Should I book a cervical length scan if I've had a LLETZ procedure?

[Chrissayeth]

Back in 2013 I had an abnormal smear so needed to have a LLETZ performed.

Today I saw a consultant as I'm 14 weeks an am concerned about giving birth prematurely or even worse, a late m/c. He said to me as I've only had one procedure and only a small amount was taken that there was no need to look into it any further. I'm kind of annoyed as I thought at least I'd be offered a cervical length scan at 16 weeks!

I'm considering booking one privately for peace of mind, it costs £90 though, so I couldn't afford to have one done weekly as they're routinely done on nhs. I've read about women who get seen every week when they've just had one procedure and it feels kind of unfair I don't get that treatment. I don't trust the consultant tbh, this is my first baby and I'm not going to play Russian roulette with their life.

If I do have one done privately will they be able to tell me if there are any concerns and pass this onto my midwife? So that she can refer back to the consultant as kind of like an "F you, idiot, now do your job properly" haha.

I just am so anxious as I have had regular spotting and some bleeds from 8 weeks and continuing, I told him this too and still he didn't seem concerned.

F you, idiot, now do your job properly

What a pleasant person you are.

How would you feel if a doctor called you and idiot for asking and said f you?

If your anxiety over this ‘Russian roulette’ hasn’t been eased, rather than finding one upmanship games why don’t you have a read of the RCOG guidelines for lletz/cervical lengthening? then you either reassure yourself or if you identify a concern ask for a second opinion to discuss that concern.

Or you can continue in the nasty tone you’ve taken.

@TisTheSeasonToBe I'd get a whole lot nastier if I lost my baby! How dare you call me a gameplayer? Learn some freaking compassion! I just am aware there are doctors that mess up and I came on here looking for some reassurance not you, you're the horrible person.

I would absolutely pay the £90 to get an idea of your length- I was in the same boat as you and I did. Thankfully my cervix was still long. I would say start with the one and see what your measurements are- you will hopefully have a nice long cervix so no need to go back for another privately. If there is an issue at the private scan they will provide you with a full report to show the consultant. The NICE guidelines suggest that a cervical length scan should be performed when there has been any previous cervical trauma including LLETZ procedure, my midwife told me that the NICE guidelines are “just guidelines” and my trust don’t do cervical length scans unless you’ve had 2 LLETZ procedures. A quick google search evidences that this varies massively from trust to trust and had I lived in a different part of the U.K. I would have been given a cervical length scan as standard after having one LLETZ procedure.

Sadly with the state of the NHS these days we have to advocate hard for our wellbeing so you are doing the right thing. Rather be safe than sorry always for the sake of £90. Best of luck xx

@Phiphi123 thank you so much for your response, that's really helpful to know and I will certainly book one now. At how many weeks did you have your private scan and did you carry your baby to 40 weeks or were you a bit early?

I was 16 weeks when I had my private scan so found out it was a little boy then too I’m still pregnant!! 31 weeks and fingers crossed all ok so far...I felt a million times better once I’d had the private scan and knew I’d done everything I could to make sure things were ok xx

Bloody hell, OP. You need to stop speaking to people so rudely.

@Phiphi123 thanks phi, well you're all good now, shouldn't be long off! Even if you're a few weeks early it's still going to be OK, have you started your maternity leave yet? You'll be fine! Oh I didn't know they'll tell you gender too, definitely worth the money then to find out early! xx

It’s always hard if you don’t feel the doctor has listened to your concerns properly. However - it’s possible/probable that he is in fact doing his job properly - the key thing is how much length the LLETZ removed. Sounds like he has likely looked at that - but you can ask for this information (from the doctor, your GP, or the colposcopy clinic). If under 10mm there is really no evidence of added risk due to the LLETZ.

That said I understand the anxiety. In terms of what you’ve heard about monitoring NT - Standard high risk preterm birth monitoring would be 2 weekly. There’s no need to do it weekly as surveillance, only weekly if there’s extra concerns.

If your LLETZ was less than 10mm, to settle your mind it would be worth paying for a scan at 16 weeks. In terms of what to do with result: if less than 25mm urgent referral back; I’d ask for a less urgent review of things if it’s under 30mm as well. If over 30mm then would be reassured - you could consider doing another at around 20 weeks again for reassurance. They shouldn’t really be done after 24 weeks so it would be wasting your money to do that.

I hope that helps a bit. Also hope the bleeding settles for you soon - please ask for another referral for review if that is ongoing (as I don’t think you should have to pay for private scans for that!).

I didn't, TBH it didn't even occur to me. I had had one child before the procedure, though, but accepted the midwife's response when I raised it at my booking in appointment with DC2.

I had no issues with either that pregnancy or the two afterwards.

@TenThousandSpoons0 thank you for your detailed response that's put my mind at ease. I know I shouldn't question doctors I mean they know what they're talking about, just he didn't go into this detail to reassure me he was very short with me like he just wanted me gone tbh. If he'd said all this it would have made me understand a bit more. I will go ahead and book a scan at 16 weeks anyway like the woman above said she has done and then if it's all good from there then it's no loss to my bank account as I get to see baby again and maybe even gender reveal early which is all worth it.

Our trust was previously 2 LLETZ procedures or more, then they changed to any number of LLETZ, and then due to Covid all routine cervical monitoring was suspended. It’s just coming back in now. But they wouldn’t do it weekly. Usually if it’s good at 16 weeks that is reassuring enough for the consultants.

You should always question doctors if you don’t feel they’ve explained properly, or things don’t seem quite right. Some have better ways of explaining things than others- some are just having a rushed day - and occasionally some don’t know what they’re doing but thankfully that’s less common! Glad it helped :) and yes bonus to look at baby at 16 weeks anyway