cervical incompetence diagnosed at 21 weeks -- options?

[Anonymous]

I just returned from an ultrasound where my cervix was measuring under 3cm length (around 2.6) and funneling on the inside. There is no other sign of opening: my cervix is firm and completely closed on the outside and I don't have spotting or fluid/mucus leaking. The OB who checked me out referred me to the high-risk OB (whom I'm seeing on Tuesday -- bad timing!) and told me to take it easy this weekend: not a lot of walking, no exercise, lots of water, off my feet as much as possible.

I'm wondering if anyone has had a rescue cerclage at such a late time rather than a preventative one in the first trimester. I have read that they are performed up to 24 weeks, but become riskier and less successful once the cervix actually starts to change. I am also wondering if people have had successful treatment (medications and/or bed rest) and were able to carry the pregnancy to full term (36+ weeks).

I'm trying not to freak out, but I definitely didn't see this coming. (This is my first pregnancy, so I don't have the history of 2nd trimester loss that would have led to a preventative cerclage.)

Thanks!

[Anonymous]

I was diagnosed with a short cervix that was funnelling at 28 weeks, so later than you, but it was measuring if I remember correctly 1. something, so pretty dire. I was put on bedrest immediately and eventually at 31 weeks went to hospital bed rest. With lots of drugs we were able to carry to 34 weeks! Take it EASY!

[Anonymous]

I was under 2 for quite a while with my twins but on total bedrest. The funneling will also be a concern. But, I think if they were super worried they would not have let you wait till Tuesday.

If I were you, I would probably put myself on semi-bed rest until Tuesday. And if you feel anything weird you could always go to Georgetown or somewhere with a good high risk dept and go to L & D and get checked out there for another opinion.

Good luck.

[Anonymous]

The fact that are you aren't in the hospital is a good sign BUT I would not take any chances and put yourself on total bedrest until Tuesday. Get up to shower every other day and pee whenever you need to. I wouldnt worry too much about 2.6cm - what you need to worry about is the funneling.

I had a baby at 24 weeks (had no idea I was funneling and my cervix shorteneed) - I am pregnant again and had a preventative cerclage at 13 weeks. I know MANY women who have had rescue cerclages and made it well into 30 weeks and several that made it full term.

Unfortunately, the rest of your pregnancy may not be what you imagined but bed rest is a heck of a lot better than your baby in the NICU.

Good luck and please let me know if you need any advice!

[Anonymous]

Our friend had cerclage at 20 weeks and was less than 3cm when diagnosed. She successfully carried to term and has a beautiful, healthy baby. She was on pretty strict bed rest (did get out some towards the end) and took it seriously the rest of her pregnancy. Please take it VERY easy this weekend until you see the high-risk OB and try not to stress (ha!) which doesn't do any favors for you or the baby. My SIL had cerclage with all 3 of her pregnancies and all were 38+ weeks and totally healthy. Best wishes.

[Anonymous]

Seriously shocked your OB didn't put you on modified bedrest for the weekend -- meaning lay on the couch, feet up for most of the day. Here's a success story to put your mind at ease though -- I was 23 weeks with twins, cervix measured 3-5mm (yes, mm NOT cm) and I was a "fingertip" dilated. I was on hospital bedrest for the duration of my pregnancy and delivered my twins at just shy of 34 weeks, which was 11 weeks later.

Agree with PP advice to rest, relax and if anything feels weird to get yourself to G-town or Fairfax hospitals where there are high risk perinatology units with doctors on-call around the clock.

[Anonymous]

I agree, get to a perinatologist as soon as you can. Dr. Pinckert is wonderful - he's placed my 2 preventative cerclages and my 3rd is scheduled in 10 days. He's great and I'm sure has done many rescue cerclages as well.

[Anonymous]

I delivered my first one early so I am being monitored very closely with this one. I might be having a preventative cerclage. I am 18 weeks now. Cervix is still above 3 cm but decreased significantly from two weeks earlier. I don't have funneling to my knowledge so I can't speak to that but I don't think 2.6 is horrible although it is definitely below average of 3.5. They might still take some action but it could be a lot worst and it is good that they caught it when they did. I also go to Dr. Pinckert's practice and would highly recommend it (Greater Washington Maternal Fetal Medicine in Maryland). I have another scan on tuesday but until then, am on modified bed rest which entails staying off my feet, limited walking, lifting etc. Good luck!

[Anonymous]

OP here: Thanks, everyone. I have been off my feet and lying down most of the day, and am again lying down after being up making some salads for tomorrow.

I am glad they caught it early, too, and am expecting they will offer me the cerclage this week, and am thinking I'll go ahead and do that. With no other signs of premature labor, I'm hoping that will allow me to at least maintain moderate rest and not go to full bed rest (I cannot imagine that for four months, I don't know how people don't go nuts with joint pain when they have to stay in bed that long!).

I am definitely trying not to stress and we've axed a whole bunch of plans for the weekend (painting a room, going to the pool, dinner out with friends). So, we might actually relax more this way.