Cervix measuring at 2.9cm 20 weeks - should I be worried?

[MintGreenLife]

I’m 20+1 and just had my 20 week scan plus internal to check cervix length. Everything looks perfect with baby so that’s great. Cervix was 2.9cm though, which is a lot shorter than at 18 weeks when it was 3.5cm! I’m waiting to see the midwife now (not sure why as last time I saw consultant about it). Will wait to see what they say, but am quietly panicking as surely that’s a big reduction in length in two weeks?!

Just seen the midwife and it’s actually 2.8cm. Been told they wouldn’t do anything unless it’s 2.5cm or less, but that seems very close 😕

I’m 31 weeks and have never had an internal examination to look at cervix length, is this a regular check?

@Grognonne no it’s not, it’s because I had cervical surgery (LLETZ)

Have they booked you in to scan you again either next week or the week after? I would want scanning weekly for the next few weeks or if ur not happy and wanting a stitch asking to speak to your consultant and requesting a stitch and or progesterone. You have until 24 weeks to have a stitch x

@boymum88 thanks for your reply, think maybe we’ve spoken before! They are going to check again at 22 weeks but don’t have an appointment yet. I think I’ll ask for a telephone appointment with the consultant as not feeling brilliant about waiting another two weeks/ not feeling confident about just leaving it seeing as it shortened by 7mm in two weeks! X

All I would say is push for the care that you feel is right and that ur happy with, it's ur body and baby not theirs. I wouldn't be happy waiting two weeks xx

@boymum88 thanks, I’ll try and sort a call with the consultant x

Welcome, prob suggested it before but if ur on fb join the incompetent cervix uk group and the add on group incompetent cervix uk pregnancy related

@boymum88 thank you xx

Hi Mintgreenlife. I just had to post on here because I'm in pretty much an identical situation although a few weeks ahead.

Cervix measure 2.9 at 18 weeks and then 1.9 at 20 weeks. I had emergency cerclage the following morning (extremely frightened but it was absolutely fine) and started progesterone. I'm 23 weeks today.

Insist on an appointment in a week's time, no longer, if you haven't already.

I am now on self-directed bedrest. The NHS advise against it but everything you read online says do it. Message me if you have any Qs. I know exactly what you mean about 2.9 being a bit close. That's how I felt when mine was 2.9 as the fact was it had decreased.

@Bigbellies thanks so much for your reply - not sure why I didn't see it last night. So sorry to hear this happened to you. This is what I'm worried about - it seems crazy to leave it another two weeks and just see, when it's already shortened 7mm in two weeks. I feel sick thinking about it to be honest.

I'm going to call the hospital today firstly because I'm not currently booked in for a two week follow up and the midwife I saw yesterday said she would call me in the afternoon with an appointment and hasn't, and secondly because I feel like I should really be dealing with the consultant and have a lot of questions and worries. I will suggest a follow up appointment in a week and will see what they say.

I have seen lots of people get put on bedrest. From your research is there anything else you are doing? I think I'll try and take some bedrest this week, maybe in the afternoons to be on the safe side. I was in the middle of decorating the nursery but feel like I should maybe wait and see what the outcome of the next scan is before I resume anything like that xx

@MintGreenLife so couple of thugs, when I was in the waiting week between scans to see if the cervix would shorten again, I stayed in bed. The cervix still shortened, so its definitely not the golden elixir to stop your cervix shortening but I think after the stitch it absolutely helps take the pressure off. I can feel 'more's when I stand and walk. I do the stairs twice a day only, I sit up to eat. I might do 10 minutes of folding clothes and straighten the bed etc. Absolutely no lifting, cleaning or heavy cooking. Just toast and eggs. If you have the stitch get people lined up to help you.

I dont want to scare you but I had a Neo natal death at 23 weeks in 2019. It was my first and so they weren't measuring the cervix. This time round they have been measuring and they caught it, so it seems that is what the problem was. The cervix had started funnelling.

Insist on that appointment and let me know how you get on. Definitely speak to the consultant.

As someone else mentioned, they dont really do the stitch after 24 weeks. You may be ok, it may shorten no more. But if you have had cervical surgery in the past then theres a chance you have an incompetent cervix. The cerclage is absolutely fine. It was my first epidural, bit scary but you really do not feel a thing and afterward I was just achey, not in severe pain.

Let me know how you get on today.

@MintGreenLife started progesterone pessaries. They relax the womb and help prolong the pregnancy but research seems a bit inconclusive. Basically it doesn't hurt to do that as well.

@Bigbellies thanks so much, that's some pretty serious bedrest then! I went up to bed early last night and was propped up on pillows, and realised maybe that's not good enough, but also I know you're not meant to lie on your back in pregnancy, so not really sure what the solution is there?

I'm so sorry for your loss, but am glad you are getting the right care this time around, although it shouldn't have been that way. Initially I wasn't even going to have my cervix length checked, but I pushed for it and am thankful now that I did.

I have managed to find out that I have my next appointment on the 30th, got hold of the consultants secretary too and have emailed her my concerns to be passed on, so hopefully I'll get an email or a phone call today x

@MintGreenLife I lie at around 45 degrees in the day, maybe a bit lower ensuring lower body is as flat as poss, not great for the neck but I'm cushioned and getting used to it, other than that I lie on my sides flat when watching telly and reading.

I think lying totally flat on your back is no/no but I'm slightly propped and that seems to be ok. No dizziness.

Best of luck today.

Oh OP, exact same thing happened to me! Mine was 2.5mm and no one even said a thing, I saw it on my papers after the appointment, googled it (as you do LOL) and called midwife in utter panic! She agreed it was a bit on the low side and called the hospital to arrange a re scan (she had to push for it) but when I went in a week later, it went up to normal measurements. The US lady said that as it's a muscle, it can shorten and lengthen from time to time plus there are a few ways of measuring it and it's not always 100% accurate. They offered me another checkup too and by that time it was even longer so I just put it at the back of my mind... Good luck to you

Just remembered, it did say "no funnelling" which is why they weren't concerned apparently. And cervix wasn't funnelling at the first and second rescan either. Does your US paper say anything about that at all?

Just be careful with full bed rest it is not recommend due to the risk of dvt and is not proven to help. If you do full bed rest then have a conversation with ur dr so they can look at ted stocking and even blood thinners.

Most drs will say once you have the stitch placed is to go back to light duty's or sofa surfing.
I'm sofa surfing, so spend most of the day on the sofa, still get up to cook and bit of light cleaning and clothes washing and try to go for a short walk 3 times a week and look after my ds when he's not at nursery.

If u don't have any luck with ur local hospital today, maybe reach out to one of the ic specialist doctors, one is in Leeds one is in London. Lady's go to them from all over the uk

@Bigbellies I'm a freelancer and work from home, so working from my bed laying at 45 degrees would probably be doable! Thanks so much for all your help so far.

@eensyweensySpider thanks so much for sharing your experience. It's frightening isn't it! I didn't expect it at all after getting such a good measurement first time around. I'm holding onto hope that something similar will happen to me. The sonographer did say something I didn't understand - 'this part is contracting, so I won't measure that' - she showed me on the screen and I saw her actively not measuring a section, but whether that was my cervix or my uterus I don't know. I wish I asked now, as am wondering if perhaps the reason why it's so much shorter than last time is that part of the cervix has been disregarded and not measured. I've asked the consultant what this could mean. I'm left feeling quite confused about it all, so hope I get some answers soon.

I'm not sure why but I'm not given any scan reports - everything is online with my trust and they don't even upload the reports there. I was told no funnelling and that everything is tightly closed, so fingers crossed those are good signs.

@boymum88 thanks so much for your opinion/experience. I will certainly ask the consultant if bedrest is a good idea. I have been worrying about ending up doing no exercise at all, as would be good to be able to take the dog out a few times a week.

Feeling a bit better being able to speak to you all and get good advice. At least I am being proactive. Will see what the consultant says today, and will just have to try and keep in my mind that the measurement could easily be higher again next time. It's so hard not to worry though! xx

[quote MintGreenLife]@Bigbellies I'm a freelancer and work from home, so working from my bed laying at 45 degrees would probably be doable! Thanks so much for all your help so far.

@eensyweensySpider thanks so much for sharing your experience. It's frightening isn't it! I didn't expect it at all after getting such a good measurement first time around. I'm holding onto hope that something similar will happen to me. The sonographer did say something I didn't understand - 'this part is contracting, so I won't measure that' - she showed me on the screen and I saw her actively not measuring a section, but whether that was my cervix or my uterus I don't know. I wish I asked now, as am wondering if perhaps the reason why it's so much shorter than last time is that part of the cervix has been disregarded and not measured. I've asked the consultant what this could mean. I'm left feeling quite confused about it all, so hope I get some answers soon.

I'm not sure why but I'm not given any scan reports - everything is online with my trust and they don't even upload the reports there. I was told no funnelling and that everything is tightly closed, so fingers crossed those are good signs.

@boymum88 thanks so much for your opinion/experience. I will certainly ask the consultant if bedrest is a good idea. I have been worrying about ending up doing no exercise at all, as would be good to be able to take the dog out a few times a week.

Feeling a bit better being able to speak to you all and get good advice. At least I am being proactive. Will see what the consultant says today, and will just have to try and keep in my mind that the measurement could easily be higher again next time. It's so hard not to worry though! xx[/quote]
I had the contraction bit too OP! I obsessed over it, thinking I'm contracting with a short cervix... I can think about it a bit lighthearted now but at the time it was bloody scary!! At my rescan, they said the contractions were normal, they happen throughout the pregnancy but we just don't feel them. Also, she did measure my cervix at 2 parts and added the numbers up!! Just try and focus on the no funnelling and closed cervix parts for now

@eensyweensySpider I feel like that comment about my cervix contracting was so casually put out there, and then I've been left with no clue what that even means and if it's OK! I really hope that the fact it was contracting at that moment in time is why it was measuring short, especially as by what she said it sounds like she decided not to include the contracting part in the measurements, but who knows?! You're right, I'll try my best to focus on the positives for now, worrying isn't going to help. I felt so sad yesterday as felt the cervix measurement completely overshadowed the fact that our baby boy was looking perfectly healthy and normal at the 20 week scan x

I had a previous pre term birth/loss at 23 weeks and so was under the care of the pre term birth unit for next pregnancy (which resulted in my beautiful daughter).

If you are concerned, it might be worth asking if you can have a fetal fibronectin swab.

The details of this combined with e.g. cervix length / gestation etc give a good indication of if you are likely to go into labour in the next 1/2/4 weeks / preterm.

Thank you @Bumbers I will look that up and will ask my consultant about it. I'm so sorry for your loss and thank you for sharing your experience x

@MintGreenLife Just checking in to see if all is well

@eensyweensySpider thanks so much for checking in, very good timing actually as I've just had a call from the consultant. I'm so glad I pushed for a second opinion as he wants to get me started on progesterone pessaries. I had convinced myself that maybe my cervix hadn't shortened and was in fact just measured during a contraction making it look shorter, but he said it wouldn't have been measured during a contraction and that what the sonographer said to me actually meant she was waiting for the contraction to pass.

I feel upset really, I didn't expect this to actually be an issue that I would need help with. I'm so glad I'll be getting something that may help improve the situation, but in the back of my mind I can't help but worry that it might not help and then what xx