LLETZ and cervical stitch

[Jcol28]

Hi everyone, just looking for similar stories really.

I had an LLETZ procedure in March this year for CIN 1. They removed all problematic cells and margins were clear, so that’s great. They removed a depth of 1.5cm - which was more than I was expecting for CIN1. I was only made aware of the depth they took at 15 weeks pregnant.

I’m now 16 weeks pregnant and under surveillance for the length of my cervix due to having had this procedure. Currently the length of my cervix is 29mm, I am being reviewed every 2 weeks up until week 24 and I believe the threshold for having to have a stitch during this period of surveillance is 25mm.

My husband and I weren’t anticipating any of this. This surveillance period had not been mentioned to us until this week. We had planned a trip away in early October which is looking unlikely now whilst I’m being monitored.

Wanting to hear from anyone who’s had the stitch. When did they put it in for you (I.e. what week and how long was your cervix when they put it in) feeling a bit anxious about the ‘let’s wait and see’ of it all. Can you elect to get a stitch if you’re worried about pre-term labour?

Hi I haven't had the stitch but they wanted to do the wait and see approach with me.
I can't imagine it will take that long to go from 2.9 to 2.5cm (2.5 is when they act and put a stitch in) So I am surprised they are going to wait and see at quite a short cervical length already.
Can you ask again or ask for a second opinion?
I am worried for you that it can shorten quickly..
Can you ask for progesterone pessarys?
While they were monitoring me with with wait and see approach I was given the pessarys, and they worked absolute miracle for me and I didn't need the stitch. Currently nearly 29 weeks and progesterone is keeping everything stable. (Shortening to 1.7cm in my previous pregnancy at 22 weeks)

Thanks for the reply @Lillybobs86! I read about the pessaries but so far haven’t been offered them/haven’t even had them mentioned to me.

Yes that’s my concern exactly, I’m already at 29mm and I’ve got 8 weeks to try and not dip to 25mm - it feels very unlikely to me, especially as more weight is sitting on the cervix.

I’ve got a couple of midwife appointments next week (not with the consultant) but I’ll ask there and let them know that I’m anxious about this.

I carried fine in my previous pregnancy and ended up having to get induced at 40+7. I have no idea how long my cervix was last time as it didn’t require monitoring. But everything I’ve read so far indicates 29mm is pretty short for this point in the pregnancy.

Do you mind me asking whether there had been any monitoring in your previous pregnancy?

I had 1.5cm removed during a LLETZ procedure. I’ve since had 2 pregnancies, (also had one pregnancy before the LLETZ) both of which had cervical scans from 16 weeks. You really don’t need to panic. It’s actually a lot more common than you’d think, most women don’t actually need to have the stitch. My last pregnancy I went until 40+2. My current pregnancy my cervix actually lengthened between scans and I’m now almost 35 weeks.

I had my stitch put in at 14mm at I think week 22/23 after being scanned at week 21. They did try the pessaries for a week but it shortened further during that time. We had to change a holiday abroad for a UK one just in case so I feel the frustration but the risk wasn't worth it.

My stitch came out at week 36, waters broke exactly a week later so I think it did the job! Both DS and I were totally fine. I think once you're being monitored you're ok, once they decided I needed a stitch they moved very quickly and I was in for it the next day.

You might be ok.

I had 1.7cm of cervix removed with lletz and had my cervical length scan at 24 weeks - it was still 5.5cm. I appreciate I may have a long cervix but I don’t think it shortens that quickly.

@Jcol28 sorry to ask as it's not about pregnancy but was there a reason they treated you for CIN1?
I thought they left CIN1 unless it escalated to CIN2 ?

No monitoring at all in my previous pregnancy even though I had weekly scans (private abroad ) not sure if they didn't see cervix on abdominal scan or if it looked normal each week prior to 22 weeks. I will never know.
This time I'm back in the uk and they are fully aware of my history and I had to wait a long time see a consultant. No one offered me progesterone and I even asked the general labour ward for it while I wait to meet the pre term consultant regarding possible stitch in this pregnancy and no one gave it to me.
I had read so many positive stories about it and learnt about it online that I was determined and took it upon myself to get it, I called my gp to convince him who immediately gave it to me once I explained my history.
I started taking it straight away and it's been a miracle worker.
Once I met the pre term consultant she was happy I was on it and the progress and she agreed I should continue it.
Try to see if they will give it to you or even ask your gp - I learnt that no one feels the fear that we do it and seem to take the very laid back approach which is extremely risky 🤦🏽‍♀️

I had LLETZ followed by a cone biopsy. Monitored every 2 weeks and, like a previous poster, my cervix lengthened. Same for second pregnancy. Don't panic (easier said than done, I know), not everyone needs a stitch.

@solice84 I was monitored for it for a year but then a story close to home made me not inclined to wait and see. I said to the consultant that I wasn’t comfortable with waiting to see if it progresses as I have a young son and also wanted to have more children. I would rather nip it in the bud. At that appointment the consultant looked at my cervix and saw it had now spread to three quadrants and agreed LLETZ was the appropriate action to take.

Thanks everyone for the reassuring stories! Hopefully it does lengthen 🤞🏻I’ll still ask about the pessaries as I see no harm and I’ve heard good things. I’ve got a GP appointment next week so I’ll bring it up there.

Yeah I think a UK trip is on the cards if I continue to be monitored after the next appointment, frustrating but that’s life and this is obviously far more important!

Hello. I had 1 lletz last year and 12mm removed. I didn't think it would cause a problem but on Monday my scan revealed my cervix had shortened to 1.3cm! I had an emergency stitch put in within hours and antibiotics.

On my 18 week scan it was 5cm so things changed within 2 weeks. Keep going for those scans!!!!

Let me know how you get on. I'm a similar gestation (20+5) so here if you need to talk x

@himlah oh wow! Such a change in such a short space of time. Yes will definitely keep going for the scans. I’ll reach back out here after my next one!

Hey everyone - said I’d provide an update so I am! Had my monitoring scan today and my cervix has shortened by 11mm so they are now putting in the stitch today! I’m 18mm at 18 weeks.

A lady opposite me in hospital had an LLETZ in November (15mm taken as well) and her cervix went from 30mm, to 24mm to 18mm in 3 weeks. She’s currently 19 weeks pregnant.

Sharing for anyone who might find this information useful who’s had an LLETZ and looking to conceive or in the early stages of pregnancy - try and find out how much was taken from your cervix as early as you can.

Hope you are okay and your procedure goes well, it's over very quickly! I am 2 weeks post my stitch today and feeling really anxious so hear to talk throughout our journeys if you need somebody :-)

It seems it's more common than we are told. My consultant told me 'you won't have any issues if you had under 15mm removed', yet here I am with hardly any cervix length.

I think they should scan all women who have had a lletz, regardless of how much was taken. X

@himlah all done last night and waiting to go home today. It went well - but the consultant said we caught it at the right time and the stitch was definitely needed in my case. Had to do a bit of ‘tugging’ to stitch enough in place. So now it’s rest until 34 weeks which is a long way to go!

Very relieved it got out it when it did and hoping it will hold out from here forward! Been given the pessaries now too in order to keep it closed up.

It is very anxiety inducing, feel free to private message or keep checking in here as the weeks go on!

The thing with the cervix is that some women can have a short cervix and it be fine, and for some it means that the cervix is weaker and impact pregnancy. They often want to monitor because the stitch comes with its own risks.

There is a really good Facebook group - Incompetent cervix UK and there is a pregnancy related group as well. I didn't have LLETZ but had a stitch at 15 weeks with 20mm of cervix.

@Jcol28 this sounds just like my case. The consultant said the same to me as well. I'm so pleased they were able to do it for you.

Yes I'm on 400mg of cyclogest twice a day. I agree with the other comment about joining the Facebook group, it's very useful.

Will you have any extra checks now or just told you to rest up until 34 weeks?

Glad they caught it just in time and you managed to get the stitch.
Rest up - I did bed rest with my first pregnancy from 22 weeks to 37 with Araban pessary as I was too late for stitch, bed rest was difficult but you'll be fine and it will go quick.
I'm pregnancy with my second and take 400 progesterone a day as well and it's worked a miracle, I strongly advise inserting rectally though I had nothing but infections and thrush when took vaginally as the progesterone can do more harm than good when the pessary dissolves and irritates the cervix.
Your body absorbs the progesterone the same way and works in same way I'm 31 weeks now without a stitch and so grateful to progesterone x

Hi all, apologies to jump on an old thread, hopefully some of you are still around to answer!
I had LLETZ back in January this year and had some of my cervix removed, no idea how much as I wasn’t told.
I am now pregnant with my first and my midwife said I should expect for my cervix to be measured between 16-20 weeks. I have received my letter and they are going to measure me at my 20 week scan and not before- should I push to have this earlier?
a lot of what I’ve read, most seem to have the measure before 20 weeks, I may be just being over cautious as it’s my first…. What do you think?
many thanks 🤍

@eed32 please push for earlier. I kept being told I was not at risk but went private in the end and did not have much cervix left. I was so angry at the nhs for dismissing my concerns.

Thank you! I am seeing my midwife on Thursday, I will push to be seen earlier. I was surprised when I was told I wouldn’t be seen until 20 weeks

@eed32 I wouldn't even wait till Thursday - the likely hood they will have appointments available is slim.
I would go ahead and book privately for peace of mind - that's what I did many times x

@Jcol28 hi! I know this is an old post but wondering how everything went? I have had a lletz for CIN1/CIN2 but not had anything about getting my cervix measured

Hiya! know you’ve pointed your message at someone else but just thought I’d say my progress. I had CIN2 this January and had some of my cervix removed (minimal), got pregnant in June, where I live they now only check the cervix at 20 weeks, I didn’t want to wait as is my first pregnancy, so paid private to get checked, all fine and was at 20 weeks too, didn’t need stitch, now currently 34+1 and all still fine 😀

@eed32 oh that’s good! I think from memory it was also minimal for me but I just wanted to be safe. I’ve asked my midwife who will check so hopefully will hear back next week! I’m classed as intermediate risk of preterm so in the middle I guess. Thank you for sharing!