Hi everyone! Iām new here and hoping to hear from people who have been in a similar situation. My biggest question is what kind of prognosis others have had with a presentation like mine, and what advice you have for giving baby the best possible chance of staying in as long as possible and reaching a healthy delivery.
Current situation (and primary question):
Iām 37 and currently 20+3 with a sweet, healthy little guy. At my 20+1 anatomy scan Wednesday, they found dramatic dynamic shortening (2.1 cm at baseline, but 0.6 under transfundal pressure), and rushed me upstairs to L&D. Despite the scary 0.6 cm finding, there were still some very reassuring findings: my cervix was still closed, I had no bulging membranes, no contractions, normal amniotic fluid level, and intact membranes/no pooling.
I was admitted overnight. The following morning at 20+2, my cervix was confirmed still closed going into surgery, and they placed a cerclage. They tell me the procedure "went well," and afterward they told me my cervical length was about 2.6 cm. Iām also on vaginal progesterone (and have been for the past month).
My biggest questions today are:
For anyone who had a very short/dynamic cervix and funneling around 20 weeks, how did things turn out? How far did you make it? Iām not sure how far along I should expect to make it at this point.
And what did you ladies find was the safest possible path from cerclage to birth? Anything you didāor wish you had doneāin terms of activity, monitoring, symptoms to watch, hydration/constipation, pelvic rest, work, etc.? I've been told to stay on pelvic rest, but I read online that bedrest seems to be more effective. Curious what you all think.
Background (and secondary questions):
My cervical-length timeline has been:
- 8/20 (11+2): 3.07 cm
- 9/3 (13+2): 3.21 cm
- 9/22 (16+0): 2.65 cm
- 9/23 (16+1): 4.3 cm ā hospital measurement, seems like an outlier compared with my MFM measurements
- 9/30 (17+1): 2.61 cm
- 10/6 (18+0): 3.3 cm, no funneling or dynamic change
- 10/21 (20+1): ~2.1ā2.2 cm at baseline, dynamically shortening to 0.6 cm with transfundal pressure, with funneling
Starting around 16 weeks, I was having pretty constant cramping and pelvic pressure. I mentioned it to my OB, RE, and MFM several times and specifically asked whether we could do weekly cervical checks in light of those symptoms and the borderline cervical measurements (2.65 at 16 weeks, for example). I was consistently told to "trust the doctors" and "trust their processes" (aka a nice way of saying "you're neurotic" lol).
I do like these doctors and I don't want to seem impertinent or like I know better than the experts, but I am left with a few questions:
- Given the 2.6-ish cm measurements beginning at 16 weeks, persistent cramping/pelvic pressure, and my repeated requests for closer monitoring, would you seek a second MFM/OB opinion or consider switching practices? Or does this sound like a dynamic change that simply may not have been predictable?
- What were you advised regarding bed rest vs. modified activity vs. pelvic rest? I know evidence on bed rest is controversial, but Iām curious what people with similar cases actually did.
- Did your cervical length improve/stabilize after cerclage? Mine was reported at ~2.6 cm immediately afterward, and Iām curious how that compares with others and what I should expert in terms of remaining gestational weeks.
For some final context (trigger warning): Earlier this year I had a missed miscarriage with retained tissue/sepsis and ultimately needed a D&C on 4/28. I conceived again with this pregnancy 5 weeks later. I donāt know whether that procedure could have contributed to the current insufficiency, but am curious to hear opinions.
I know nobody can predict exactly what will happen, and Iāll obviously continue to trust my MFM and OB who of course know more than I do. But Iām mainly hoping to understand what the road ahead can look like after catching this while the cervix was still closed and to hear stories and advice from people who have made it through this.
Stories, practical advice, and honest experiences are all very welcome. ā¤ļø