Ectropion and Nabothian Cysts in pregnancy...

[spotty26]

I am 24 weeks pregnant and last Monday had some bleeding (after intercourse the previous night - Feels naughty admitting that!). We went to the delivery suite and I had an internal exam by a Doctor and midwife.

Whilst the speculum was still in place the Doctor started telling me what she could see, cysts, mucus, and telling me I urgently need a smear post baby.

I surprised myself by asking the doctor to kindly finish the procedure before explaining what the problem was.

She said I had cervical erosion /ectropian and a large nabothian cyst she started saying I needed a referral to Colposcopy asap. In the meantime the Midwife was making stern, I am worried about you faces, and also seemed a bit cross with the Doctor's bedside manner. The Doctor left the room for a bit then came back and said actually she had spoken to the senior registrar and I just needed to come back every time I have a bleed and to take it easy.

When the doctor left the Midwife said she was concerned about something she had seen, thick mucus (TMI sorry) and a "hole in my cervix". I thought she thought I was dilating. Half an hour later, having done other obs the midwife said, she had read I had had two children and was now less worried about the " hole" as the cervix never closes up totally post babies. She sent me packing to rest up, no sex, come back if I bled again and cervical smear 6/52 after the baby.

The next day my own midwife was visiting me I explained what had happened. She laughed it off a bit and said don't worry cervical erosion is normal etc etc I just have a "battered old cervix and pregnancy hormones".

Yesterday (and saturday) I had some blood smeared mucus, told my midwife, who said I must go back to the hospital. A consultant saw me, did an internal scan to measure my cervix which was 33mm. Weirdly he asked me what I thought was causing this (as a property lawyer I am not particularly qualified in diagnosing cervical problems and was rather hoping he would enlighten me!).

Anyway, was sent packing again and told I do not need to come back each time this happens now only if significant blood, watery discharge or pain.

Anyone have anything to give me comfort on this please. I have obviously googled it all and it suggests that nabothian cysts are benign etc. I am slightly panicked now. I wonder should I try to use my work healthcare policy and get a second opinion?

Thanks in advance

I really don't think you should be getting worried, from what you've said, the midwife who visited you at home summed it up neatly.

Thanks for replying. I really like and trust my midwife but she did not know what a Nabothian Cyst was, which slightly undermined my confidence in her. I will stop fretting and get back to the Baby name forum...

Ectropion and nabothian cysts are just descriptive terms, and normal especially in pregnancy. As is thick mucus. When was your last smear? Sounds like you may have had quite a junior doc examine you initially who opened her mouth before engaging her brain....! If you're still concerned you could always go and chat it over with your GP.
HTH, and congratulations on your pregnancy

Yes, the doctor was a youngish female. Polish and a bit stern and without the nurturing bedside manner the midwives normally have.

I cannot remember exactly when my last smear was, I think after my youngest was born but I could be imagining that, at most 4 years ago and at least 2.5 years ago. I will hot foot it down for a smear after DC3 arrives.

Well don't worry about it now. Did the consultant do an internal examination with a speculum?

Feel reassured if they did, as they would have said if anything looked less than normal, and do get your smear done once your little one arrives.
Good luck!

No just the internal scanning machine.

PS the doctor who did the initial speculum was a registrar, she put on the notes "no sinister features". It was the midwife's facial expressions that really got me going but then she had confided in me that she had just had a miscarriage and had only returned to work recently. I think she was being ultra careful. It was her I saw yesterday in triage and she pulled some strings to get the consultant to come along and do the cervical scan so I think she was genuinely concerned it was early labour. She said she had been hoping she would not see me again and had been talking to the other midwives to see if I had been back on her days off. She was a really kind lady.

Thanks Poppycat.

Am not sure what to advise now, as from your description, the junior doc described a completely normal cervix. It's just her comment about you needing colposcopy that is weird. If she was concerned she should have had a more senior doc examine you. This is nothing to do with your pregnancy by the way.

Sorry have cross posts, hang on a sec..

Nabothian cysts are completely normal and not in themselves indicators of anything suspicious. Ectropions and erosions are quite common in pregnancy and can cause post-coital bleeding. Post-coital bleeding should be investigated, but don't rush to have a smear within 3 months of the birth unless advised by your GP/consultant as it may well be an abnormal or inadequate result due to the cervix being traumatised by hormones and delivery.

It really sounds as if the small amount of blood stained mucus you describe is coming from the ectropion and DTD which is completely normal and nothing to worry about, and may have been what the consultant was referring to. (DTD!)
Obviously you should go back and get checked if you have any more bleeding, pain, etc. It certainly doesn't sound as if there is anything to be concerned over regarding your pregnancy.
The bit I am a little concerned over is that you're not sure when your last smear was and that the doc mentioned colposcopy twice. However if she was concerned she really should have had another doc take a look. Plus her description of your cervix was completely normal and you said she wrote no sinister features in your notes.

Thanks Sidge

Poppycat Just looked again at the part of my notes written up after speaking to the senior registrar "no colposcopy required at present" but she did put "needs speculum every time PV bleeding and cervix measurement" but the Consultant did not do another internal speculum exam.

Anyway, I suppose I cannot do much while pregnant and just have to put it to the back of my mind until I can go and get a smear.

Thanks again for your time.

No worries. Good luck
Will look out for you on baby name boards!

And really don't worry re colposcopy. Reading notes sounds as if junior doc just being a bit OTT