Shortening Cervix

[Salina2]

Hi, I was hoping someone could give me a little guidance and advice. I am 20 weeks pregnant with my 2nd, I have been monitored very closely as my first child was borne prematurely at 26+3. I had a internal scan a few days ago and they have noticed my cervix has shortened from 40mm to 27mm, the doctor offered me the stitch or to take the progesterone (cyclogest) until my next internal scan in a few days. I was told the risks with the cervix Cerclage and it didn't make sense to have it done until I tried the progesterone treatment for a week. Can someone tell me if they have had the Cerclage and how short there cervix was, and or if you only had the progesterone treatment and how successful it was? Any advice would be greatful as I have been very stressed and don't feel like the doctors are consistent in there advice.

Hi, I hope the eventual outcome for your first child was a positive one? My DS1 was born at 24 weeks so I've been on a similar journey to you.

Do they know why your DC1 was born so early? Do they know it was due to cervical incompetence or are they unsure/suspect a different reason? I'm asking because I see you've got to 20 weeks with DC2 without the consultant taking action already.

So my experience, in short, is as follows:
With DS1 I had my 20 week scan and the sonographer just happened to take the scanning thing (paddle?) lower than she would normally and noticed that my cervix was short (somewhere between 1.2cm-1.5cm). I had a stitch put in a couple of days later. It got me to 24 weeks, when it broke and I found myself in unstoppable labour. I wasn't offered progesterone at any point. My consultant said I'd most likely been in pre-labour already when they put the stitch in, hence it was never going to work as hoped, but I am enormously grateful that it got me that far.

For DS2 I had two stitches at 12 weeks at the top and bottom of my cervix, so that it was completely closed. I also had progesterone twice a day from 12 weeks. DS2 arrived at 38 weeks. My pregnancy was overseen in a high risk specialist pregnancy unit and my consultant there was an expert on extremely premature labour and how to prevent it. His opinion was that stitches + cyclogest are the best combination to use (this was 12 years ago so I may be out of date) - and this was certainly my experience.

Given that you've already had a 26 weeker, my suggestion would be to consider having the stitch plus progesterone. I think progesterone can be added in at any time, whereas stitches can't be put in easily or safely once you get to (I think) around 23 weeks. But in my experience, the sooner you start either or both, the more effective they are likely to be. Good luck.

Thank you for your reply, so my first who was born at 26 weeks was a surprise and very hard to say the least, but we got through it and he is a cheeky 1 and half year old now who has more energy than I could imagine they suspected I had an infection with my DS1 but they couldn't say for sure which is why they have been keeping a close eye on me.

My internal scan at 18 weeks my cervix was at its full length of 40mm and two weeks later it has shortened to 28mm, since then due to my high levels of stress Iv been to the emergency maternity unit twice this week, doctor assessed me and said my cervix seems pretty much the same as it was at 28mm and to continue with the progesterone until my next app in a few days and make a decision then. Doctor said the progesterone can work as well as the stitch but all doctors have different opinions on this.

I feel like I am heading towards a stitch and if it means I can go further in my pregnancy and not have another pre term labour then I will definitely have it down. I am however scared of the risks involved which is why I didn't go for it straight away.

I will see what the doctor says about my cervix on Wednesday and I guess I will have to make the decision of having the stitch or not, I'm glad to hear your stitch was successful and you gave birth to a healthy baby, I hope I have the same outcome, thank you for sharing

I started the progesterone pessaries at 24 weeks, three a day as my cervix had shortened from 3.4 to 2.4 in a week. They worked well for me, he didn't want to do the stitch at that point as felt it may rupture my waters. I was signed off at 32 weeks as my cervix was soft and my DD was pretty much fully engaged. I was ordered to rest as much as possible, then signed back to midwife care at 36 weeks which is when I stopped the pessaries. Examined at 37 weeks due to reduced movement and I was 1cm dilated. DD stayed put until 40+5

Hope they work for you too x

annlee3817 thank you for sharing, that gives me a lot of hope and reassurance, I am now just over 20 weeks but I am on one pessary 400 a night, maybe they might increase my dose? I have a 1 1/2 year old so it's not that easy to rest as much as I think I should but I have a lot of support from my husband so I'm coping well. After my appointment on Wednesday I think I will be given the chance to decide on what to do which is why I'm trying to get as much info as possible to decide on what's best to do. I'm happy to hear your baby was born at full term and healthy