Cervical length check

[Lithgow2000]

Hi everyone

I've read up alot about cervical length checks after LLETZ and as I expected, when I went to my booking in appointment this week, the midwife mentioned i'd need a scan done.

What i didn't expect is the fact that this is going to be done alongside my 20 week scan. I've read alot online where people are having it done around 14-16 weeks and even having stitches put in at that point.

If you've had to have this done. What week were you? I'm just a bit nervous 20 weeks could be too late.

Thanks in advance x

Do you have any of the notes from your LLETZ? It may well be that the notes say they only removed a small bit and therefore the check at 20 weeks is a ‘just in case’ rather than ‘we’re concerned’.

I had a LLETZ in 2017 and was pregnant with DD in 2020. Midwife ran my LLETZ notes past a consultant who said he was satisfied from the notes that it had been a small amount so I didn’t need a separate check before 20 weeks. So as you have they combined them. Based on the measurement they were happy to proceed without a stitch and DD arrived 4 days overdue. When I was pregnant with DS in 2021 they just asked if I’d made it to term with DD and didn’t bother measuring again.

Hopefully it’s a sign they’re not concerned rather than them doing it late to save on appointments! I was at the same hospital for my LLETZ as for my pregnancy with DD so I think that helped with the notes being shared.

I remember when I was having the LLETZ I was super concerned about future pregnancy but it all went well for me so please don’t think that it’s inevitably a problem - remember most people who don’t experience a problem don’t post online about not having had a problem! Good luck :)

Thank you so much for your response. It's so great to heat positive stories.

I requested my medical records so i'd have an idea myself but there's no mention of the amount taken, only that there were some cin2 & cin1. It was only the midwife who told me it would be 20 weeks so I haven't spoken to a consultant or anything yet. The internet has so many scary stories doesn't it :(

Oh god it really does. Trust me I had a really low period when I had the LLETZ, I had CIN2 and we were engaged and I knew we’d be trying for a baby within a few years and I convinced myself there was going to be a problem. But I can honestly say I know of 4 women not including me who have had a LLETZ and all of us have had successful pregnancies - I don’t know the ins and outs for a couple of them but all announced pregnancies have resulted in healthy babies so please don’t assume a LLETZ is bad news, there are tonnes of us out there!

Useful that you have your notes, I wonder if maybe there’s a policy of only reporting amount taken if it’s significant enough to warrant concern in the future? I’m sure all hospitals have a different arrangements. How long ago was your LLETZ and was it at the same hospital you’re booked in at for baby? If recent maybe you could contact the department for some reassurance?

Also just as a reassurance, if this was your booking in appt then I’m guessing your first trimester. While the worry never really goes away I was so anxious during the first 12 weeks, when you don’t look pregnant (or if you’re lucky with morning sickness, don’t feel pregnant!) it’s easy to obsess about all the ways it can go wrong. Hopefully the worries will start to ease as pregnancy progresses but do remember it’s so normal to worry about stuff like this and going down an internet rabbit hole/Dr Google really doesn’t help! Sorry, I know that probably sounds so patronising (and hypocritical, all I did was Google, especially with baby 1!) but honestly, once you’ve got the essential info from trusted sources eg NHS or relevant charities, try and close the websites if you possibly can!

You are so kind, it means so much that you've taken so much time to explain and reassure me.

I had the lletz done in 2011 so a long time ago when i was very young. I think this is why i'm a bit more anxious now because i burshed it off at the time having no interest in having a baby 😂

It's at a different hospital but under the same board. I've been assigned a consultant and i suppose maybe they can check? I would go private if 20 weeks isn't suitable. I just have a bad feeling about it in my gut that i can't shake off.

I had lletz in 2010 and gave birth the first day of 2020
I can't even remember my lletz being mentioned . Just presumed as it was so long ago it wasn't relevant but I'm not sure
Anyway I had no issues
Unfortunately being pregnant triggered the hpv again and now I have precancerous cells again . Yay .

Sorry to hear that. Isn't being a woman so much fun 😂

I think you're offered a check as standard now. As my lletz was 12 years ago and they still want to check. Nice to hear some non horror stories 😊

i was prescribed progesterone pessaries from about 16 weeks as cervical length shortened. the last week they can do a stitch is around 20 weeks so depends on what you and the consultant decide.

also depends on how much cervix length they take away during lletz procedure. i was on pessaries and went into labour 6 weeks early so make sure your booking midwife refers you to the appropriate clinic because you will definately need to be monitored

Thank you. I didn't get to decide anything, i was just told it would be at 20 weeks by the midwife. Did the consultant contact you after your booking appointment?

They have recently changed the rules on lletz and scans - so they are more cautious than they were a few years ago.

6 years ago I didn’t need a scan with dd1 and this pregnancy I fell in to the “needing a scan” category. They need to do it before 24 weeks so 20 should be fine. The internet is full of horror stories but try not to worry too much.

Thank you so much!

That’s ok, I’m sure it’s fine for the majority of women, just you don’t hear about that, only the horror stories. Good luck.

I’ve never had a LLETZ so my experience is slightly different but I had cervical length scans due to having a septate uterus. With DC1 I had scans at 16, 20 and 24 weeks. With DC2 I had scans at 16 and 20 weeks and was told as my cervix was okay I didn’t need a further scan at 24 weeks.

DC1 was born full term but DC2 was born 4 weeks early but I don’t think that was due to a cervix issue.

I had my scans exactly the same as yours at 20 weeks. They gave me progesterone pessaries and monitored for another week, but my cervix shortened and I had the stitch at 22/23 weeks. All fine and DS was born at 38 weeks. However, most people who've had lletz won't need a stitch anyway! Either way you'll be ok.

I can't comment about LLETZ, however I have an unusually short cervical length. No surgery or any other reason anyone could identify.

I had no idea this was the case until it was picked up at my 20 week scan (actually done closer to 24 weeks) where essentially it was already very, very short. DD1 was born at 27+5.

The standard scan wouldn't have shown anything, it was a transvaginal scan that at the time they were doing as part of a study.

With my second pregnancy i was under a consultant - but one I sought out at one of the teaching hospitals. I was terrified of having another prem baby or late second trimester loss.

So I would say: if you're concerned look to talk to a senior obstetrician early in pregnancy or before TTC to discuss your history and your concerns. You might need to go private for this. (I basically found the specialist for my particular issue, got through to their PA at their NHS trust and asked for a private appointment which wasn't very orthodox.

Definitely try and get your notes or write down as much detail as you recall, your GP may have info on file as they will usually receive letters/notes that you may never see.

People have mentioned stitches, so with the caveat that DD1 is nearly 18 and DD2 14...the info I got was:

• most evidence is that stitches placed early are more effective- with DD2 I had one at ?12 weeks ie post nuchal fold scan and when the risk of early miscarriage has reduced
• a PP has said 'go private' - basically you cannot get high risk pregnancy and obstetric treatment outside the NHS. You might see a consultant obstetrician privately to discuss options but treatment will always be within the NHS because that is where 24 hour care exists.
• if the pre TTC or early pregnancy indications are that you might need more monitoring, you are welcome to DM me
• and as others above have said, it may well be the case that you have a straightforward full term pregnancy.

This is perfect thank you! I'm just worried something can go wrong before 20 weeks but it sounds like it's an ok time to check x

Thank you. Too late to have ttc conversations unfortunately as I'm nearly 11 weeks. I did request my notes but they're very vague and only say there was cin2 and cin1 present.

I just don't want to wait until 20 weeks if theres a risk before then

Oh and regarding outcomes - DD1 (my premmie who spent the first 56 days of her life in hospital) is nearly 18 and doing her A levels.

DD2 was born at 38 weeks, about 36 hours after the stitch I'd had was removed. My big pink baby who I took home in my arms when she was 2 days old. I had 3 admissions and 22 antenatal appointments in that pregnancy for scans and checkups so to say the NHS looked after us is an understatement.

Great outcomes but I wouldn't wish the prem baby experience on anyone.

So pleased to hear you had good outcomes. DD1 was born at 39 weeks and DD2 was born at 35 weeks and luckily needed no intervention but the risk of having an even earlier baby is putting me off DC3 in the future.

@Lithgow2000 congratulations and apologies for not RTFT properly. I think in that case perhaps ask to have a transvaginal scan to allay concerns. I personally regret the fact I had my 20 week scan so late but the reality is that it likely made no difference.
Plus the study I was in indicated that while cervical length at 20 weeks correlates with early delivery outcomes vary a lot and no-one understood why. But hey, DD1 and I are immortalised in a table in a paper publised in the New England Journal of Medicine

So glad everything worked out ok ❤️

I will be having a scan, but it's at 20 weeks and i don't have a choice in that. It's late miscarriage that worries me rather than early labour, as I know it will have been picked up by then

Honestly I would ask to check. I had a LLETZ in 2015 and have had scans with DC 2 & 3. Both starting from 16 weeks. It’s not just checking the length of the cervix but also comparing multiple results and seeing if there is any shortening between scans. So you should definitely be having one before 20 weeks.

My hospital wouldn't scan me until 20 weeks. I went private in the end and good job I did because my cervix was only 13mm long and I needed an emergency stitch :(

Push for the scan! I only had 1 previous lletz.

I was 15 weeks when NHS finally saw me for a cervical scan.
I couldn't wait that long though so I went for a private cervical scan at 13 weeks before that and my cervix was already short and in need of intervention.
I managed my situation with progesterone though and that stabled it x