Cervix Question

Just wondering if anyone can tell me if it is normal for the cervix to start shortening once you hit 20 week. At my last US it had shortened 1cm from 4.8 to 3.5 which is still ok but I have been 4.5 since 15 weeks then all of a sudden it shortened a whole centimeter.

My Specialist said to not be concerned unless it gets to 2.5 or lower then we'll start talking about stitches etc. He also said he has seen women who are dilating at 28 weeks, I just hope to make it that far.

I am really not very comfortable with the thought of this after what happened last time.

Can someone please tell be if the cervix normally starts to shorten etc around this time? does it fluctuate at all? I am starting to be worried thats all.

Thanks

Nae x

Not sure about the whole shortening thing but I think after you have had a baby vaginally, it is normal for it to be a couple of cm dialated for the last part of pg. It may be because you have already had a baby that it has shortened.

If your specialist isn't concerned, that is a very good sign.

Sorry I couldn't be of more help.

Hi Nae
The cervix does naturally shorten as a preg approaches FT & 3.5cm is still a great measurement so try not to worry too much if you can! You are having pretty regular scans arent you so thats excellent. 2.5cm was the benchmark I was aware of in my case too although I had the stitch placed at 14 wks.
My cervix halved in length between 19 & 21 wks & so I had hospital bedrest for 3 weeks which brought my length back up & continued rest kept it stable & I made it to 38 wks when the stitch came out. I have heard that 18-24wks is the highest risk period for IC as this is when the baby is starting to put pressure on the cervix. It certainly seemed to be the case for me. Although I know they dont think you have IC the same pressure theory would apply I guess & this might help explain the fluctuation.
Anyway, sorry if none of that helps - hope it makes some sense :doh:
Good luck!!

TG summed up my thoughts. I am told mine is always shorter and 1cm dilation at any point in time during my pregnancy is normal for me as I am multiparous. Although I can understand how concerning this is for you. I would be scared too. It could well be that your cervix is experienced now - but talk to your specialist about your concerns and make sure its monitored to your liking. Never feel like any concern is too much to ask. You and your baby's health is the job they are being paid to care for.

Thanks girls,

I know 3.5 is still a good length. I went back over the DVD of my scan and he just clicked the two sides rather than draw a line along the cervix which I am sure would make a difference to the measurement as well. It will be interesting to see what happens at this next scan on Thurs.

TG - thanks for your support hun (as always) :hug:

ALM - makes perfect sense to me, the Specialist did push on my uterus to see it that makes a difference but there was no change. I don't have another appointment with my Ob until after 24 weeks so depending on what happens next scan I will ring him and see about an earlier appointment.

Inertia - if you don't mind me asking - whats multiparous? Does having an experienced cervix make a difference?

I guess the one thing I am holding on to is that fact that I am STILL 5cm off where I was at this point in my previous pregnancy (2cm dilated when admitted). I think I am just being paranoid :lol:

Thanks again all, would value anyone elses input if they know something about this as well

Ta

Nae x x x

Hey Nae,

Multiparous is having birthed more than one child. I am actually considered grand multi as it is also over 3 births.

Experienced bodies and cervices prepare easier for the next labour and delivery than last time. However as your specialist is worried about an incompetant cervix (I hate that term so much), then I would make sure he keeps an eye on it because of the same deal.

Try and stay positive, especially seeing as a cervical stitch has a very high success rate against pre-term labour.

Hi NaeNae,

My cervix was measured to be 0.8cm (8mm) at 19 weeks. Since then I have had a 15mm then 8mm and the last one was 20mm (2cm) - I'm now almost 23 weeks. From my experience there is some variation in the measurement depending on the sonographer and whether or not they are pushing in on the cervix or not. One sonographer demonstrated how she could get different measurements by moviong the probe around. So I think while you are still within the safe threshold (>2.5cm) you can rest easy. It is good that they are keeping an eye on it though.

From my understanding, in a 'normal' pregnancy the cervix starts to shorten sometime after 30 weeks at an average rate of between 0.5-1cm per week. However, everyone is so different and what may mean early labour for one is completely normal for another.

I didn't get a stitch because I am already too short and the risk of other complications is too great. My ob started me on progesterone pessaries last week befor I got the 20mm measurement, so that might be something to talk to your ob about if it does start to shorten below 2.5cm. Whether they contributed to the large jump in my cervix length or not is anyones guess. Maybe it is just the bed rest ????? According to my ob, they don't really know. But the randomised control trials for the progesterone treatment show a significant decrease in delivering before 34 weeks in women with shortened cervix. It's my best shot.

I hope that helps to give you some peace of mind.

Nae,
With my stitch and prev pregnancys that ended with abrupt cervix shortening my cervix with a stitch in was 3.5cm at 20 weeks. Prev scans on the pre term labour and rupture of membranes were 1.5 at 13 weeks and 1.8 at 18 weeks:rolleyes: they thought that was normal!

From the point of 16 weeks the baby starts to put weight on the cervix due to its increasing size so as time goes on the cervical length should maintain and may shorten according to the week but not shorten significantly.

Your obst is right my gauge was 2.0cm and then I would of been hospitalised thankfully it never shortened past 2.9cm.

As long as they are monitoring you and they know your previous pregnancy history they should be aware of the importance of the scans. How often do you have us's? Aftern 30 weeks they became a little less determined to have me have them 2 weekly as it was a milestone I never that thought I would reach

Bec

Bec,
I have my scans weekly until 24 weeks, that when they are stopping, though depending on how my next few go I may request to be scanned longer say until 30 weeks.

Susan,
I see the same sonographer every week and he has pushed and prodded but there has been no change in the cervix when there has been extra pressure iykwim. Are you using pesseries? are you on bed rest?

Not long for me to wait until my next scan, I have decided to try to not stress until I get to my next scan, I just don't want to get too late if there is a problem and they cannot stop things progressing.

Still I have a great Ob and the specialist has been a specialist for a very very long time so I trust them both. I have my Obs home and mobile number if something is worrying me and I cannot get any help with the Hossy staff.

I am just so anxious, all I want is a healthy baby to bring home at least a 34 weeker!!

Nae x

Hi Nae,

Maybe my cervix changes with pressure because it is so short and when at 8mm I also have funnelling. So When the sonographer presses in a certain way it actually appears to lengthen the cervix, but not by much, maybe about 5mm. I'll take every mm I can get at this point.

Yes, I have been on bed rest for 3 weeks now, since it was discovered (and going mad). I started the pessaries last week, a couple of days before my last scan when I measured 20mm. My ob said he'd like me to stay on them till around 28 weeks and see where to go from there. I am also having weekly scans till 24 weeks, then dropping back to forntightly or monthly.

Bring on that 28 week window!

Best Wishes
Susan

I know what 3 weeks in bed is like Susan :hug: just remember its for a good cause!! Sounds like your in great hands and your Ob is doing everything possible to help you hold on. Will be keeping everything crossed for you, its never a pleasent thing to go through.

Nae x

Thanks Nae, and good luck with your scan today.

Susan

arrhhhh,

My scan did not go as well as I had hoped. I have shortened further to 2.75 which resulted in me breaking down with the specialist into a blubbering mess. I then rang and demanded to see my Ob, which was fortunate that I did because he is going away for 2 weeks.
He has assured me that I am still within what is considered "normal" but for my sanity he introduced me to another Ob who I can see while he is away. He also organised for me to have another scan on Monday to see if there have been any further changes.

If I get down to 2cm they will put a stitch in asap and who knows what will happen from there as there are no guarntees.

It was explained to me that this could very well be the normal thing for my body and that we may be putiing a stitch in unneccessarily, and that some women shorten and infact dilate but carry to term.

The good thing is that when external pressure is applied to the uterus there are no changes, I have had no bleeding and no contractions (not even felt BH contractions). I am not sure what it will mean for work either whether or not i will need to stop etc as it is not proven that bed rest helps (even though I think it does).

So anyway the waiting game begins, I have a game plan which I am happy with and though my Ob and the Specialist are not concerned about me in anyway shape or form I am pleased to know they both have my back and are doing all they can. They have also assured me that the shortening does not necessarily mean I will go into labour early either - which is a good thing.

I am still upset about it obviously, but I am STILL further than I was last time .

Nae x x

:hug: Nae, I'm sorry the scan wasn't so good. I'm glad you have someone keeping an eye on you though while your OB is away. Look after yourself and rest up as much as possible.

Nae,
I was going to be prescribed niphethene (sp) will get my preg notes out when I find them as well as bed rest. Take it easy hun off your feet as much as possible;), Guee I was on bedrest from 12 weeks..ahhhh it was bliss of course I was at home and could sneak the walk around when no one was home:redface:
Bec

Hi Nae
Just wanted to wish you luck for your next scan. Your length is still good and sounds like your doctors are pretty on top of it all so like you said, all you can do now is play the waiting game. I don't know why doctors can't agree on the whole bedrest thing. My cervix grew after bedrest so it obviously has some benefit!
Anyway, good luck and keep us posted.
Jo

Hi Nae good luck for that scan on Monday, I say rest, rest, rest as much as you can.. I am glad that your docs are right on the ball but still trust your gut instinct and if you feel you need that stitch have it... thinking of yu and praying everything keeps going as it should.:pray:pam.