Questions about cervical competancy...

Specialties Ob/Gyn

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Hi, I am a future nursing student (still working on pre-requisites) and also currently working on my 3rd child :yelclap: . I do have a couple of concerns that I can't seem to put to rest.

I have had two surgeries on my cervix; a cone biopsy and a LEEP. This has of course concerned my healthcare providers in regards to a possible incompetent cervix. With my first child I had a shortened cervix but never enough to require a cerclage (sp?). I had a lot of scar tissue on my cervix and my nurse-midwife told me that in some ways it was good because it was helping to hold the baby in (my baby was 8 lbs 13 oz when she was born at 38 weeks) This of course became a bad thing when it came to labor because I was in HARD labor for a couple of days but kept being sent home because my cervix was not dialating (I was active duty AF and you never know what doc you are going to get in L&D). I went back in on the 2nd day because my water broke. Thank goodness the nurse mid-wife I mentioned was scheduled to come on shift. She came in to see me and saw that I was in a lot of pain. She checked my cervix and said "well that explains it.." swiped her fingers around my cervix and lo and behold I go from 3cm to complete instantaneously. Baby would have been born right away except for her shoulder being caught.

With my second child I had a bad feeling that if I went into hard labor I would have her where-ever I was at. I know that some people don't agree with instincts like this but it was a very strong feeling. I went into L&D at about 11 pm and admittedly was not progressing quickly but was at 5-6cm's so they kept me just in case. I was so glad that the doc decided to keep me because my feelings were so strong. Early the next morning I went into hard labor and cervix was dialating slooooowly (darn stubborn thing). When I finally got to 8cm the doc said that it would be maybe a couple of hours before the pushing stage. About 30 minutes later the nurse in charge of my case came in and he let me know that they lost the baby's heartbeat on the monitor. Nothing to worry about, etc. He moved the straps around here and there while teaching a new L&D nurse but couldn't locate anything. He started working a little faster (I really liked him btw... he really knew his stuff) and went to reach for an internal fetal monitor. While this was going on I heard a very faint cry from beneath the sheets just before the trainee lifted it up. There was my daughter already halfway born with the cord wrapped around her neck. No one knew how long she had been there (I had an epidural and couldn't feel anything, which btw will not have again). The nurse had to finish delivering her just as the doc came in and the next thing I knew 3 peds docs and several nurses were working on recusitating her. She was a 3 apgar and ended with a 7.

Now that I'm working on my 3rd I want to know how worried I should be about my cervix acting oddly. My last 2 experiences make me concerned about carrying full term (my 2nd was born at 37 weeks) or possibly having the baby so quickly that I am unable to get to the hospital. I do relay these concerns to my doc's but because I am at a military hospital you do not see the same doc every time, in fact it is not unusual to see 5 or 6 throughout your pregnancy. Each one has a different philosophy and range from very concerned to "don't worry, what we will in our head is what we usually get....". I again have a short cervix, a little shorter than last time.

I have lurked enough :chuckle on these boards to know that I respect the opinions of most everyone here. Should I be concerned?

Jodi

P.S. I know this was a little long but I was hoping that my history might help explain my concerns and why I can't seem to shake them.

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This posted twice in the forum. Not sure why....

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I don't know how concerned you should be. I have seen post op cervices perform GREAT, others not. Please do be sure to ask your OB/GYN this. (You should have a preconception check up anyhow). GOOD luck to you!

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Here is a forum that may be helpful!

http://bbs.babycenter.com/board/pregnancy/pregcomplications/1252536

The good news is that you made it to term with your prior pgs., but it would still make sense to take some precautions. I would ask the dr. to get a baseline cervical length measurement (do you know how long your cervix is?), and then another one again at around 18 weeks. Don't be afraid to call your dr. if you have any concerns.

Good luck!

Shannon

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Thanks for the replies! I'm currently 13 weeks but at 11 weeks my cervical length was 3.0 cm. I was told that it is quite short but still within range. It is shorter than with my previous two pregnancies, though and my biggest concern is that if I didn't have to push even once during my last delivery will that mean that my cervix is less strong than I need it to be. I've seen two doctors so far and I have had two different answers. One said it's possible and the other seemed to not worry too much.

With this being my last baby and having had so many complications with my second (gestational diabetes, bed-rest, cystocele, short cervix, complications at delivery) I want this pregnancy to have as little neurotic worring as possible :roll

I'll definately check out that website!

Jodi

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