Weak cervix / progesterone pessaries??

[KateQPR]

Hello!

I'm new here! I'm 17 weeks pregnant, and after two LLETZ procedures on my cervix in the last 10 years, my docs are scanning me every two weeks to keep an eye on my cervical length. Meanwhile, i'm so paranoid i'll lose the baby, i'm having private scans inbetween too, so one every week.

So far my cervix has gone from 3.7cm at 12 and 14 weeks to 3.4 at my last scan, so i'm now starting to worry it's starting to weaken. My doc has said i can have a stitch, but that it does comes with risks of m/c, especially the later you do it. Also there's a change my cervix is just fine!

I've also heard that some women are being given progesterone pessaries now in mid pregnancy to help strengthen the cervix, rather than the stitch. And apparently early tests show it's as effective but less risky than the stitch.

Just wondered if anyone had any thoughts or info on any of this? I'm really struggling to enjoy this pregnancy as i'm so worried about the outcome and my choices. I'm going to see a private consultant next week to get a second opinion and hopefully put my mind at rest. But other women's experiences and views really help. Also i figure the more i know about my possible choices of treatment the better.

Sorry for such a long post......phew!

Kate

Hi Kate, and sorry nyou're having such a worrying time of it. I've had the same history as you two LLETZ (past 10 years) and was monitored at my request during my last pregnancy. It was my paranoia that made me request scans (from 20 weeks onwards)but they gave in in the end and monitored me for cervbical length. All was fine .
I've subsequently leant that cervical incompetence from LLETZ, D&C etc is incredibly rare. In the past the cold cutting method was linked to problmes, as was the cone biopsies, but now techniques have improved so much that cervical incomptentce following a LLETZ, even multiple ones, is very rare (so says my Consultant). I've just started ttc after mmc in July, and am myself a bit paranoid about weak cervix etc esp after subsequent D&C on top of everything, but am encouraged by the litertaure on LLETZ. Remeber, cervical incompetence is very rare, and there's no proven link to it follwing LLETZ. Hope this helps!

On and welcome to mumsnet

Thanks Diege,

It's good to hear reassuring words! Sometimes i get myself so worried i convince myself this pregnancy isn't going to end happily. How sad is that?

I think once i've seen both my NHS doc and private consultant this week i'll hopefully feel a bit more confident and reassured. Fingers crossed i have the same good experience as you.

What level CIN did you have, if you don't mind me asking? I had level 2/3, and then level 1. I guess that might make a difference because it depends how much they have to take away?

Anyway, glad your experience was a positive one.

Kate

How strange I had same as you, CIN 2/3 in then CIN 1!! The first was pretty straight forward, but with the CIN1 (from smear) they couldn't see any abnormal cells on the colposcopy, so advocated doing a cone biopsy as they thought it was higher up the cervix beyond the transformation zone (unusal, but it happens). In the end the head consultant thought a cone was too radical, and downgraded to a generous LLETZ. Ironically, the actual biopsy came back clear, so not really sure if the smear was overread or it just corrected itself . Regardless, had the two procedures and all has been fine since - normal smears (yearly) plus normal pregnancies (I have 3 dds, two after 1st LLETZ, third after second .
Oh meant to say before that the midwife told me that they find that women who have had LLETZ often take longer for their cervix to dilate ironically because of the scar tissue?
I'm sure your consultants will put your mind at rest, though if you're anything like me the relief lasts for about 10 mins then it's onto the usual anxiety again

Hi Kate, I haven't had any of those procedures but I have a stitch which was put in at 21 weeks in this pregnancy. I was having cervical scans in this pg as I lost my DD last year at 20 weeks with no contractions etc. I began funneling at 20/21 weeks. I was so scared of having the stitch but I am now 32 weeks and hoping it will let me go to term. I have had normal term births before my loss but have had alot of m/c and d and c s and instrumental deliveries which maybe weakened my cervix. Hope all goes OK with your pregnancy and appointments xxxx

I had my son at 31w5d and was put on the pessaries at 23w with DS2. I've got no reason at all to have a weak cervix and mine was 30mm at 18w so you're doing really well! When are you due?

Hi, I had cancerous cells about 5 years ago, past CN3, so has 3 LLETZ and a cone biopsy over 12 months - am now 21 weeks pregnant with a cervix that keeps changing. Was down to 14mm, but is now about 31mm - consultant is not sure how but does say that it is never static through pregnancy so don't worry too much! I'm sure 3mm change in your case could just be normal - you are certainly longer than I have ever been and no-one is recommending at stitch for me.
Advice given to me is that if it is over 15mm is fine, below that is 'short' - so on that advice you should be fine (although of course it is an individual thing), apparently 34mm is right in the healthy area and what you would expect from someone who had never had any cervical interference. Having a stitch can be more dangerous, especially if your cervix is normal now - I certainly would be cautious, and am doing what I can to avoid that.
My consultant has also said that LLETZ and cone biopsy don't have a huge risk of miscarriage/prem labour as they are minor treatments - especially if you have a good cervical length which you do.
I am in my first pregnancy too, and was really concerned at 16weeks when I was told it was 14mm, however I am now feeling better about it and trying to enjoy being pregnant too.
Good luck and try to be positive

Hi, I have been searching for the right place to post my question, I have had CN1 for the past two years and have had 3 biopsies, one only 4 months before I fell pg (now 13 weeks) I am seeing a consultant tomorrow re possiblility of an incompetent cervix but also have an appointment at the colposcopy clinic on Monday. Will they want to do another biopsy?? I'm not sure I want them to?

Hi Bella

Don't have direct experience of this but do have cervical issues and so have a stitch in this pregnancy. There are a group of us currently pregnant, some of whom are pregnant after cervical surgery so do join us
here if you want. Treatment for cervical issues can vary a lot so it's a good place to find out about what questions to ask.

Lizzytee thank you! I shall pop over if I have any questions. Thanks again!!

has any one been on the pessaries having bee told thir cervix is weak instead of opting for the cervical stitch.

HI

I am currently taking pessaries due to having a 'short cervix'. My last pregnancy I was told that my cervix was weak and therefore had a stich. Thankfully I managed to carry to 29 weeks (membranes went at 28 weeks) and have a lovely 5 year old son.

This time round they wouldn't put a stitch in as they reckoned there was a danger that I could rip my cervix as it wasn't weak after all, just short.

Therefore I am 20 weeks pregnant and have been taking the pessaries now for 4 weeks twice daily. Am dubious to the outcome of the pessaries. Would have rather had choice of having the stich again.

Julie