Cervix length

[Alexandra6]

Hi, I just had another cervix scan at 14 weeks and it is measuring 24mm now, no funnelling. I'm seeing two consultants and one recommends a stitch but it's up to me, the other I'm seeing again tomorrow but his approach seems to be wait and see. It also says the 'intravaginal cervix is somewhat short anteriorly, less than 1.5cm'. Does anyone know what to make of these results? Has anyone else had scans at this stage and what were your results? I know over 3cm is what they like to see and am feeling anxious about it.

Hi Alexandra,

Sorry to hear this is still ongoing. My cervix at 14 weeks measured about the same - 2.3/2.4. I feel quite lucky in retrospect that there was no discussion about it really, they just told me I needed the stitch and booked me in for it, so I didn't have to think about it. They told me they recommended the stitch for under 2.5cm, didn't mention 3cm at all, so you're very close to the cut-off, which is prob why they're not jumping straight in.

Since the stitch they've been taking 2 measurements - I think for me it's above and below the stitch, but I also get the impression it relates to the part of the cervix which goes into the uterus and the part which pokes down (if that makes sense). Not sure I can interpret your results, though, sorry!

Is there a midwife or someone you can talk this through with at the hospital who might be able to advise you?

Piz

Hi Alexandra (hello Piz!)

Am also sorry to hear this is still ongoing and at 2/2.3 i was also just advised to go for it.

as it happens, when they actually saw my cervix during surgery it was much less in places so i'm even happier that i had the stitch.

is there a reason why you're particularly reticent about having it done? i do undertand that it is surgery and obviously hugely daunting, but any risks are miniscule and the benefits are huge.

the surgery itself is actually very straighforward, i feel completely fine and forget i have the stitch! (apart from when abstaining from sex and exercise!)

K

Hi piz still ongoing and so hard to know what to do!! I am now wondering if not getting the stitch is the worst decision I've ever made Seeing the other consultant tomorrow and he will measure too and give his view again, he's the one who says I should wait and see and he's meant to be really good - but then how do you know?!

Hi kelly it's the other consultant at a different hospital (meant to be one of the best) saying I shouldn't just get a precautionary stitch that's making me hesitate. He's seeing me again tomorrow. I did read online about infection risks and I'm worried about aggravating things with an unnecessary stitch but if the medical opinion was a unanimous "get a stitch", I would go for it. I don't know who to listen to, will quiz this other guy tomorrow. Today I had a word with the woman in the room with us (think she's a midwife) and she said she thinks I should wait and also listen to my gut. Am just sitting in the hospital coffee shop crying as I'm feeling so confused, I don't know what to do! The first consultant also wasn't pushing for a stitch today and said if I leave it, my chances are quite good and he'll measure me again at 17 weeks but I'm not sure if he's just saying that now due to pressure from the other consultant who he knows I've seen. I'm googling and it seems that measurement is short enough to act and what if I leave it and it's my fault I lose my baby?!

Hi Kelly, fellow member of the Short Cervix Club (we should start our own thread on here for ongoing questions!)

Alexandra, it sucks you've not been given one definitive answer to just go for, I think the differing opinions is making it really hard for you. I agree with Kelly, now my stitch is in I really don't notice it at all and I'm even being fairly active, taking the dog out twice a day, doing yoga etc. The procedure to have it in is horrible but the benefits make it worthwhile. Maybe you can just be really honest with the consultant tomorrow and tell him what a hard time you're having and see if he can give you some well-rounded info?

Thinking of you!

Piz

I am loving the Short Cervix Club idea!

Alexandra, the risk of infection really is very small and I was given antibiotics which I took just in case, I never had any problems. is the consultant giving this as a major reason why not to bother?

If you are on the low side plus 1.5 cms in some places, I think this qualifies you for the stitch for sure. before i was scanned to make sure of length, they thought 2.5, and even before the scan they all said, inclduing the sonographer at the Fetal Medical Centre, that 2.5 meant a stitch was best. it was never in doubt.

Agreed it is a shame your advice is so confusing. In the States they tell you bed rest after a stitch, in the UK they say no need at all! So there is conflicting advice every step of the way.

i also remember the tears when i was told i had to have the stitch, i really do. 4 days later i'd had it done and it was over with. 8 weeks later and am completely fine.

best of luck and thinking of you (and you piz!)

Thanks, I've just been reading this healthymother.wordpress.com/2008/07/16/what-is-cervical-shortening/

• I guess it explains why at my length they might wait and see before stitching but am not sure why there seem to be differing medical opinions on this.

I've also looked back at another recent thread on here and read this post about the FMC so really confused why this advice is different (this does seem to back up waiting before stitching at 2.5cm although mine is slightly under). Do you pay to go there Kelly? Am wondering if it's worth me getting a third opinion?

"Nobody seemed (or seems now) especially concerned about my cervical length. Prof Nicolaides at the FMC did mine at the 13 wk nuchal (at my request) and said 2.8cm was within normal limits. I did mention stitches and he told me they wouldn't even consider it (in his clinic at Kings I am presuming?) until under 2.5 with evidence of funnelling and serial shortening"

Hi! Was me who was just quoted re: my experience at FMC. This was at 13 weeks (requested when having nuchal) and measured by the prof. He told me that 2.8 was 'within normal limits'. 2.5 seems to be the magic number, so I'm guessing anything under, even 'just under' might prompt a stitch. Think this fits with Kelly's account?
Remember too that any judgement will take individual circumstances into account. So for me personally the fact I have had 3 children AFTER 2 very large LLETZs was important for the prof. in reaching his judgement. I think if I had had a 2nd tri loss after measuring 2.8 in the past he would have suggested a stitch. I am lucky that my cervix at the last scan (18 weeks) measured a very greedy 4cm so they can and do 'grow'.
Personally in your situation I would be thinking of the stitch as it is relatively risk free at this stage in pregnancy. If I was 20 plus weeks I might hold on a bit as the surgery is riskier/less successful then. I think you will be in a better position to make a judgement after the consultant appointment tomorrow - try to be totally honest and get everything out, including the anxiety you are feeing. Regardless of any medical evidence/anything people post in here, if you are anxious now you are going to be a nervous wreck by 20 weeks unless you reach a decision and are as happy as you can be with it. Please let us know how you get on xxx

I live overseas and there's a Fetal Medical Centre here, yes I paid (through the nose) but all is private healthcare here.

i do think that Diege makes some very good points, if you are this anxious about it now, this is only going to get worse.

and for me, any worry of the stitch would be way less than worrying for the rest of my pregnancy about my cervix not holding out.

best of luck, will be thinking of you.

Thanks so much, it's been really difficult. I saw the second consultant again today and was measured by two people at his hospital. They said my cervix actually looks ok to them, their measurements were around 3 and just above which makes it longer?! I really get the feeling scanning the cervix isn't an exact science especially when we're talking about a matter of mm. Their advice was to not stitch as there is the potential of causing problems to the cervix when in their opinion, it's doing ok on its own. I'm well aware that these specialists can't predict how my cervix will perform but I think on balance, it's probably best to wait until my next scan in three weeks and see how it's doing then (am praying it lengthens like Dieg's did). The whole thing is so confusing and feels risky, putting so much faith in what is essentially guess work and I get the feeling they're leaving the decision with me precisely because it's hard for them to predict.

My gut feeling is to leave the cervix alone for now and keep being scanned but I will never forgive myself if it fails! Some sensitive girl in my office made a comment about my baby coming out funny due to all the scans but it sounds like regular scanning isn't rare so hopefully no problems there! I actually wish more people had cervix scans so I could compare experiences!

Hello Alexandra, I think we have crossed paths on a short cervix thread before! I am sorry this is still ongoing for you and you are getting such conflicting advice.

I don't think my experience will be helpful to you really as circumstances are so different. My first child was born at 24 weeks due to suspected IC. So, this time round when they scanned at 14 weeks and found I had a cervix of 2.5 they advised me to have a pre-emptitive stitch in. So if you needed any information or experiences about the procedure itself or pregnancy afterwards then I'm your girl! Am now 30 weeks.

Be kind to yourself. This is a tough decision that they have not really made easy for you, but both sides have pros and cons and you know yourself best.

I'm also sorry about your awful colleague. And quite angry on your behalf actually. There is no evidence whatsoever to show that scanning does any harm at all. And I have been scanned roughly every 2-3 weeks since 8 weeks pregnant!

Thinking about you

I can't believe your stupid colleague. Helpful, not.
My first was born at 25 weeks with suspected IC so I am having regular checks of cervix with this pregnancy. Am 25, 5. My ob told me that 2.4 is the cut off but that they scan regularly to see if that's just the way the cervix is or whether there is serial shortening. I get checked every two weeks, now moved to weekly. My ob told me that the intraviginal section is largely disregarded and it's the other bit of cervix and funneling that matters. So you are okay for the moment it seems? I am based in Belgium now but my OB here is english and he told me that the UK stance is to do no harm, which is basically not to do a preemptive stitch. So that might cause some of the confliction in opinion. I'm so sorry you have this worry. Wouldn't it be lovely to have a trouble free oblivious pregnancy!

rainbow I'm really glad your pregnancy is going well yes they def take previous IC loss into account as a big indication you need a stitch so am glad yours is working well. I said to my consultant that I can't afford a late loss before we're cautious but at the same time I do understand they don't know how the cervix will act as I've never been pregnant before.

expat that's interesting, how have your measurements been as you've gone along? So true about the worry, I remember a little gap between my 12 week scan and my cervix scan where I was really enjoying the pregnancy and am jealous some people get that feeling for the whole second trimester! Thanks for replying as it's good to hear from people who didn't have the stitch and it's going ok.

I am hoping my cervix is longer at the next scan as that seems to be possible from Diege's experience.

Hi Alexandra. I have some experience in this area as I was under the preterm clinic due to a past cervical cone biopsy. I had a measurement of 2.9cm at 16 weeks, which then "grew" to 4.0cm at 18 weeks. It was back to 3.0cm at 22 weeks. So they can "grow" , as well as reduce. I had something called a fetal fibronectin test along with my scans. Is this something you could have? It's a swab from around the cervix that can detect if you're likely to go into preterm labour within the next two weeks. It looks for signs of a leak of the "glue" that holds the baby in (in simple terms!). It's a pretty accurate test too. It might help you relax in between scans if you're now to be scanned every few weeks? I'm not sure if all hospitals offer it but worth enquiring about.

Also with regards to the scans. I'm diabetic, had a big clotty bleed at 12 weeks plus had all the extra cervical scans on top so at 27 weeks I've already had 10 scans or so and got another 3 booked. You're not having them for your own amusement, you're having them for medical reasons. Don't feel bad over that!

Good luck with everything x

Thanks gingerbread that's so interesting, where did you have your fibronectin tests as I'm signed up for that too! From 20 weeks, so after my next set of "normal" cervix scans at 17 weeks. How far along are you now?

Oh thats good you're going to have ff tests. Could you possibly ask if you could bring your first one forward by a few weeks? I had my first one done at 18 weeks i think. i had my tests at the hospital I'm due to give birth at. They have their own preterm surveillance clinic. I'm not sure all hospitals have this.

I'm 27 weeks along now. I've been discharged from the preterm clinic now, though whenever I have a scan in another dept I usually cheekily ask "how's my cervix looking?" and they will usually have a quick look at it for me.

Hi everyone, I have ic and had a stitch placed at 14 weeks during my last pg. I was also given progesterone suppositories as studies have shown it can help prevent pre term births for those who's cervix have shortened

Op hope the pg goes smoothly, I know how worrying it can be

Oh ginger I REALLY wanted to start that at 18 weeks but stupidly I booked a holiday for weeks 18-20 (before all the cervix stuff when I was looking forward to a nice, relaxed second trimester) and it's all paid for. Apparently you can't do the FF tests before 18 weeks. I was going to cancel anyway despite the fact I could really do with a break, but the consultant said why don't I have a normal cervix scan just before and then start the FF tests when I get back. I am now doubting if that's the right decision to still go on the holiday, the baby is so much more important but at least I would get the scan just before and if it looks any shorter at all, I could always cancel last minute? Oh god, maybe I'm going away right at the key time that could make all the difference?

Oh I'm so sorry if I've inadvertently put more doubt in your head! :(
I went through real mental anguish when going into 2nd tri with all the cervix stuff, I had to work full time (work stopped my company sick pay) and every day I was in tears wondering if I was making things worse.

Why don't you follow the consultant's advice on the holiday, have a scan just before you go, then if any problems or doubts at all, just cancel the holiday if you feel you can't go. But you might go to the scan, be measuring a really good length and get a bit of confidence back.

Xx

Thanks ginger and yes that's true, it could be a reassuring measurement just before and if it isn't, then I cancel. I really appreciate the support on here, finding it hard talking to people in real life properly about this and how anxious I'm feeling, wondering every minute of every day if it's shortening! It's so good to hear that both yours and Diege's lengthened x

No problem. It is a very stressful and worrying situation and its good to talk to others that are going through the same x

Chiming in again, I think the holiday is a great idea. It is so important to get a break from all the stress and worry if you can, and like you say if the measurment worries you at all you could always cancel. Now I just need to take my own advice... :)

I am another who had increasing cervical length as the pregnancy went on. Mine grew by about a centimetre between 14-18 weeks and has stayed pretty steady since then. I also had progesterone suppositories, might be worth asking the doctor about them?

Thinking about you today x

Hi Alexandra, my cervix length has been good so far with no issues and has recently got longer so am feeling cautiously optimisitic. Am also on prog. supps. I would go on holiday if I were you. The vitamin D, downtime and change of scenery would be great for you. You could have a scan just before you go and when you retun to keep your mind at rest. If it helps you my ob told me that it takes 2-3 weeks for a cervix failure to be catastrophic, from the beginning of funnelling to the cervix opening and then going into labour.

HI alexandra

just to echo others. i've also been on progesteron suppositories since 12 weeks. my consultant says I will be until the day i give birth. they are supposed to really help - and i'm 21+2 now, so here's hoping! perhaps something to ask about.

one more thing - every time i get scanned (which has been every two weeks so far) they check my cervix, and it has never lengthened - they told me that after my surgeries it's just physically impossible. the good thing is that it hasn't shortened or funneled since the stitch.

expatal, that's really interesting about the 2-3 week thing!

Thanks, that's interesting you're all on progesterone as it hasn't even been mentioned to me!! I might try and ask my consultants. I've been googling foods that increase progesterone so at least I feel like I'm doing something!

kelly I was also told by one consultants that it can't lengthen. However there are others on here and the Internet who have had lengthening! So it either goes to show just how inaccurate these scans are or it must be able to happen??? I'm hoping the latter and our consultants are wrong. I can't remember for definite but I THINK the other consultant told me they can be dynamic (shorten/lengthen).

rainbow did your cervix lengthen due to the stitch or would that have happened anyway I wonder? Obviously I'm hoping the latter again as I'm not having the stitch now eek! I guess there's no way of knowing?