Ultrasound ~ Recheck of Cervical Length

First, the good news!  Baby girl is looking great, and the ultrasound tech even made sure to get me a few pictures of her, despite the order for just a cervical length recheck today.  Her heart rate was 143 bpm, she was moving all around, and the amniotic fluid volume looked perfect.  My doctor was very pleased with my blood pressure and weight gain thus far too.  Baby is still head down right up against my cervix, and although they claim she still has enough space to change positions several times a day, somehow I doubt she has moved much in the past three weeks, as her position is identical to my last ultrasound.  Here is a picture of her cute little hand and fingers 🙂

162 Days ~ 23w1d
162 Days ~ 23w1d

So now the bad…  And there was far more bad than good news today 😦  Three weeks ago at my last ultrasound my cervix measured 2 cm, too short since we’d expect it to be between 4 cm and 5 cm at this point.  Well, today it’s even shorter, only 1.4 cm now.  So again, my regular OB consulted with the high risk provider on call.  Really long story short, they are giving me one more week until I’m not sure what happens.  I’ll have another scan next Tuesday morning and if at that time my cervix is shorter I’ll receive steroids to mature baby’s lungs should I deliver soon.  They considered giving me steroids today, but there are risks to both me and baby, and since we don’t know when I’ll deliver, they would rather wait until we know more.  The risks of steroids to baby include stunting her growth, as studies have shown baby’s who received several doses of steroids in-utero were born with smaller than average heads.  Risks to me center around blood sugar and blood pressure issues.  So we decided to wait a week when we know.  For the time being I’ll continue on the progesterone and ‘take it easy’,  She didn’t specifically tell me certain activities were off-limits but she did stress I should pay attention to how I feel.  If I notice increased pelvic pressure or an increase in the frequency of tightening in my uterus, I’m to rest.  She also stressed not being afraid to call, for any reason, which was comforting.

I asked a lot of questions although for the life of me most of the appointment seems like a blur now.  I asked what happens if my cervix continues to shorten, or if it thins to nothing.  My doctor was honest and said the risk of me delivering early is high, although how early we don’t really know.  She said if my cervix gets much thinner the chances of my water breaking increases and thus baby would need to be delivered.  She did say they can keep you pregnant in the hospital after your water breaks, but I didn’t ask for how long.

I didn’t really get scared during the appointment until my doctor brought up viability and survival rates.  She wanted to be honest and make sure I understood what we’re dealing with…  She said the vast majority of hospitals will not resuscitate before 24 weeks, I am 23w1d today.  The good news, my hospital will resuscitate as early as 18 weeks, although regardless, outcomes aren’t promising, even at 23 weeks the mortality rates are high.  I wasn’t sure what to say or think at that point, other than I guess it’s best to know risks now rather than to be surprised later.  I think I’m still a little in denial though, not ready to believe this baby is anywhere near ready to be born.  There is a chance I’ll deliver at 40 weeks, so for now I’m living in that dream.

I’ll end this post here, as really I’m not sure what else to say at this point…  I have a lot of fear running through my head, how could I not?  I feel like we’ve been through so much during the past three years, trying on our own, the failed IUIs, a year of IVF, and now 23 weeks of thinking we are finally going to welcome a baby into our life.  I am not prepared for this to be taken away from me.

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59 thoughts on “Ultrasound ~ Recheck of Cervical Length

  1. Have they done a fetal fibronectin test? I’d hope they’d run that before administering the steroids. They only feared I’d have a preterm delivery because I had a positive fetal fibronectin along with my short cervix. As far as concerns about steroids, I’d never heard the small head thing. Bella’s has been over 90th percentile her whole life and I had two doses of steroids at 26 weeks when they thought she was coming out :-).

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    1. They have not done that test, in fact, I wasn’t aware of it until I just googled it! I’ll ask about it, thank you!
      As for the risks with steroids, I think my doctor was referring to a study where steroids were given weekly. I believe she just wants to make sure they are given before delivery but not too far in advance.

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      1. Yes they should definitely do that test before any additional measures are taken. Mine was positive which just made them take my situation more seriously, even though she ended up not coming prematurely. Interestingly, my practice no longer advises bedrest for preterm labor! Now they just do progesterone. However, I’d probably do bedrest if it happens again since it worked last time!

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  2. I am so sorry you are having to go through this. It sounds like you have a good team of doctors looking out for you. Thoughts your way that everything goes smooth until at least 32 weeks, if not the full 40!

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  3. i am happy to hear that she is thriving and growing well! with this now being a very real threat are you considering “bed rest”? i would be off my feet and taking it easy immediately. take care of yourself! i am hoping for the best for you and your baby.

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    1. Bed rest was mentioned. My doctor mentioned that many studies show it isn’t all that effective with my situation. Part of me wishes they’d prescribe it though, at least I would feel like I was doing something to help. I’m planning to rest as much as I can on my own for now…

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  4. Stefanie, you are strong, you will get through this. The baby may come early and if so you have a great hospital. Try not to stress too much and just rest. Sit down, keep your feet up and let her grow. You have done everything you can. If the doctors were so concerned you’d be bed rested in the hospital, so it’s positive you are not.

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  5. Oh goodness! I wish this wasn’t the case for you right now and I’ll be praying your baby girl stays in and goes to term or at least close to it. I had the steroid shots at 33w6d as initially they had talked about inducing me around 35-36 weeks. I’m hoping you can make it to that point as well before they need to consider it.

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  6. Praying for you and sending positive thoughts. You are very close to viability, so even if you do deliver early (and you probably have several more weeks to go) your girl will have a good chance. This is so scary, and I’m sorry you are going through this.

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  7. I am so sorry – of course you are flooded with fears. This is scary! To offer some perspective, I have been on ridiculously high steroid levels and on a minimum of 20 mg per day since before the egg transfer in this pregnancy and baby is still measuring well over 60 and into 70th percentiles and head circumference in particular is a very good size – by comparison at this point my son was measuring much much smaller (my immune issues were undiagnosed and untreated in his pregnancy). Steroids are scary but much less scary than preterm labour under 28-30 weeks. I hope desperately that your cervix does not efface or shorten further but I am so grateful that you are being monitored very closely now. If strict bed rest or hospitalization is necessary to keep baby in there a few more weeks, so be it. (Listen up, sweet baby: You need to stay put, little girl!!). Hugs and prayers coming your way in the meantime.

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  8. Stef, I am so sorry you are going through this. You have a great team of doctors and like they said don’t ever be afraid to call them if you have any concerns! Try to rest as much as you can, and take care of yourself. Sending lots of prayers your little girls stays in for many more weeks to come.

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  9. Sorry to hear that your cervix shortened. My high risk doctor stitches it closed once it gets down to 2 cm (called a cerclage). Is this an option for you? Also, do you know if total bed rest would help? You and your sweet baby girl are in my prayers.

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    1. We actually did talk about stitching my cervix, but she said it works best when you’re dilated, which I’m not, so we’re waiting on that for now… I really hope my doctors know what they’re doing! Bed rest was mentioned too, but she said studies are inconclusive on whether or not it helps with a short cervix, although if mine gets worse we will get to that. Fun times ahead! My OB works at a teaching hospital, so they are all about their research here. Not sure if that is a good thing or bad though…

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      1. Sounds like you are in good hands! Just remember that no matter how scary things seem, nothing is too hard for God. Jeremiah 32:17 has really helped me get through the past 7 months.

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  10. Try to breathe and lay as much as possible. This has happened to 2 people I know IRL and they were put on bedrest early, which actually helped! One even got off bedrest because her cervix was normal again. I don’t know why they haven’t brought that up! Lay down and take that pressure off your cervix, ok? And everything will be ok. 😊 You were meant to have this baby.

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    1. Bed rest was mentioned, and I get the impression it might come to that, but my doctor, loving her studies, thinks there are as many stories out there where bed rest didn’t help than those that show it did work. So, we shall see. I feel like I have to trust my doctors, but there is a huge part of me that would prefer bed rest, so I’d at least feel like we were doing something to help besides the progesterone. I do plan to rest as much as I can when I’m not working, and thankfully my work is not physical.

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  11. Also the friend who ended up getting off bedrest gave birth almost a week late and her baby was 9# with a normal sized hear even though she had been getting steroid shots because they thought he was coming as early as 18 weeks.

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  12. Thinking so many positive thoughts for you. I hope they have a solid plan when you meet with them again. Chronicles of a Non Belly Mama (another WP blog) was dealing with a shortened cervix as well. (Her wife was, anyway.) Her doctor put her on bed rest around the mid-20 weeks sometime when her cervix was 2 cm (I think), and the babies stayed put until about 37 weeks, I believe.

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  13. I was also going to suggest the FFN test – when I went to MFM the doctor said it is very accurate when it has a negative result, but there are a lot of false positives. Worth looking into. I am thinking of you!!

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      1. I wouldn’t hesitate to ask them!! It really can’t hurt to ask or do the test! If it is negative then it buys you a week or two of time/calm/less stress!! I would almost demand the test! But in a very nice way of course… 😉

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          1. Do it! It is perfectly okay for you to research & be an advocate for yourself – and your baby!!! I hope they will do the test for you!

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