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.

i think the lenghtening depends on whether you have a short cervix via birth/nature or if it is caused by having most of it hacked away during surgery!

for mine to grow my body would have to regenarate tissue a la the Terminator!

Kelly, the 2-3 week thing is probably the only thing that stops me going into meltdown seeing that a scan every 2 weeks would spot things unravelling in time. I've asked him many neurotic questions - such as what if I start funneling the minute this scan is finished etc and he always replies that it would be caught in time.

diege had two LLETZ and hers lengthened though? Maybe we start off at a shorter length after our treatments but it can still act like a normal cervix, just at shorter measurements because of the parts missing?

Hi Alexandra. I'm in a very similar position but a few weeks ahead of you. Had first cervical scan at 21 weeks (history of cone biopsy) when I measured 28mm. Consultant not concerned but I insisted on repeat scan two weeks later, which was yesterday. It took two sonographers to agree on a measurement - I must have a tricky cervix! They stated it was 23mm, which I was very upset about. But then when I went into see consultant she had a print of scan in front of her with a measurement of 25.7, so I am beyond confused.

Anyway, another scan next week and if it's reduced to worrying thinness, then a stitch will be discussed.

I totally understand how you feel about making right decision for the baby and not forgiving yourself if it goes wrong. My consultant is very hesitant about stitches too and is also supposed to be very good. I think she will only do it if it goes below 20mm with evidence of funnelling. Also wondering about getting second opinion but feel I'm running our of time now as I'll be 24 weeks next Weds. Please keep us up to date with what's going on. It's such a horrible worry isn't it, particularly when friends seem to sail through with minimal issues. Anyway, take care and hope all goes well over next few weeks. And enjoy your holiday!!!

I was on the progesterone from 18-30 weeks last time, although my case is different as my cervix is just weak probably not short. Although it's never been measured

Thanks sw25, did you see I posted on your thread too before I saw this

I'm not sure about your tricky cervix as I have had the same with two sonographers looking and saying what they think it is - I honestly think it's hard to measure on the scans and they're estimating from what they can see. I had two scans this week - both different measurements and only a day apart!

Definitely keep me up to date please - when is your next scan?

I've asked about the progesterone and was told the evidence of benefit is still unclear and side effects can be unpleasant. Hmm. It is hard to know what to do - as why do some consultants/hospitals recommend it then?

Sorry, missed your question! My consultant told me that cervix can be very variable, so it may well have grown and shrunk on it's own if I had had the stitch or not.

Again, with the progesterone, my doctor said that there was some evidence to show it could help and certainly no evidence it did any harm. Using them made me feel better, as it felt like a positive step to help. As far as side effects go, the only thing I had were some headaches in the first fortnight of using them. These were annoying, but certainly not unbareable. I started these at 12 weeks, and am still on them at 30. I will keep using them for another 4-6 weeks.

Side effects of progesterone, none for me, other than occasional constipation which I think is par for the course when pregnant anyway!

Could any reluctance to prescribe them or do the stitch on the doctors part come from a cost point of view? Just a thought...?

Hmm I don't think so kelly as that's the consultant who suggested the stitch. It just seems different consultants and hospitals have different strategies. Just so hard to know if the advice is right for you, I guess it's hard for the consultants to predict things too in their defence.

Thanks rainbow I am keeping everything crossed that my length increases by my next scan!

can i just add as a sonographer; It is really hard to get a good accurate measurement of a cervical length. (I am assuming they are measuring it via the internal scan.!)
They are one of the worst things I have to do and take about 6 measurements then compare all image to decide on most accurate measurement.. but then I do have OCD when it comes to obstetrics!

Worley, OCD is a trait definitely appreciated in sonographers!

Hi Alexandra, hope you're ok. Just thought I'd update you as to what's going on with me. So my last scan was last Weds, when it measured 25.7 mm ( two weeks earlier it had been 28mm). The sonographers took ages measuring and printed out 6 different sonograms for the consultant to look at. The lowest measurement recorded on those scans was 23mm, but the consultant explained that that particular scan wasnt accurate as the whole cervix couldn't be seen. She still seemed unconcerned about 25.7 and said it wasn't enough of a reduction to consider a stitch. She also said there was no sign of funnelling either at this stage.

The following day I felt very anxious, weird crampy pains (one of the sonographers was really rough!), and I was still concerned about the 23mm measurement, so I emailed my consultant with my concerns. She actually called me back within hours and arranged for me to see another consultant for second opinion last Friday ( I've been so impressed so far with the consultant care I've had on the NHS - almost like private care).

Anyway, new consultant was also lovely. She reassured me that 25.7 is still a decent measurement for someone who's had a cervical procedure. With regards to a stitch, she said at the moment, my cervix did not look like it needed one and that she wouldn't normally put one in until it measured under 2cm - usually 1.5. I asked if 24 weeks was the deadline for placing stitch, but she said she's done them as late as 28 weeks. She also explained that at nearly 24 weeks, I am almost approaching a stage where the baby has a chance of survival if it was born. If he can just stay put for the next month I think I'll feel a lot more relaxed. It's so stressful though - every little twinge or cramp panics me and I've been having some crampy pains that are worrying me. I may pop down to the EPC later to be checked out! I just want my body to hold him in until 30 weeks at least - keeping fingers tightly crossed!

Oh, and consultant also said that bed rest is only really helpful once you've had the stitch. She said I was fine to do moderate exercise, have sex, baths/swimming etc (although of course I'm abstaining from all of those to be on the safe side). Still pottering about in garden and doing moderate housework, but making sure I sit/lie down for substantial periods each day (lucky enough not to be working at the mo). I spent months in bed at the beginning due to hideously awful nausea/morning sickness, so I really don't want to go back to bedrest again! My pregnancy has been so awful so far that I doubt very much I will do it again, which is why I desperately want to protect this one.

When is your next scan? Mine is on Thursday and I've requested that the consultant performs it, to which she agreed which is fab. I'm at Frimley Park Hospital in Surrey - are you in London? I am really hoping that we both have a positive result this time and that we can both start enjoying our pregnancies, rather than obsessively worrying! Xxxxxx

Hi sw thanks so much for that update, can't tell you how good it is hearing from people who understand! All sounds very positive and I'm hoping my cervix length doesn't shorten much at all by the time I'm at your stage. I'm in London, I am now 15 weeks but there is a 3 week break between my scans so I'll be scanned in 2 weeks time, at 17 weeks. How often do they think you'll be scanned in the next month? I totally understand the feeling anxious about any twinges/cramps, I'm like that already. I'm also not doing anything like exercise, sex etc, and making sure I'm not on my feet for long periods of time, it just feels like the common sense thing to do. Keep me posted on everything if you don't mind! Glad you're doing ok, just think, one more month and every day it's getting safer and safer

What's making it even more difficult is getting people to understand I need to take it easy. I'm working full time and some people have said the best thing in pregnancy is to live as normal and be active, but logically I feel like the best thing is to have my feet up as much as poss and to take it really easy to avoid cervix pressure. I feel paranoid that people think I'm milking it or trying to make a drama out of my pregnancy - just wish they knew I would LOVE to not be worrying about this and enjoying my pregnancy more. Oh and I now have a urine infection and might need antibiotics which I REALLY don't want to take when pregnant but apparently it's dangerous not to. Again something I could really do without! I'm hoping it's cleared up naturally, waiting for results.

worley thanks for your note above, I also appreciate OCD in a sonographer! I suspected it was tough to measure and difficult to make a call on it, I had that feeling in my scans. I don't suppose you can give a rough estimate of how many shortish cervix stories you see work out well?!

Hplacello! Back from hols and reporting in with a further instalment of cervix news after 20 week scan yesterday at FMC in London.
Soooo, to cut a long story short, all well with baby but placenta looking a little low, so she did an internal scan just to get a really good look at it. Also looked at cervix internally as I had mentioned I had had it measured at 18 weeks (NHS abdominal scan : 4cm). She measured 2.9cm internally which I was happy with but then of course worried that it had somehow reduced in 2 weeks by what would be quite a bit. Anyway, turns out that she doubts it ever really was 4cm as that scan was abdominal and my bladder was full-ish and while you can get away with tummy scans for cervix early on, internal scans are far more accurate. She said in general you could knock off a cm from a abdominal scan at 20 weeks. She stressed that 2.9 was not short at all, and that 3cm is actually as much as it could ever be after 2 lots of cervical surgery (apparently 4cm is top of range for not-messed-about-with cervixes). She also told me that the guidelines for cervical measurements had changed in the last few mths and that anything above 2cm was no longer considered 'short'. She said I should be very pleased with my cervix and not to worry. Hope this helps a bit!

Hi diege I love your posts this fits in with my second consultants non-panic approach at my cervix measurements and am keeping my fingers crossed that in two weeks, they are about the same. I feel like then, if I can be monitored regularly and make it through July and August and take it easy, things are looking good! I hope I can be proud of my cervix too! I start my fetal fibronectin tests at 20 weeks hopefully too so another way of monitoring.

So will you get scanned again to make sure now or do you now carry on as a normal pregnancy would? Glad things are going well for you and thanks for giving me lots of hope!

Hi Alex! Well I had a consultant's appointment yesterday and they say they're not at all worried about my cervix and it's no longer being measured. She said the 4cm measurement was unlikely to be very accurate as it was done abdominally with a full bladder, which can artificially lengthen cervical length after about 14 weeks. My 2.9 was good enough for her though so I'm not going to worry about it anymore. That's ok though, as I have a low lying placenta to worry about now .
I think the fibronectin tests and serial scanning is the way forward for you - you will get great reassurance from the tests, and it seems that this fits too with your most recent consultant's appointment. Keep us updated!

I am sorry to jump in in your thread, I hope you don't mind as I also have a short cervix and have many concerns and questions.

I have surgery [LEEP] on my cervix in 1996, but the notes were not clear on how much was removed. After much difficulty [a whole other story] I am currently 18 weeks pregnant, I have had 2 cervical scans so far, the first was at 14 weeks and I have a measurement of 3.2, the next one was last Thursday where the measurement had changed to 2.7.

After a weekend of worry and tears, I am trying to be calm and find out more.

I saw a consultant who did not seem concerned yet, and did not think a change of 5mm was a lot be concerned about.

I have seen loads of information from people in the USA where there seems to be loads of progesterone, bed rest and stitches but in the UK, there appears to much less intervention...

Any advice, reassurance or tips would be so appreciated :)

Hi Holly,

Sorry to hear you're stressed but congrats on your pregnancy! Your cervix measurements sound good to me - I was told they'd only put a stitch in under 2.5cm and other people on here have been told 15cm!

What did the consultant say? Will they scan you again soon? I think I'm going to start a 'short cervix club' thread now in ante-natal clubs and hope that we can create a sort-of database of info which people can share to reassure a bit. There are a few of us on here freaking out and it's not fun!

I wouldn't worry too much with your measurements, sounds like they're keeping an eye on you. Do keep us updated and ask any more questions you might have!

Piz

Link to the Short Cervix Club here - hope it's useful!

sorry, here