Cervical scar tissue (CST) -- anyone else?

[HelenBusyBee]

Hi everyone, this is my first time on Mumsnet and I hope that someone may have some words of advice for me, or that this even helps someone else :)

I'm in my first pregnancy and am currently 41+2. I am going to be induced on Saturday (when I'll be 41+4) at a local hospital here in Spain, where I live. The reason for this is because I've had minimal (barely noticeable) contractions so far and the baby's quite big.

However, in both of my check-ups this week, the obstetrician has been unable to try a stretch and sweep to get things started because the os (the top of the cervix) has scar tissue that has made it too small to even do this.

This is because I had an op about 15 years ago to remove abnormal cells, which left cervical scar tissue (CST) that made my periods very painful (doctor was surprised it was even possible) and smears difficult (and uncomfortable). Even to conceive, I had to have a procedure to open up the os.

The obstetrician has now suggested that if it doesn't open when I'm induced, I may need a C-section. I want to avoid this and have done some research today that suggests massging the scar tissue during labour helps to break it down and for dilation to happen.

Has anybody else had this problem in the UK or Spain? How was it dealt with? Any tips or suggestions, please? Thanks very much :)

Helen

If it helps anyone else, the only info I've found is from the States:

birthfaith.org/midwives/cervical-scar-tissue
www.birthresourcenetwork.org/blog/98-cervical-scar-tissue--a-big-issue-that-no-one-is-talking-about
www.improvingbirth.org/2012/07/cervical-scar-tissue-a-cause-of-unnecessary-c-sections/
www.mothering.com/community/t/487157/methods-to-break-open-scar-tissue-on-cervix-what-have-you-seen

If anyone has any info in Spanish (I can't find any!), that would be brilliant.

I'm afraid I don't know anything about this but I'm just replying because it will make it more likely someone who does will see it.

I hope everything goes well and you will be snuggling a lovely newborn soon!

Hi glorious, thanks very much for bumping me up and your best wishes

I wish I had known when I was being induced with DC2 that scar tissue could be broken down (I found out afterwards but was in no position at the time to do any research!) as I ended up with a c-section. I'd been stuck at a 4x6cm (an oval!) for several hours despite maximum syntocin. In my case the scar tissue was from a cervical stitch which had torn through with contractions ten days earlier. They just went straight to c-section, and this is at a top London teaching hospital. So you may have to argue your case quite strongly unless your medical team are particularly open/flexible.

Good for you for doing your research and I hope you are able to deliver naturally. I read similar articles to yours afterwards and it makes me wistful for what might have been! The c-section was totally fine of course, but still.

Ahh.. just realised you've probably already delivered by now! Hope it went well - let us know

Hi CrispyFB, thanks for your reply. Sorry for taking ages to reply but I was in hospital when you posted :)

I was finally taken in to be induced at 7am on 31 March (after the hospital postponed it a few times as it looked like things might be about to kick off on their own after several uncomfortable sweep attempts), delivered DS at 2am on 1 April (42 weeks exactly).

Things started off well (too well for the midwives' taste, they were expecting me to feel pain sooner with a lower level of Syntocin). However, I just wasn't dilating (and they didn't use Propess as originally planned, went straight to Syntocin).

I still have no idea what actually happened, but they just about managed to break my waters (dilation was still only about 1cm). I can't remember exactly what order things happened in, but something went pop at some point (I wondered if this might be the scar tissue) and I began dilating.

I'm not sure if I had the epidural before this or after; I think afterwards. (Withstood the contractions until the pain made me throw up and I decided pain relief was needed! They don't do gas and air in Spain, just go straight to epidural.)

Baby was on the large side (9lb 9oz) so I also needed an episiotomy (3 stitches). Have a vague memory of the doctor, as she was putting in the stitches, saying there was a lot of blood and she didn't know where it was coming from, but that seemed to have been resolved by the time I was wheeled onto the ward at about 4am.

Later that day, I was still haemorrhaging. Leaving out all the details of the problems we had to finally receive attention and be taken seriously, the hospital put me on the list for a blood transfusion but tried a coagulation agent first, which luckily worked. They were also going to send me for a scan to find out the cause of the problem, but as the bleeding stopped, they didn't do that either.

So, in short, I have no idea what finally happened to the scar tissue and whether that caused the haemorrhage. If not that, I also have no idea what caused the bleeding. I also seem to have a mild bladder prolapse, which may need further treatment.

All in all, not the experience I was hoping for (are they ever?!). And as a result, feel completely yuck about the less-than-pretty changes 'down there' and am concerned about what's actually happened to my cervix...

So I'm sorry I can't offer any words of wisdom to anyone else with the same problem. I don't know if the process would have been any different in a UK hospital (apart from the pain relief, perhaps?), but I suspect they talk through and look at all the options with you. That really didn't happen here, and perhaps I should have spoken out more, but the medical environment is quite different.

That said, the two midwives who were with me for the most hours were absolutely amazing. I can't thank them enough and I thank my lucky stars that I got them rather than some of the others who were on duty afterwards (and who I had the pleasure of for a short time).

More than a decade later @HelenBusyBee and I’m in the same situation, very scarred and short cervix after lletz procedure 2 years ago and looking at options. Consultant said her main concern is that I won’t open (the concern before was that I’d have an extremely premature baby or late loss, but 30 weeks now so that’s passed!) The only stories I’ve managed to find are pointing me towards C-section. I’d love a vaginal birth and to get to experience what aeons of women have, but I also want to protect my scarred cervix in case (unlikely in my case) I get to be pregnant again. Anyway, you likely won’t see this but thank you for sharing your experience!