Cervical Incompetance or just Labour?

I didn't know where else to put this and Cervical Incompetance is a medical condition of sorts.

When I was at my Ob the other day doing a check up/ grief support consultation thingy I asked him if he thought I had cervial weakness and he said no.
He went on to tell me he felt that contractions started the premature labour and that it was for that reason that my cervic opened early. He then went on to explain about bacteria that lives in the vagina etc and how it changes and that reaction may cause premature labour but there seems to be a very very fine line between the two and whether a person will receive a sture or not.

Now my ob is not pro suture which is kind of good because I agree a foreign body increases risk of infection etc but how will I know for next time?

I cannot prepare myself mentally for my next pregnancy knowing that no one knows for sure whether I have a weak cervix or whether it was just contractions that started my labour.

Being told that I will be closely monitored doesn't help.

I understand the difference between the two but how can premature labour just start? surely there is a trigger for it or something that starts the contractions?

Does anyone have any idea?

Has anyone had a similar problem where there seems to be no definative answer and went on to have a term pregnancy afterwards?

My ob seems to be very well respected and I trust him, I am just not convinced this was a contraction problem.

Nae x

When I was 23 weeks pregnant I went into pre term labour with my DS. Thankfully my Dr stopped the labour and I went on to have him at 42 weeks.

I asked for answers why and she didn't have any other than to slow down and take it a little easier. I had been travelling alot with work and doing 12 hour days.

I was careful with pregnancy number 2 and had Paisley at 41 weeks.

Sorry I don't have any answers for you. Just my experience.

Thanks for posting Kris, wow I cannot believe how long you sat after going into prem labour. What did your dr do?
after my mc I thought I was taking it easier this time, maybe I wasn't. I did do a lot of extra shifts but wasn't doing any lifting or moving around too much etc. I know nothing will turn back the clock but I just don't know what I can do differently for next time :rolleyes:

I had those horrid steriod injections for the baby's lungs and the oral medication to stop the labour (can't remember what this was) My dr monitored me very closely and gave me an U/S in her office every visit.
On her advice I cut back my hours at work to 10-4. Stopped the travelling totally and prayed that he would hang on.
My Dad passed away 2 weeks before my pre term labour so I believe he was looking after us.

Sometimes there is no rhyme or reason why things happen.

NaeNae,

I just recently had my DS at 35w1d. It was a very quick labour and there was no chance of stopping it - I was fully dilated when I got to hosp. I asked my OB and she told me that they still have no idea what causes/triggers labour and that just because it happens with one pg doesn't mean it will happen again.

I hope you get some answers NaeNae :hug:

Hi Nae, definately no experience with this, but....... wondered if having a stitch is an option anyway??????? Then perhaps it rules that out as a problem. The only things I have read about preterm labour, are more related to infection, if it is about contractions and your BH are strong ones maybe it is next to impossible to get to term. Maybe a second/third opinion is in order, anything to hopefully get answers.:hug:

I'm just curious Nae. Did you feel contractions?
My friend lost her son at 25 weeks due to a weak cervix.
She had no contractions. She went to the toilet & felt the bag when she was wiping & knew something was wrong then.
I don't know but it may help to know that.

Hi Nae,
This may not be the answer you are seeking but I thought I'd share.

I had an infection called chorioamnionitis with Lachie and this is the reason my already weak cervix ( like yourself I had an colposcopy and part of my cervix removed due to abnormal cells) dilated. Chorioamionitis is an infection in the membranes/uterus which inflames and irritates the cervix. Hence dilation and labour occurs. At my checkup I was told that it would be my choice to have the suture with my next pg. My Ob was prepared to do it for me and keep me on and off low dose antibiotics to help prevent infection. He gave me the pro's and con's of the suture but I told him I wanted to do everything I could to save my next baby.

We had no time to prepare ourselves for the next pg. Eight weeks after we lost Lachie I woke one morning with the extreme metal taste in my mouth and knew straight away I was pg. My GP referred me to my Ob- even though I was a public patient he took me on as though I was a private and saw me whenever I needed. At 13 1/2 weeks I had my suture put in and was sent home that day after with no bleeding and antibiotics. I was seen every fortnight by my Ob and inbetween with my GP.

At my 20 week scan my cervix was 2.3cm. My DD was born 9 weeks early due to PE and at my last scan it was 1.2cm. My induction was planned and suture taken out. I dilated 2cm instantly.

I believe that without the suture I wouldn't have gotten as far as I did.

I too think that there has to be some sort of trigger for pre term labour.

My advice to you is to seek multiple opinions. You know your body and what you went through with Nikita. If you feel strongly about it not being a contraction problem then write a letter of request to the hossy you had Nikita at and request a copy of your notes from the time you were in. You will need proof of identity to go with it too. Maybe having a few different opinions will give you a more difinitive answer.

Tiff xox

Hi Nae

Firstly let me say how sorry I am for your loss
I lost our dd at 20 weeks at my 19/20 week scan they told me that my cervix was shorter than they would expect to see at this time. All my ob said was that i would probaly deliver early ( little did I know that it meant this early) and if they had known sooner they may have put a stitch in. i went into labour a week later there was nothing they could do.
After all the tests were run all they could tell me was it was mechanical ???? and if i decided to fall pregant again they would put a stitch in.
Well I have fallen pregnant again and decided I didnt want to see the same ob and wanted a second opinion.
My ob now has been wonderful I am on fortnightly visits and he ran many tests and have had a lot of scans looked at my history and the events that led up to and including the delivery decided that it wasnt mechanical I didnt need a stitch I am nearly 32 weeks and all is going well. He still couldnt give me a definate reason for why it happened although he did discover I have fibroids which he said could have contributed to it.
All I am saying it hasnt been easy and I have been scared this whole pregnancy and will continue till I am holding this bundle say in my arms
please ask lots of questions get a second opinion if need be. I believe you need to be informed about everything before you can make the decision to try again.
I am here if you need to talk.

Thinking of you
Smiling D

Hi Nae
I am feeling just like you at the moment, we lost our son on the 22/4 at 23+5weeks, and got our results back the other day. Like you my Ob said I had acute chorioamnionitis and that was the likely cause of my labour, but the report also says Incompetent Cervix, which he doesn't seem keen on believing either. His options for the next pregnancy were, he could put a stitch in at 12ish weeks OR he would get me to have fortnightly scans to check the length of my cervix. He would prefer me to have the scans and swabs for infection as well. I think I am happy with the latter as well, but am going to have a chat with my GP, she is great. It is good to have some answers, but when they aren't definitive it is really hard isn't it? I hope you are doing OK, feel free to PM me if you want.
Helen

Dear NaeNae,
I totally understand how you are feeling. It is a very confusing time. In August 2006 we lost out lil boy at 20 wks 4 days.
I went into early labour and the doctors were unable to stop the contractions.
I received the results back and they could not find a cause for the early labour. Bub was growing fine and no infection and perfect placenta. They said the next time I got pregnant that everything would be fine as this loss was just "very bad luck" as they put it.
So with my next pregnancy I went on thinking that there was nothing wrong and that we would have no trouble. At 21 weeks I went to the hospital for a scan and they asked if I had earlier in the pregnancy had an ultrasound of my cervix, to which I answered no of course as no one told me there was any need of it. So the next week I had the scan and they told me that I had a short cervix and that I just needed to be careful and not lift anything heavy. So the next day I saw my midwife and she took me up to see the Ob that second as she was very concerned, then that afternoon at 22 + 3 days preg I was told to get a cervical suture placed. They told me that they are supposed to put them in at around 12 to 14 weeks and that in my case it may be too late and I might go into premature labour again. I decided that I would get it put in and the next day I had the McDonald stitch, which is the easiest to put in and take out. They gave me an epidural and put it in.

Thankfully everything went well and I just had a bit of pain and bleeding for a week or so. I had to quit work though and wasn't aloud to stand for longer than 30 mins and could not pick up heavy things or even do the vacuuming. In March our lil man was born at 38 weeks, 1 week after the stitch was removed and very healthy. Next time I will be getting the stitch put in at 14 weeks!
If there is anything else you might want to know, Im here.
Thinking of you
Danielle

NaeNae - Please dont blame yourself sweetheart.. After I had my first two m/c's and then feel pg with my DD3 I wanted further testing done as I just didnt want to wait for another loss, one of the tests they did was in case I had an Incompetant cervix, they did the u/s at 14weeks as I was advised that it had to be done at 14weeks not before not after. This was done by u/s. If you are concerned about your next pg hun, ask for them to do this u/s to check for an incompetant cervix. If it turns out that you do they will do something early before it is too late, if it turns out that you dont have an incompetant cervix you have one less thing to worry about. Thankfully I didnt have an incompetant cervix which was a huge relief. Lots of :hug:

Nae,
As you already know I do have IC and have lost babies thru a close monitoring situation..my IC wasnt diagnosed fully until I had a term baby with a stitch in. The monitoring pregnancy I had a scan done at 19 weeks on a Monday and by Wed I has in hospital with my membranes ruptured. It is a hard one to call and although I was put in a situation when I fell pregnant the 3rd time what to do...I'm glad I went the stitch
Good luck
Bec

Thanks so much everyone for sharing your stories and for all of your imput. When I went into the hospital they took swaps but no signs of infection came up so we can at least rule that out. Bub was healthy as was the placenta. My time in both hospitals (warragul and the royal womens) I had scans done of my cervix but a previous scan at 19 weeks didn't go there he was looking more at Niki.

Krisp -I know those steroid injections though I only had two and was due for my third of the day after Niki had been born. They aren't two bad I s'pose ... though I was having daily injections of a blood thinning thing and they stung.

Bjrose - I actually had some pretty good cramping a few days before I went into the hospital. LIke period cramps but at the time I had no idea what was normal or not so was planning on mentioning it at my next Ob appointment which was the following monday. I know now that they were contractions but I could have also dilated a bit .... I guess its a bit of the old what came first the chicken or the egg scenario!

Csab - do you know if you can request the scan? I wonder how they can tell so early whether or not you have an IC?

Thanks so much everyone,

part of me really wants to get a stitch put in next time as a "just in case" but if its not a cervix problem (which I really think it is) then I don't want to weaken something that may not be broken.

Gosh its horrible, I don't want to lose a third child and I am so scared this will happen.

Nae x

Nae - The hospital actually requested the scan for me, as they wanted to rule an IC out. When you become pg again I would ask that that scan be done. As I said it needs to be done early on at 14weeks which was what I was advised by the hospital. They find out early if there is a problem as further on in the pgcy it could be too late. IYKWIM. Please tho make sure you request that scan to rule it out or for it to give you the reason the for needing a stitch. Also let them know your reasons for wanting it done to back yourself up if they ask "Why are you requesting it" tell them as well that you want to make sure that your doing everything you possibly can to carry a baby to term. :hug:

Nae,
I was so touched when I first read your message, as I knew exactly what you are going through. We lost our first baby, a dear little girl Isabella at 24 weeks 5 days. I had no idea I was in labour as I had a painless dilation of the cervix. I had a little bit of pain but just thought I was constipated. Then a membrane started to come down when I was on the toilet. By the time I got to hospital I was already 6cm dilated and although I desparately wanted them to do something to stop the labour they said I would definetly be having the baby that day. Our precious little girl was born on the 3-06-08 and passed away on 5-06-08. It was so hard to comprehend everything that happened and it still is. Everyday I ask myself why and wonder what I did wrong as I had had the perfect pregnancy and you wonder what you did wrong to deserve this. My ob has said that I have a short cervix and next time we have the choice of either having the stitch in at 14wks or just monitoring the length of cervix through scans every 2wks and then put a stitich in if need by. I am so worried and don't know which way to go. It's good to hear other people's experiences to see if they have any helpful info.
AR

:hug: Anike,

I am so sorry for the passing of your little Isabella. Its a very tough time and you always seem to go back and blame yourself for your baby coming so early. I understand how you must be feeling but try not to be angry or upset with yourself :hug:

I have resorted to thinking Niki's purpose for life was to let me know there was a problem with my body (despite what the Ob thinks). She was alittle angel that was sent to me to let me know of this problem so future babies could be taken care of and kept incubating.

I miss my little angel every moment of everyday and my heart aches and longs for her all the time, but she wasn't mine to keep, she was a little messenger and will always be watching over us until the day we are reunited.

I know that the wound is still fresh but if you ever need to chat or want to off load anything please feel free to pm me anytime.

:hug:
Nae x

Danielle,
I have recently read your post dated 24th June and was interested in what you had to say as I lost my baby in June this year. I had been having a perfect pregnancy with no problems and all scans had been fine. On the 3rd June I had a painless labour (had no idea I was even in labour) and my little girl was born at 24 weeks 5 days. We named her Isabella and she was so beautiful, just so so tiny. She lived for 2 days and then could'nt hold on any longer. Her kidneys and lungs weren't working properly. My husband and I are devastated. This was our first baby and we just can't understand what went wrong. My ob said I had painless dilation of the cervix. Apparently my cervix shortened and by the time we knew this it was too late to stop the labour. I was reading your post which indicated that you had a scan to determine whether you had a short cervix. Is this correct? I'm doing lots of research to see what will happen next time. My ob has said we can monitor it, by having scans fortnightly to keep an eye on the length of the cervix or he has said we can put a stitch in at 14 weeks. It is all very confusing. Can you offer any suggestions?
Thanks
Anike

Hey Anike,

I know you posted for Danielle but I wanted to share with you what has been told to me.

It will not be what you want to hear but sometimes our bodies just do these things without any rhyme or reason. If you have read the same type of things that I read when I was trying to work out what happened if its a weak cervix with close monitoring they can detect changes and put a stitch in if necessary. If it was a labour problem then there is little if anything they can do.

For people like us, it will just be a matter of close monitoring (request weekly monitoring if that will make you feel better) and hoping for the best, a full term pregnancy.

We may be at different stages in our grief process, but for me letting go of "why did my body do this" has been the most empowering part. Even though it sucks arse big time, sometimes things just happen and its out of our control.

Hon I am sending you big loving and understanding hugs, I hope you can let go of the "why" soon.

If you ever want to chat pm me

Nae x x x

Nae,

Thanks for you replies (both times - don't think I got around to saying thanks after your first reply).

My ob said it was painless dilation of the cervix. He said I must have a short cervix and can either have a stitch at 14wks next time or monitor and then have a stitch if it's shortening. Not sure which way we'll go. I know there can be complications with the stitch but I also know that cervix could possibly shorten the day after I've had a scan and then I wouldn't be having another scan for another fortnight.

I know I need to get past the 'why' stage, it's just hard because you think none of this should of happened. Have you tried again for a baby?

Thanks for keeping in touch.
Anike

Hi Anike,

Yeah I know hon. Its really just a matter of waiting til next time, my cervix had shortened too when I was admitted and we still do not know why I had contraction or why the membranes were buldging.

Its just something they have to watch very closely for next time.

Dh and I aren't trying at the moment only because I had a caesar and have been advised to wait 6-9 months. We are going to start trying in the New year seems like a good time - New Year = New Outcome (hopefully)

Besides, everything is still pretty raw, we're still trying to organise plaques and Niki has only been gone for 2 months we need to make sure our relationship gets back on track so that we can provide a loving and warm environment for our next child.

Part of me so wants a baby in my arms but its not the right thing to try to fill the void. There will always be that void and I need to become 100% comfortable with that before I even consider another child.

But that just me.

Take care of yourself and leave the self blame and the Why's behind you ... they do try to sneak back in but we have the power over our minds not the other way around.

To help me, when I have a "bad day" and i hate myself for having a dumb body for giving birth too early, I get out into the garden or do renovations just something to put me in a different headspace and something to get me going physically and after 30 min or so I find I am not thinking of anything except for the task at hand.

You will find your own outlet and your own way of controlling the brain tricks.

Much Love to you I do feel your pain and I can say that looking for the joy in each day really truely does help.

For me ... today I discovered the first flower in Nikita's garden had bloomed there is life and happiness even surrounding death and saddness.

Anytime you need a chat even just to let off some angst pm me I am more than happy to listen - from one mum to another x x x

Luv Nae x