scan at 13-14 weeks will show if you have a shortened cervix, my radiographer gave the all clear to my obst which now looking back had a length of 1.6 cm That is short for that amount of weeks, I lost 2 babys in the second trimester with results like the one mentioned previously STILL to have obst say....ahhh its too hard to say if you have i/c.
Obst that dont do stitches all that much rather not do them and risk infection. Find someone who deals with prem labour, multiple births and they will give you a honest opinion. Good luck I had alot of IVF and D&C's , hysteroscopys and laps which I am sure is why I was given a second hand cervix.

ETA: Anything under 2cm is short ....with my stich in my cervix stayed at about 2.5 - 2.7, anything under 2 I was hospitalised on bedrest

[Mildez]

Loula I am sorry to hear its taken so long to get to this point of pregnancy and I can understand your anxiety and fears for this baby. I have absolutely everything crossed for you for a smooth sailing second and third trimester. Hope the spotting ceases (for piece of mind) and the weeks fly by. With your history and difficulty concieving I would imagine your Ob is more then obliging (or should be) to monitor you more closely then neccessary just to keep an eye on things and for some reassurance for you. If in the event your cevix appeared to be shortening they could offer you a cervical cerclage/suture provided it wasn't too short or sometimes nifedipine and bed rest. Obviously its not something that would or should be offered due to the risks unless the benefits outway the risk IYKWIM!

crumpet and Minky I am so sorry to hear that your beautiful bub's were born to soon. I wish things were done differently to change the outcome. Hugest

As a midwife I have only seen one lady have a suture put in (that didn't have a past history of second trimester labour/birth) based on an ultrasound which showed funnelling and shortening of the cervix. The rest have unfortunately all had past prem births. Fortunately our Obstetrician is very good at the procedure and to date have all been successful in prolonging the pregnancy into the third trimester. If like you Crumpet the cervix is already dilated too far or the membranes coming down to far he can't do it.

Loula the subchronic haemorrage seems to be one of the more common reason for bleeding/spotting in pregnancy.

[crumpet]

I lost 2 babys in the second trimester with results like the one mentioned previously STILL to have obst say....ahhh its too hard to say if you have i/c.
Obst that dont do stitches all that much rather not do them and risk infection. Find someone who deals with prem labour, multiple births and they will give you a honest opinion.

wow minky big ((HUGS)) to u thats terrible ur OB treated u like that!!

i definatly agree get a second opinion!!!

crumpet and Minky I am so sorry to hear that your beautiful bub's were born to soon. I wish things were done differently to change the outcome. Hugest

. If like you Crumpet the cervix is already dilated too far or the membranes coming down to far he can't do it.

Loula the subchronic haemorrage seems to be one of the more common reason for bleeding/spotting in pregnancy.

thanks emmy.....

unfortunatly for us it was to late, but make sure u get it looked at just to be on the safe side id hate for anyone to go throught what im going through.....

[Loula]

Ladies i am so sorry that you have been through this, and wish you all the very best for future pg.

My ob is a high risk ob and he is happy for me to have another scan for this reason at 16 weeks. But is that too early? would the 20 week scan be enough?

Ive been getting pains when i sit or walk in my v! maybe i should get checked for another UTI?

[Mildez]

Loula I'd have the scan at 16weeks and then the usual morphology scan. They will be able to compare the two scans (although not always accurate as the cervix does change lengths especially as pregnancy porgresses) if in the event the cervix was shortening at your 16week scan chances are its still long enough that if a suture was to be placed the risk wouldn't be to great to put the suture in. In my experience as a midwife the suture usually goes in around the 15-16weeks (can be earlier or much later) with women who have a history of IC. The longer it was left the higher the chance that the cervix is already dilating or to short making the risk much greater.
In saying this I am sure it wouldn't be neccessary but maybe it will give you some piece of mind and another chance to see your bub. A scan is not invasive either.

[Loula]

Thank you again x

[Michelle71]

Get the scan Lou. It is mainly for cervical length check and then do the usual morphology one. It will reassure you and hopefully give the OB an early hint if there are and cervix issues

[crumpet]

Ladies i am so sorry that you have been through this, and wish you all the very best for future pg.

My ob is a high risk ob and he is happy for me to have another scan for this reason at 16 weeks. But is that too early? would the 20 week scan be enough?

Ive been getting pains when i sit or walk in my v! maybe i should get checked for another UTI?

loula id be getting the scan done as well hon.....

when my cervix showed up short at 12weeks i was put on full bed rest and then had a follow up scan at 14weeks, byt then it had lengthend slightly so i could come off bed rest, then i had another scan at 18weeks at my request and it was still ok, then went at 20 weeks for my morph scan and my cervix had shrunk again, by 21 weeks i was in hopsital in full bed rest with the bed elevated, it all happened before we could do anything about it, my waters then buldged out of the cervix and i got a infection and my bub arrived at 22 weeks.

take every scan u can get if ur worried, it will help keep ur mind at ease!!!

good luck keep us updated!!