High risk of premature labour and only 21 weeks. Please help!

[YoungWoman94]

I will warn you now this might be a long post..

I'm 19 (Please don't judge) and I'm just over 21 weeks pregnant. I lost my son at 23 weeks back in 2012, my pregnancy was perfect you could say no difficulties included. Until the day I went into labour which I won't go into detail about. But basically my Consultant said I have a suspected weak cervix.

They've kept a close eye on me and at my 17week scan my cervix showed 2.4cm which didn't concern my consultant. The weekend passed and on the monday I had a little bleed and a big pain, so I went straight to hospital.. they kept me in over night and said everything was fine but luckily they rescanned me. The scan showed my cervix to be 1.2cm with slight funneling. They booked me in for a stitch that afternoon and it went well, I got discharged the next night.

Anyway I had my cervix checked on Monday at my 21week scan and had my consultant appointment yesterday. He basically said my cevix hasn't improved but hasnted worsened. Its still really short with funneling.. He said he cant tell me what will happen, but you could tell by his face he was concerned. I'm allowed back to college (3days a week in my last year now) but can't walk there and have to rest the other days. My consultant says my cervix might not hold long, and I have a rescan in 2 weeks to check what's happening and Steroids injections at 24weeks.

I'm so scared, I can't bury another baby. My partner is VERY supportive, but he starts work again on the 20th and he travels across the UK. The day I had my stitch pit in he was working 6+ hours away and his boss wouldnt let him leave until he had finisjed the job (he got to me at 2am).

Has anyone experienced a weak cervix, had a cervical stitch or a premature labour? Or have any advice? I'm usually so strong but feel like I'm crumbling, im behind with college too due to me being in hospital and I'm a distinction student... finding it all to much. Thank you. X

I'm sorry you are going through this. I'm in the same place as you, my cervix was 0.4cm and funneling at 18 weeks when I had my stitch. I'm 20 weeks now. I've been on bed rest for 5 weeks and probably will be for however long my pregnancy lasts. I'm also taking progesterone suppositories which are supposed to help with the cervix and magnesium which is supposed to help stop contractions. Feel free to ask me any questions, I've done quite a lot of research into it.

MissMedusa, Sorry you're going through this too! Have you had a previous loss? Have they rescanned you yet to tell you whether your cervix is strengthening? After my stitch I was given 2 days of tablets to take which were to prevent contractions, but other than that I haven't been given any. I've been doing research but haven't found much on anything. Just hoping I make it to 24 weeks

I've had losses before but this is the first time I've made it to the second trimester. I haven't had another scan since the operation but should be getting one next week. I'll report the outcome. Doctors have predicted that I should make it to 26-28 weeks but right now I'm hoping to make it to 24 weeks

Hi there Young,

I'm so sorry this is happening to you. I hope you have some good support from friends and family.

I have a similar situation. In Jan 13 I lost my first child as went into labour at 22+3. So with my 2nd pregnancy I had an elective suture put in at 17 weeks when my cervix was measuring about 4.8 nice and long. I also have fortnightly cervical length scans since 14 weeks. At 22 weeks my cervix had shortened (but not opened or funnelled) to 2.1! My consultant said not to worry as we have the stitch. So I just carried on as normal over Christmas but tried to rest a lot. At my 24 week scan my cervix stil measured 2.1 but was open up to a few mm above the stitch. Below the stitch is closed. I am now on hospital bed rest. Only allowed to get up to shower and go to the toilet.

I had steroids on Tuesday and the aim is to get to 28 weeks, then 30 and hopefully 34.

By all sccounts stitches are very effective at holding things together and the fact that you have a stitch should give you some reassurance. Although I know what it's like to be so worried, I have posted about this subject quite a lot. When do you next see consultant? I do think that the bed rest I am on must help in someway. Do you think you could go on bed rest? The jury are still out on how effective it is but it's good too feel like you are doing something. It's not easy it will be worth it I hope.

Try to stay strong, I know that your first loss must be playing on your mind hun. But you have taken steps in this pregnancy that are different to ensure this pregnancy has a different outcome for you.

Take care x

Any luck on having another scan yet MissMedusa?

212 Sorry to hear about your loss and that you are going through this. I have put myself on bed rest as my cervix is so short and funnelled so didn't want to risk having her early. I have a scan booked in for Tuesday to check everything is still ok (I'll be 22+6) and then I see my consultant again on the Thursday after my scan (23+1). I'm assuming he will book me in for steroids then? Could you tell me what happens when you have steroids? Will I have to stay in hospital for 12 or 24 hours until I've had all my injections? My consultant hasn't told me anything about them, just that i'll be needing them. How many weeks are you now? Glad there keeping a close eye on you

I'm so sorry to hear of your worrying pregnancy.

I had 3mm at 18w3d with DC2 and had an emergency stitch. As I mentioned on your other thread, I had a 50/50 chance of hitting 24 weeks.. we got to 35! Slowest weeks of my life, however..

I was put on strict bedrest (this was five years ago, they now don't recommend it as much as they did back then) until 32 weeks when it became "modified".

I also had progesterone injections weekly (the equivalent of pessaries twice a day which is what tends to happen here in the UK now) If you're not on the pessaries, you should be as it's one of the few things with good scientific research behind it that increases your odds. Please ask your doctor if you're not! I've needed them with DC3 and this DC4, I take them rectally twice a day 200mg Cyclogest.

The tablets they give you are most likely only useful for a few days, there is nothing really scientifically proven that can buy you more than a few days if you go into preterm labour. Sometimes people use magnesium sulphate on an IV in hospital, but for the most part people just have the progesterone.

Transvaginal stitches are on average 80% successful (from what I read years ago, may have improved since) and that depends on when they were put in and what was left of your cervix. 1.2cm is not that bad at all comparatively, so your odds may well be more than 80%. I hope so!!

I had steroid injections with DC2 at 34 weeks (had PTL that stalled) - I happened to be in the hospital at the time but if you're already an outpatient you'd probably just come back the next day. Hurts a bit but nothing too bad.. and compared to the alternative, well, yes.

In case you were wondering, I have a transabdominal cerclage (TAC) these days which is a permanent stitch placed via a c-section-style incision at 13 weeks with my previous pregnancy. They're pretty rare, only a few doctors in the UK do them, but it means I can have a normal pregnancy and not worry about cervical length aside from a few check-ups. They're only recommended in certain circumstances though (mine were quite complex!) as it's major surgery and baby can only be delivered via c-section. It may be something to ask about for future pregnancies however depending on the outcome with this one.

Lots of luck - just take it one day at a time and focus completely on that 24 week milestone. Then 26 weeks (another good milestone in terms of outcome) and then the golden 28 weeks where it's 90-95%+ all will be good in the long term.

Also I am so sorry to hear about the loss of your son I can't even begin to imagine how hard that was for you. Life can be so unfair.

Thanks for sharing crispy, your story gives us hope.

I had my scan today and unsurprisingly am funneled down to the stitch, which in my case is at the very tip of my cervix. I'll be fine as long as the stitch holds but if/once that goes, I have no cervix left to keep baby in. I'm on bed rest now and can imagine I will be for the rest of the pregnancy. I was having regular (5-10 min. apart), sharp-shooting pains on my left side which were triggering braxton-hicks contractions. I thought it might be an ovarian cyst but the dr. couldn't see anything and just said I should go to the hospital if it doesn't go away but I've now put a heating pad on my right side (just for 15 min. as they're not supposed to be good for baby) and the pains have gone away completely so now I'm thinking (hoping) they were just round ligament pain rather than something more sinister.

Counting down the days until I hit 24 weeks (20 days)

3mm!! That's so short! It's amazing that you carried your little one for so long, that's given me a lot more hope. I think the main worry is with my first I didn't know I was in labour and he thinks it may happen again because contractions started. I had some tablets given to me after I had the stitch placed.. I don't know what they were called, but they were to stop the Uterus contracting I think. But I only had 2 days worth.

My consultant hasn't told me to stay on bedrest... he told me to rest but to carry on with daily life. He also hasn't told me about the Pressaries. (That's what I was given to take Rectually for 2 days after my stitch).

Thank you for your help Crispy I'm going to write down a few questions to ask him x

I knew nothing really about cervixes when I went for the fateful scan beyond thinking they should probably be about 3-4cm or something. So when they said 3mm I was sure they must have meant cm at first. But then when all the doctors came in with worried expressions and talked about "wafer thin" and "surgery right away" I realised it was serious! They had to push her back up with foley balloon, which I believe is a balloon filled with water. She hadn't yet started coming out, but the sac was bulging (I was 1-2cm dilated)

She's five years old now and started school last term

The doctor I saw did a modified MacDonald stitch which was proprietary to him - probably improved my odds but with 3mm it was going to need something like that! It was such a weird stitch that when it was taken out at 34 weeks after I went into labour, the doctors could not get it out very easily (different hospital!) But for most emergency stitches, a Shirodkar is just fine, especially if it's over 10mm.

I spent most of the rest of the pregnancy at around 20-25mm - I assume they managed to pull down a bit of cervix to give a bit of length when fitting the stitch. There was never more than a few mm above the top of the stitch which means there were almost certainly times when I was funnelled to the stitch.

I was given indomethacin which is a NSAID like ibuprofen after the stitch for a few days too - you just reminded me. It calms contractions for a little bit (doesn't work long term) as the uterus is liable to be irritable after all that messing around there. Perhaps it was something similar you had? That would make sense. But it would be fabulous if you could get on the progesterone pessaries asap.. anything to improve the odds even slightly. I'm amazed you've not been offered them!

Bedrest is such a controversial subject. There are risks to the mother associated with bedrest, along the lines of greater risk of clots, loss of muscle tone, general health and fitness etc so these things have to be considered. It's prescribed probably too readily in the US, and not readily enough in the UK (in my opinion!) For most people bedrest doesn't change the outcome e.g. for bleeding or some other issues along those lines, but when simple old gravity is involved like with a weak cervix how can it not improve the chances? In your situation I'd probably spend as much time as I can resting or preferably reclined.. which was what I did! Bloody miserable though. And even with strict bedrest there are no guarantees.

Please don't feel guilty about your first although I know that is easier said than done. There was no way you could have known. When I went in, it was my second after all so I should have known what was "normal", and I'd had NO indication anything was up. Most people don't - all seems normal and there's no way to tell. It was just complete and utter luck that I happened to go for an anatomy scan a bit earlier than usual at a place where they did cervical length checks (still lots of places don't ) and catch it literally just in time - I was told I would have been in labour in under 48 hours.

Good for you for being proactive and making a list of questions for your doctor. Obviously advocating for your baby doesn't mean a happy ending, but it really improves the chances. Doctors often need a kick up the bum

MissMedusa I'm so sorry you're going through this too. It is the most terrifying thing that countdown to 24 weeks and utterly miserable. You soon find out who your friends are when you're on bedrest too..! Really hope the shooting pains go soon. It's bad enough when you're low risk pregnant, but when you're high risk not only are you dealing with the pain, you're dealing with the anxiety just in case it means something else. So stressful and horrible.

Lots of Stay Pregnant thoughts sent in both of your directions and yet more to 212 as well. The Crap Cervix Club is not a nice club to be in at all and I wish nobody ever was in it.