Pregnancy after cone biopsy

[Worrying2020]

Hello ladies, I am 9+1 and had my booking appointment on Friday. I told the midwife that I've had a cone biopsy in the past and the doctor who did it told me I will need a cervical stitch when I'm pregnant one day so I've always known I will need one. The midwife was quite dismissive of it and said that's not true, people with cone biopsy don't always need a stitch and she said she will send a referral so I'm seen around week 24. I think this is really late considering that it's best to put a stitch between weeks 12 and 24. Also, I've read so many sad stories where a stitch could have saved the pregnancy and naturally I'm really worried now (I had an early miscarriage in March so this adds even more to my worries). Really don't know who can I ask for more help and to be seen sooner than that so that's it's determined whether I do need one or not? Not sure if I would see a consultant at my 12 week scan? I will really appreciate if you can share your experience with me if you had a cone biopsy or different circumstances under which you needed a cervical stitch and at what point of the pregnancy did you have it?

You are quite correct to question this.
I suggest that you phone the antenatal clinic at your hospital in the morning and speak to the senior midwife there. Explain what you were told previously & that you want to double check. That is completely reasonable.
Was the cone biopsy done at the same hospital? If so they can easily look up your notes to check the information & plan accordingly. If not ring your GP who should have a letter on your notes about it that you can give to the maternity team.
Hope all goes well for you.

I don't have experience of this specific issue, but I am certain you must not be fobbed off by the midwife. I doubt you will see a doctor at the 12 week scan. I would call them tomorrow, or perhaps email, and insist that you are referred to a pre term or prematurity clinic for monitoring...I think most start monitoring around 12-14 weeks, 24 is not soon enough for sure. If there is not a pre term clinic at your hospital then insist on a phone call with a consultant to discuss next steps.

Hell no do not listen to her, she is wrong u need to be seen just ideally after ur 12 week scan some hospitals won't see u until 16 weeks but I don't agree with it bein that late. They need to measure ur cervix by ultrasound and if below 2.5cm offer a stitch. That being said a biopsy dose not mean u will def need a stitch or u will have problems many lady's have over 10mm of cervix removed and go on to have normal cervix during pregnancy
I would try the midwife again and ask to be referred to a consultant I think normally pre term clinic or ring the clinic ur self, if not joy seek out another option, their are a few really good consultants about that are happy to take self referrals

Also 24 weeks is to late as they will not put stitch's in after 24 weeks, I say this having had a baby at 28 weeks and now 20 week with stitch placed at 13+5 weeks

Completely agree with you to question. I was referred to the prem clinic because of a different past procedure (LLETZ) and given that same warning one day when you are pregnant you'll need a stitch.

The clinic fitted me in at 12/13 weeks as I had a trip booked. That gave them a baseline to decide to see me every 2 or 4 weeks. They can't do the stitch after 24 weeks.

Start with a call to the maternity line?

I nearly had a battle to get the appointment because I was away and I told them quite clearly I'm not losing a baby because of the diary clash.

Definitely call the hospital. I had to have cervical scans every 2 weeks from 16 weeks to 24 weeks due to previous LLETZ. They won’t put a stitch in after 24 weeks so you need to get onto someone about it. Your midwife should have referred you to a consultant honestly I’d be really annoyed if I were you.

I echo what the previous posters have said, I had Lletz and two reasonable sizes removed of my cervix. I had cervical scans every 2 weeks from 16 weeks, and around 21/22 weeks every week.
My cervix shortened and I had to have progesterone pessaries daily until 34 weeks. I was high risk of pre term labour.

Deffo query it!!! 24 weeks would be too late.

At my hospital (large Nhs trust) the cervical scan clinic is in the same area as the triage unit etc so I’d deffo ring up about it

Thank you so much for your replies ladies! You really gave me the reassurance I needed to follow this up! I will phone the antenatal clinic this morning.
@Sussexmidwife thanks for your advice. The problem is that not only was it not done in the same hospital, it was done in a different country many years ago (I'm now a British citizen but was born in an another European country). This is also why the midwife was dismissive of it as she said it's a wrong practice to give patients the stitch preventively and if I want it done I should go back to my own country and get it done there 🙁 I know not everybody who has had a cone biopsy needs it so I'm not insisting to have it no matter what but this goes back to my worry that being seen at 24 weeks will be too late if I do need one
@serialplanner @Oneandabean @Changedmynameagain1 may I please ask you how did you (or do you plan to) give birth considering you've had LLETZ? I told the midwife I was told I MAY to have an elective c-section and she said "oh my word... oh my word ... oh my word (quite condescendingly) everybody should be told to give birth naturally, what a poor, poor practice". She did put a note for somebody to give me a call to discuss birth options but she said they will most likely persuade me to give birth naturally. This is further down the line and haven't thought about it yet but I was wondering about your own experience considering you've had a procedure similar to mine? Thanks a lot for your time

There’s absolutely no reason you couldn’t give birth naturally. Once you get to full term they can remove the stitch and you just give birth vaginally. I’m now31 weeks and after regular scans it turns out I didn’t need a stitch but they told me there would have been no problems if I had. The stitch just prevents preterm labour.

No one mentioned anything different about the birth for me.

Silly midwife. You are not asking for a stitch you are asking to be checked to make sure you don't need one. It's so infuriating that a comment like that could change your experience. Thank god for places like Mumsnet!

Hi Ladies, so I called the hospital and the midwife I spoke to arrange for me to see a consultant in ten days which is amazing. I think I just had bad luck with my booking experience but glad I spoke to you and grateful for your advice x

Glad that you have got an app, hopefully all is well and you won't need any intervention

Thank you for your nice words @88bowie
Have a good day

Well done OP, hope all goes well.

That midwife you saw before sounds awful!

Just to put your mind at some rest.

I had cone biopsy in 2010.... was told I May need a stitch.
Had IVF in 2015 and feel pregnant. At an ultrasound - I can't remember which one - I was told I didn't need it, my cervix wasn't too short. So I didn't have it.
Carried to 37 weeks - no other issues (other then DD being breach)

@Worrying2020 birth was exactly the same to be honest no issues there at all.

I had to take it easy in pregnancy though once on the pessaries and I was put on reduced hours at work by the consultant.
She was head down oh so low from 28 weeks and they were surprised I got so far too 37 weeks.

She came at 37 weeks following a sweep ( I had an induction planned as she was small) no issues at all though and the sweep induced labour

Good luck Op. I honestly felt so looked after during pregnancy, couldn’t fault the NHS at all. I had the consultant every two weeks, to be honest I can barely remember seeing my midwife - as the majority of appointments were with the consultant

Thanks so much for your responses and reassurance ladies

@Changedmynameagain1 Thank you! I hope now that I've reached out to them things will be better. Still can't believe that first midwife wanted a consultant to see me first at 24 weeks. When did you start having the pessaries?

This is also why the midwife was dismissive of it as she said it's a wrong practice to give patients the stitch preventively and if I want it done I should go back to my own country and get it done there 🙁

I would urge you to put a complaint in about this midwife. The above comment is completely unacceptable and xenophobic. "Go back to your own country" - how dare she!!

Pessaires from memory were 24weeks -34 weeks. The emphasise for my consultant was 34 weeks and all would be good from that point. I think statistically wise 34 weeks is their safe week for early births.

Just picked up on the comments you said the midwife said re go back to your country to get it done..... please raise it with PALS. Totally unacceptable and appalling

(Even though it was last year it’s all merged into one!!)

Thank you @Changedmynameagain1 and @41weekswithno2 I will be the honest-this comment really upset me especially that I'm now a British citizen who pays plenty of tax so it was unacceptable. In the beginning she struggled to find my native language in the drop-down menu and then she said I'll select English as your English is alright 🙄 When I told my OH who is English he was like 🤦🏼‍♂️

I hope she doesn't come across a lady who isn't able to advocate for herself she sounds like a horror

@Worrying2020 I am embarrassed that a midwife behaved like that. Her comments and “advice” about a your situation (well outside the remit of normal midwifery) fall well short of what you should expect. It would be very reasonable to raise a concern, either through PALS or by contacting the head of midwifery at your hospital. It may be that she is like this with many women, but few are able to articulate it in a way that gets heard and can be acted on.
Obviously your main concern is you and your baby, but if you do feel you can find the time and energy to report this, please do.
Wishing you a supported and stress free pregnancy from now on - and a beautiful baby in due course x

@Sussexmidwife thank you so much for your well wishes and your nice message. As you said yourself my baby is the most important thing so I will not do anything at this stage but if it turns out that I do need a stitch after I see a consultant next week I may take an action. My referral from her arrived yesterday and it's for two and a half months from now so yeah if it turns it would have been too late to see a consultant then I would be so upset that she treated me this way (especially considering that when I called ante-natal on Monday and that other midwife I spoke to arranged for me to see a consultant next week without even questioning it when I told her I've had cone biopsy).