20 weeks and cervix is already shortening

Per some of your guys advice I did go back into the doc. I saw MY doctor that day and she said that anything under a three is considered not good (cervical length) So she decided to refer me to an high risk OB. She thought I went into preterm labor before because of the weight from the twins but now she thinks I have an incompent cervix. I asked of she could check my cervix again and she said she would make me an appointment for it. So hopefully I will get in today if only for piece of mind. With the twins I had no idea I was even contracting and by then it was too late to even do anything. Does anyone know what the high risk OB will want to do? I'm hoping for a cerclage. Do those work?

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I think it may be too late for a cerclage. Anyone on here correct me if I am wrong, but I think they have to be put in between 12-16 weeks. Perhaps they can do it now, my high risk OB said she'd place on at 12 weeks, to be on the safe side. I know some women get emergency ones placed later into the pregnancy, but I believe the risk is high. Bedrest may be your best option, are you getting 17P shots? I am sure there is much more experience that I have on this board regarding cerclages. At 26 weeks, I asked and it was too late at that point, so hopefully it's not too late for you. I am sorry you are going through this again, once is enough and I hope and pray your little one cooks the full 40 weeks! Best wishes! Good luck and keep us all posted.

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My incompetent doctor finally transferred me to a high risk ob when my cervix started changing..she said I think they will give you a cerclage and put you on bed rest. I was in for a shock..I was mad at the high risk doc because he told me it was too late to put on in, and he didn't feel a cerclage was useful. They do more harm than good he said..it was bedrest for me. Lots of strict bedrest..I can now see why he didn't want a cerclage, just from all I have learned since then..but bed rest got me to 35wks..i hope you can get the high risk doc, and bed rest is very difficult-i had to use bedpans for quite a while-but well worth it in the end if you can buy more time for your baby.

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I would say it depends, sometimes placing a salvage (rescue) cerclage is worth a try. I had my first cerclage placed at 11 weeks, it tore through and I was dialated a little (1 cm) and had a bulging bag at 22 weeks, we were given three choices:

1) Do nothing, chances of delivery within the next few days was high, or

2) Place a rescue cerclage in hopes of buying more time. Biggest risk was infection and rupture, or

3) Deliver twin A (that had already passed away) and hope that cervix would close and I could continue to carry twin B. Chances of throwing me into full-blow labor resulting in both being delivered was very high (I think they threw out 90% chance they would have to deliver both babies)

After discussions and asking the MFM's what they would do if it was their daughter facing this choice, we chose 2) and successfully placed another cerclage the next day. Amnotic sac was back in uterus.

It bought me 2 1/2 more weeks, making it to viability. The second cerclage tore through again, preterm labor kicked in and twin B's water broke, we delivered at 24 wks 4 days. This is why I subsequently had a transabdominal cerclage placed.

I think a rescue cerclage is really a very last ditch effort, my doctors thought I was going to deliver at 22 weeks so it was worth a try.

I woulnd't think a doc would place a cerclage at 20 weeks with measurable cervix left, too risky. But, with your cervix being around 3, maybe it is worth a shot? Just my thought!

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i was diagnosed with a short cervix at 19 weeks (1 cm). i was put on strict bedrest and monitored once a week. my cervix fluctated between 1-2 cm and at 22 and a half weeks it went down to .7 cm. i also had funneling and a positive ffn test at that point. it was then that my doctor felt that the benefits of the cerclage outweighed the risks. i had the cerclage placed a week and a half ago. one week after the placement, my cervix is back up to 2.5 cm.....still on strict bedrest though. i think each pregnancy is different but i don't think without the ceclage i would still be hanging on. make sure to ask questions and stay proactive in your treatment. good luck!!

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Thanks everyone for your advice! I went back into the doctor Friday and it went from the 2.8 to 3.3 so I was excited to see that. My doctor is referring to the high risk OB now and I should get in sometime early this week. My doctor said to just take it easy right now and no heavy lifting.
I pray that you make it all the way Baby Clemintine! Sorry for your loss Elizabean. I lost a twin son also but was able to love him for 15 days. I don't know which would be harder... losing a baby without ever really meeting him/her or meeting the baby, only to have them taken away. I guess both would be just as hard but for different reasons.

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Momof26weeker, I am not on P17 shots but I am hoping that is something the high risk doctors will want to do. Don't those make your cervix thicker? Are there any side effects from them?
Irishflame13, I was in the hospital on bedrest with my last pregnancy and no, it is no fun :) but I knew I was doing it for the babies and was able to make it five more weeks. If I am put on bedrest, I am hoping that it is at least at home and not in the hospital.

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Proudmom88,

A bit of clarification on the 17P (alphahydroxy progesterone caproate), they do not thicken or lengthen the cervix. In fact, it doesn't affect the cervix at all but rather it is a protocol intended to calm an irritated uterus. Most docs don't prescribe this unless you have a history of pre-term labor (either in conjunction with cervical incontinence or not).

The nice part of being on this shot for 16 weeks (generally weeks 16 - 32) is that there is no down side (other than an actual pain in the bum). The progesterone only bolsters a pregnancy.

As for emergency cerclages... Elizabean (my ol' friend) is exactly correct, for some, an emergency vaginal cerclage works, for others it doesn't. Each case is individual. As for whether or not to get a cerclage if it is offered... that is an entirely individual question too. My decision making process was similar to Elizabean's, I asked myself "How will I live with myself if I didn't try every last thing in my power to save my baby's life? For me, that was what made the difference.

Good luck. I start my pregnancies with a cervix of 2.9 cm, and I made it to 28 weeks with my singleton prior to having my Transabdominal Cerclage. She is now 7 1/2 years old.

Lisa
Mom to 5 girls
1 with wings, 1 on wheels, twinkies and finally a full-termer!

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It's great to see you taking charge of your pregnancy and asking questions! There's info here on normal cervix length, and short cervix length as a predictor of preterm birth: http://bit.ly/3pUySU

You're doing the right thing by seeing a high risk OB and keeping an eye on things. From 20 weeks to 24 weeks, I went from above 3cm to 1.5 cm.

BUT, with bedrest, 17P shots and anti-contraction meds, I made it to 39 weeks. Be safe! I wish you the best!

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I had a rescue cerclage placed at 20 weeks,so it is possible,the risks are very high for rupture of membranes and infection,however if you are funneling or dialating and have nothing to lose like me then go for it!I made it to 27 weeks,with 7 weeks of bedrest after cerclage (4 on hospital bedrest)and several before.without it my daughter would have died

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Please don't HOPE for a cerclage!! DEMAND one!! If he refuses then find someone who will do it!! Read my story & you'll know why. I would have 2 little boys right now if I didn't listen to the high risk Dr. who said that they would "watch me". Watching me wasn't good enough!!

Good luck & God bless!

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Proudmom - I'm so happy to hear you are being referred to a high risk doc, please let us know how it goes. And yeah to a longer length last measurement! I'm sorry about losing your twin son too. I think any loss is hard, I wish I was able to meet Carter's twin, prior to getting pregnant with the twins I lost a singleton to IC. I was able to hold her and say goodbye. I think I had a much harder time grieving Carter's twin without being able to meet her and say goodbye. No mom should have to suffer losing a child, it's terrible.

Lisa, hello ol' abbylooper friend! Congrats on a full-term baby girl! She's beautiful, I'm so happy for you. Your husband is very outnumbered now! Good to hear from you!

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I was told my perinologist that progesterone suppositories may work wonder for short cervix along with bed rest.

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I also had a shortened cervix at 20 weeks. From my 12 week ultrasound to my 20 week ultrasound my cervix had shortened from 3.8 cm to 2.4 cm. 2.4 at 20 weeks sounded awfully short to me, but my Ob didn't even prescribe strict bedrest. We were set to take a cruise to Alaska in my 21st week, and he recommended cancelling that, and to nix any heavy lifting, and generally take it easy. He said you can place a cerclage up to 24 weeks but they are less successful when placed later in pregnancy, and he suggested that studies have shown the same outcome whether the woman gets a cerclage or is on bedrest (I question this information, though). It had taken us years to get pregnant and I was very concerned with losing the pregnancy so I put myself on bedrest while I waited to be seen by a MFM dr. The high risk doc just said take it easy and check it again every 2 weeks. Two weeks later, my cervix had gone to 2.6 but now showed funnelling. Still no concern from dr's, they just said cerclage at 22 weeks isn't worth the risk, and keep taking it easy. I kept myself on strict bedrest and ended up with an emergency c-section due to HELLP at 30 weeks. But a shortened cervix didn't end my pregnancy, so I wanted to give you some hope that you can be short at 20 weeks and not necessarily deliver due to IC. When I was in and out of the hospital in the couple weeks prior to HELLP (due to Pre-e), no sonographer made mention of a shortened cervix, so I am convinced the strict bedrest helped.

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