Cervix Shortening

[allthesharks]

I've had two premature babies (28 weeks and 33 weeks). I've been having a cervical length scan every 2 weeks. I had my last one today at 22+6 and the cervix has shortened to 27mm. It was around this time with DD2 that my cervix started to shorten and they gave me progesterone pessaries. Even with the pessaries I only got to 33 weeks. Obviously that was further than I got the first time, and she spent a relatively short time in SCBU with minimal problems. But her being born premature brought back my PTSD from the first time and it had a hugely detrimental affect on my mental health. I want to do everything possible to prevent this baby being premature. I had asked for a cerclage when I was first seen at 12 weeks, but the consultant didn't feel it was necessary as, if it was cervical incompetence that was the issue, they would have been born earlier. Instead he felt it was due to recurrent infections so I've been monitored for UTIs and I have had one course of oral antibiotics and two courses of an internal cream as I previously had group b strep. As the cervix has now shortened quite considerably, I would hope that my consultant will strongly consider a cerclage, however I have a feeling that he won't.

Has anyone else been in a similar situation? And what was the outcome?

So has your consultant said there isn’t a structural problem with your cervix? If so then yes the cerclage wouldn’t be offered as it can be an invasive surgery between 16-22 weeks and not work any way. I think as you are already at 23 weeks just rest up (ask your consultant if he recommends pelvic rest). If you can try and get a MH referral to help you cope with the anxiety - many trusts are doing these via telephone for antenatal / postnatal anxiety

I had another cervical length scan this morning at 23+6 and the cervix has shortened again to 22mm despite having started progesterone pessaries. The consultant has given me the option of having a cerclage or go back in one week to have another scan of the cervical length and then decide what to do based on that.

This length is less, at the same point in the pregnancy that it was with DD2 and she was born at 33 weeks despite the progesterone. I'm leaning towards having the cerclage, but it does come with a risk of infection which in itself could put me in to labour.

If we do nothing then the baby is likely to be born before 33 weeks. If I have a cerclage then the pregnancy could go further. But it also carries a risk that I could go in to labour even sooner.

I don't know what to do. Does anyone have any advice?

Is there a reason for this happening? Ie have you had previous surgery? LLETZ procedure?

I would personally take the consultants advice.

No known reason why this is happening. My daughter being born at 28 weeks was the first indication of any cervical incompetence.

When you say that you would take the consultants advice, which option do you mean - have the cerclage, or have a scan next week and then make a decision?