shortened cervix - HELP

I am pregnant with our second baby. Our first one came 3 months early due to PPROM. He's now 16 months and doing wonderful. When we got pregnant again, I had crinone through the first 10 weeks; ultrasound measurement for cervix length every 2 wks starting at 14 wks; I start 17P shot next wk.

The issue is that at 14 weeks my cervix measured 4.7cm; This past week at my 16 wk appt it measured 2.7cm; Now, I am getting really nervous. A short cervix was never mentioned as an issue for my last preemie pregnancy.

Has anyone gone through something similar and what did your doc do for it? Did 17P help? Cerclage? Bed Rest? HELP!

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I am so sorry to hear about your cervix. My daughter was born at 24 weeks because of cervical issues, so going into my second pregnancy (currently 16w 4d) I had a pre-pregnancy transabdominal cerclage placed. I started P17 shots at 16 weeks exactly. From what I know in talking with other women, if your cervix continues to shorten, a transvaginal cerclage could be placed. The progesterone shots are a good idea too. They also may put you on bedrest which I know with a toddler is going to be very difficult. However, it's temporary.

I would see a high-risk doctor and see what their thoughts are. I think it's a blessing that you are aware of your changes and can therefore do something about it.

Good luck to you. I will keep you in my prayers.
http://pregnancyafterpreemie.blogspot.com

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Just like the Mom above i gave birth to 24 weekers due to IC. This pregnancy i had a cerclage placed at 12 weeks and am now 30 1/2 weeks.
I Do not want to scare you, But i would ask a bout a cerclage sooner rather than later. Don't wait until your next appt. This could possibly save your baby.
Or they may just put you on strict bedrest til you are 34-35 weeks.
My daughter is 2 1/2 so i know how hard it can be to be on bedrest, but there really is nothing you can do.
Please let us know what happens! Laura

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Thanks Ladies! My doc appt is this Wednesday morning. Thankfully they had a cancellation and the girl knew that I was desperate to get in asap. I will ask about a cerclage. I also start my 17P shots this week so hopefully that will help as well. I'll keep you posted.

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I am so sorry to hear about your situation. I can completely relate to your fear. Although I didn't have the greatest outcome, I delivered my son at 23 weeks, he is now 2 1/2.... but I brought my son home! My first suggestion would be to get connected with a good perinatologist if you aren't already and then put yourself on strict bedrest if they don't.

Due to my previous history of pregnancy problems, I was treated by a perinatologist my entire pregnancy starting at 6 weeks. He was really proactive and monitored me closely with cervical checks 2x week. At 10 weeks my cervix was already at less than 2 cm and he wound up doing an abdominal cerclage. Unfortunately, I had additional cervical issues that added to my situation, but I made it through to 23 weeks. From 17 weeks on, I had less than 5 mm of cervix. I spent my entire pregnancy on complete bedrest and several weeks in the hospital on bedrest with most of that time in trendelenberg position with my feet elevated above my head. Although very draining, it was worth every second.

I delivered via emergency c-section at 23 weeks due to PPROM and failed abdominal cerclage. Thankfully the team that was supporting me agreed to start steroid tx prior to 23 weeks due to my circumstances and I had received 2 steroid injections 5 days prior to our son's birth. I think that made a huge difference in his outcome.

I guess my point is.... be persistent!!! Get a good peri that will listen to you and is on your side. Put limitations on yourself and LAY DOWN!!! Beg your peri to continue monitoring you closely with regular checks on cervical length. I am not sure how far into a pregnancy they will do a cerclage or an abdominal cerclage or if you are a candidate, but you may want to ask what your options are. I would also start the conversations with them about how early they will offer steroid shots for you and a plan just in case you deliver early again.

I am so sorry that you are going through this, but on a good note, you are aware and can do something proactive for you and your baby.... Lay down!!! You are in my thoughts!

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I hope you had a great apt this morning and hopefully the Doc will refer you to a high risk doc and evaluate if a cerclage is necessary. If you don't get the answers you desire I'd suggest you set up a phone consult with Dr. Haney in Chicago. He does them free of charge and is an amazing doctor who specializes in placing abdominal cerclages. Here is a link to his contact info:

http://www.uchospitals.edu/physicians/arthur-haney.html

I too delivered my son at 24 weeks due to an incompetent cervix. I had a McDonald cerclage placed at 11 weeks, my cervix shortened and funneled before 14 weeks and funneled all the way to the stitch by 17 weeks. My surviving twin's water broke at 24 wks 4 day when I delivered via emergency C Section. 102 days later he came home from the NICU. I then had an abdomincal cerclage placed by Dr. Haney (I traveled from Dallas to Chicago) and carried my subsequent pregnancy to 36.4 weeks.

pjmnw1 , I'm sorry to hear your abdominal cerclage failed, I haven't heard of many failing. But, so happy that your miracle survived and is home with you!

Melissa, I'm so glad to hear your TAC pregnancy is progressing so well. You are doing great!

Please keep us updated!

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UPDATE - I had my doc appt and needless to say everyone was surprised. I measured 27mm on Friday; Today I measured 48mm. My peri thinks the previous tech may have mis-measured to have that big of a discrepency. He still plans for me to be followed weekly with my local doc to monitor it, and will do a cerclage if it gets low again. He also said early studies of the 17P shot show it may help w/cervical length and I start those tomorrow. I still plan to try and take it easy so not to push my luck.

The baby looked great during the ultrasound and was measuring 17w2d. She was sticking her thumb out most of the time as if giving me the okay sign!

Thank you for all the well wishes and sharing your stories. Keep us in your prayers! I'll keep you posted.

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I lost my first son at 22 weeks. So then when I got pregnant again I had a cerclage done and it was a miracle! It doesn't hurt at all. My son John was born at 32 weeks, he is 14 months now actual and he is doing awesome. I am pregnant again and I am doing the 17P shots and I had the cerclage done at week 14. I am due in December and God-willing this has been my best pregnancy. I go to one of the top rated Maternal Fetal Medicine doctors in IL. Basically from my research and consults, with the cerclage they go in best before you start dialating. I have had 2 cerclages done now and I would be happy to be a sounding board for you if you need it at all. Use ice before the shot it helps with the tenderness! Good luck and take care

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Hi everyone...

I believe I know a couple of you ladies from Abbyloopers... I am Lisa Richards from Boston.

I too gave birth to a 22 weeker, then had a pregnancy filled with bed rest and a failed transvaginal cerclage, but luckily, it failed just before 28 weeks, and my daughter, after a long NICU stay managed to come home with us and is now about to turn 6 years old.

My Transabdominal Cerclage was placed by Dr. Leroy Charles in Florida, and I carried twins to 33 weeks and 5 days with it. I stayed on my feet the entire time.

In addition to Dr. Haney at University of Chicago, there is a Dr. on the East coast. Dr. George Davis, who is an extremely skilled surgeon in placing the TAC later in pregnancy. But at 17 weeks, you are going to have issues with both the TVC and the TAC if you wait much longer. My suggestion is to email Dr. Davis (AskDrDavis@aol.com) or Dr. Haney at the email given previously, whichever one of these docs is closest to your vacinity and ask them their opinion. In my opinion, these three gentleman (along with Dr. Coleman in Oregon) are the leading experts in cervical incontinence in the United States. They will help you understand about the dynamic measurements that a cervix with C/I can have and help you, through that information, advocate for your own care.

I hope that your cervix stays long and closed. OH, and the 17P shots (Alphahydroxy Progesterone Caproate) have no effect on the cervix directly. Indirectly, these shots are noted to calm the uterus and help strengthen the placenta, that being stated, they should keep you from contracting, and having your cervix dilate through those contractions.

Good luck, and keep your feet up as much as possible. I did a lot of floor play with my daughter, and had a friend who helped me out during the work week when my husband wasn't able to be home with my toddler and I.

Lisa R.
Boston, MA
Mom to 4 preemies
1 with wings, 1 on wheels, 2 by TAC

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