short cervix--what is it, really?

Hi everyone, I'm 24 weeks pregnant with twins, on strict bedrest for the past week since my cervix was 1.5 cm last Tuesday. Have been on modified bedrest since 19 weeks, when I started measuring below 2.5cm. Going a little crazy because I have 3 kids ages 8,6 and 2 and I feel so guilty about not being there for them...

Anyway, have a very silly question: anyone know the difference between having a short cervix, being effaced and being dilated? I'm totally confused. What is worse, to have the cervix shortened or to be dilated or effaced? I've seen forums where women say they are 1 cm dilated but their cervix is long. I didn't know that could happen. I'm just very lost in trying to understand what it means to have a cervix at 1.5cm...

Anyone who can help me? Thanks for your support!

 

:welcome: Hi there. I was put on 9 weeks of bedrest for PTL/shortening/funneling cervix.

During a normal pregnancy, the cervix remains firm, long, and closed until late in the third trimester. At that point it usually starts to soften, efface (grow shorter), and dilate (open up) as your body prepares for labor. Your cervix can also be funneling, which is when the cervix starts to open from the inside, forming a V.

It sounds like you have shortened/effaced down to 1.5, but not yet dilated. "Normal" cervical lengths(which vary from person to person) are usually in the 4-5 range, so being down at 1.5 at 24 weeks is definitely something to be concerned about.

I had shortened from 5 to 2.5 within a week, at 28 weeks, and was put on bedrest at that point. A week of strict bedrest later, my cervix had lengthened back to 4, with no funneling. I stayed on bedrest until delivery at 37 weeks.

I know how hard it is with the other kids, but what you are doing for your babies right now is SO important. :hug:

 

I agree. The whole cervical change thing is a little confusing. I'm one of those woman who is 1cm dilated, but my cervix is measuring 3.5cm with no funneling. I was put on a somewhat strict-modified bedrest (only up to use the bathroom/make a very quick sandwich) last week. My peri and OB would have put me on strict bedrest had I had any funneling or if my cervix drops below 2.5cm. From what my OB tells me it is not completely unusual for women who have had children before to start dilating early. The extra pressure from the twins causes the cervix to open a little, and usually (hopefully) many women can still go very far in their preganancy even if they are dilating early. I am not sure which situation is worse. It seems that anytime there is a significant cervical change the result is bedrest. All we can do now is lay around, and cook these babies. Hope this helps a little.

 

Thanks so much everyone. So it seems a cervix getting shorter = a cervix effacing, right? That clarifies a lot!
I'm crossing my fingers, as I have my doctor's visit today and they are going to measure me. I'm terrified of them sending me to hospital bed rest, since they said last week that's what they'd do if my cervix did not remain stable. I can't even being to imagine being away from the kids all the time!

 

Hi everyone I'm new to all this as well and I'm glad you asked the question. My cervix has been long up until 5 days ago at my last appointment, I'm at 2.5cm now. So I'm not on bedrest yet but was told to take it very easy. I go back in two weeks for a re-check. So I find it interesting that your cervix can grow back long? WOW! that's awesome so do they ever relieve the bedrest then? I pray mine gets better as I've been resting up a storm. One more quesiton do you think frequent BH contractions has anything to do with it or just all the weight and pressure from the babies?

 

My high risk doc says a cervix can never get longer, only remain stable, but I have found many examples online of women who first measured something and then it got longer. When I was 19 weeks I was put on modified bed rest because I measured 2.3, then a week later, I went up to 2.7 and a week after that (still on modified bed rest) I was at 2.9-3.0. The doc even congratulated me and he was very happy, and he then said I could wait 2 weeks to see him next time. That was around Christmas so I must confess I sat up a lot more (vs lying down) and walked a little more than I had before, and when I went in two weeks later (ie, last week) I was at 1.4, which totally freaked me out and now I'm on strict bed rest. So I'm now a total believer in taking it easy and following doctor's orders--I do think activity and being vertical vs. horizontal makes a big difference.
Good luck and stay off your feet if you can!

 

QUOTE(melli mel @ Jan 13 2009, 01:00 PM) [snapback]1145251[/snapback]
that's awesome so do they ever relieve the bedrest then?

I was free from bedrest at 35 weeks, although by then, my muscles weren't what they used to be, and I was so huge I didn't want to get up!
QUOTE
One more quesiton do you think frequent BH contractions has anything to do with it or just all the weight and pressure from the babies?

I personally think it is a combination of the two. If you are having a lot of BH's, be sure you are drinking a TON of water.
QUOTE(spw @ Jan 13 2009, 01:20 PM) [snapback]1145294[/snapback]
I do think activity and being vertical vs. horizontal makes a big difference.

Totally agree! Lie down and take the pressure off of your cervix as much as possible.

 

Here's another interesting thing... so I went to the doc last thursday and that's when they told me my cervix was 2.5 well yesterday i went because I had tons of contractions and pressure. They measured again and the tech said she had two different measurements and I asked why she said it was hard to measure because it's curved. Hmmm.. so which is the right measurement. They ultimately ended up telling me my cervix was the same so no shorter. Still have to go back in a week though.

 

QUOTE(melli mel @ Jan 15 2009, 03:41 PM) [snapback]1148776[/snapback]
Here's another interesting thing... so I went to the doc last thursday and that's when they told me my cervix was 2.5 well yesterday i went because I had tons of contractions and pressure. They measured again and the tech said she had two different measurements and I asked why she said it was hard to measure because it's curved. Hmmm.. so which is the right measurement. They ultimately ended up telling me my cervix was the same so no shorter. Still have to go back in a week though.


My cervix would actually change during the u/s. The sonographer would take one measurement, and then tell me to 'push', and take another, which would sometimes be a completely different measurement. I think it's called a dynamic cervix.

No change is good! Hang in there! :hug:

 

Hi everybody,

I am 22 weeks pregnant with twins :itwins_boys: , and during the morphologic scan two weeks ago my Dr. found that one baby has a low placenta. and that if I understood well the length of the uterus to the cervix is 1.4 cm!!?? anyhow because I freaked out a bit I wasn't in the mood to know the details and I was put on bed rest.

My question is what exactly is bed rest? I asked my Dr. whether I can sleep on my left side or right and he said OK. Also he said that it's OK if I put few pillows below my head as long as my feet are horizontal. I appreciate to know the details about the bed rest that some of you have experienced.

Thanks a bunch for sharing the experience and good luck to you all.

 

QUOTE(atina @ Jan 18 2009, 06:31 AM) [snapback]1151679[/snapback]
Hi everybody,

I am 22 weeks pregnant with twins :itwins_boys: , and during the morphologic scan two weeks ago my Dr. found that one baby has a low placenta. and that if I understood well the length of the uterus to the cervix is 1.4 cm!!?? anyhow because I freaked out a bit I wasn't in the mood to know the details and I was put on bed rest.

My question is what exactly is bed rest? I asked my Dr. whether I can sleep on my left side or right and he said OK. Also he said that it's OK if I put few pillows below my head as long as my feet are horizontal. I appreciate to know the details about the bed rest that some of you have experienced.

Thanks a bunch for sharing the experience and good luck to you all.


:welcome:

1.4 is very short for 20 weeks, so I would think that you would be on strict bedrest, which means only getting up to use the bathroom, lying horizontally the rest of the time. Drink tons and tons of water, and then some more!

I would definitely call your doctor back to be sure of his expectations for bedrest for you. I am surprised that he did not make it seem like more of an urgent situation actually, or at least from your post it didn't seem that way?

I was 2.5 at 28 weeks, and put on modified bedrest(basically rest as much as possible), and I was terrified to have the babies so early, so I put myself on strict bedrest, and stayed put for 9 weeks until delivery.

:hug:

 

I was given an emergency cerclage and put on bedrest with my twin pregnancy because my cervix was measuring 0.9 cm and I was at least 1 cm plus dilated. That was at 21 weeks. I had previously experienced another pregnancy (singleton, my 2nd born) where I was measuring about 2 cm cervical length and dilated 1.5 cm at 24 weeks. (I did 11 weeks of bedrest, got up for an entire month watching a toddler, and then had to wait until 39w6d when I went into labor naturally. . . and they were threatening to induce!)

My twin pregnancy also defied the odds with TTTS, polyhydramnios, and such a short cervix. I was having constant painless contrax too.

I guess what I'm saying is that you just can't always predict how these things will go. And I believe some women are just made differently. The best thing you can do is take precautions, stay in bed, and all that. It's better safe than sorry.

Cervical measurements via ultrasound are not always necessarily accurate. A lot of it depends on the tech and doc's interpretations. Believe me, I had so many ultrasounds throughout my pregnancy this last time, that I could predict what the measurements were going to be (longer or shorter) depending on which tech was doing the ultrasound. Another thing is that when measuring effacement, some nurses/docs will measure differently by even centimeters.

I also want to offer up some encouragement about the feelings you have about your older children. The first time I did 11 weeks of bedrest, my only child at the time was only 18 months, and I had been his daily caretaker, always with him. Never had he been to preschool or stayed the night with anyone else. It was heartbreaking. . . my mother stepped up to take fulltime care of him. (Luckily, I had an 8 year old sister at home still who made for a great playmate for him. And my parents are fabulous.) My parents had to take our 18 month old during the entire week except weekends to live 1 1/2 hours away from us. My husband had to work, so what were we going to do? 11 weeks of that. But we made it, and he was so very resilient. Still, we all vowed that would never happen again. Even my mother would break down in tears after having to pick up my son and take him to her house. It was hard for her too. But we tried to be positive, and in the end, our son gained a closer relationship with his grandparents. That has been special for him.

Well, who knew we'd have twins and all the problems that came with that pregnancy? By this last time, I had three older children: ages 7, 5 and 16 months. This time, it was worse because I ended up hospitalized for 7 weeks. The first 6 weeks of my bedrest, I was at home in bed with my mom, MIL and a friend coming in various days of the week to stay with the kids and help out here. My husband would come from work and take over, so things were a little more stable until I went into the hospital. And that tore me up. . . but. . . here's the thing you remind yourself of: 13 weeks is really a drop in the bucket of time. And ultimately, the sacrifices you make on bedrest to have a healthy family, healthy babies is worth it. Imagine if you neglected your bedrest and you ended up having such early preemies (or maybe other problems) that you spent way more time in the NICU away from your older kids? The bedrest is worth the investment. You can't predict what will happen, but you can try to prevent more problems that may take away more time from your family. Your children are resilient, and something good can come out of the experience for you all. I know that's hard to believe, but it's the hard things in life that seem to teach us the most. And in some weird way, I feel that these experiences also bless us and give us a strange keen perspective on our blessings, big and small.

Please message me anytime if you need some encouragement. . .

 

With my son I was put at modified bedrest at 18 weeks with less than 1cm dilation. At 22 weeks I got an emergency cerclage pessary due to being 1cm dilated and a very slight funnel. I was on bedrest after my pessary until I delivered at 35w 6d. I was found at 30 weeks to be 100% effaced and still 1cm dilated. I was on bedrest of up to make something to eat, get a 5 min shower and use the bathroom, otherwise horizontal. I remember we had some company come over with dinner and have a get together, all the while I was on the couch while everyone was hanging out around me.

With my twins I never was dilated as I got a cerclage at 13 weeks, no bedrest at all. They were born at 35w 5d, 1 day earlier than my cerclage removal was scheduled for.

 

Hi to all,

Thanks a lot for sharing your experience. I am so glad to have known about this forum .

My Dr. did take this matter urgently. Actually I have an appointment with him today for another measurement and if things aren't for the better, then he would recommend me a hospital bedrest, which I dread more than anything. Anyhow just before my last ultrasound measurement, I had walked or stood up for about an hour, which I think lead to such ultrasound result. So I was quite relieved to read on this forum that following bedrest measurements might improve for the better.

the issue is that staying all day long in a bedrest isn't that easy: not only the muscles became frail but also the lungs. I now have difficulties having a smooth 6 hours night sleep. Not only babies are pressing on the lungs at this stage but also due to the bedrest lungs function less efficiently. I would very much appreciate to hear from anyone who experienced short of breath during pregnancy . the thing is that carrying twins, we're breathing for 3, with the babies pressing on lungs things go not for the better I guess. I should definitely ask my Dr. about this issue today.

Anyhow, going to a strict bedrest with all the negatif results that it might carry with it is nothing compared to carrying in our hands few months later the babies that God "cooked" in our womb during those months, right?

Wish you all but the best.

 

QUOTE(atina @ Jan 19 2009, 01:30 AM) [snapback]1152659[/snapback]
Anyhow, going to a strict bedrest with all the negatif results that it might carry with it is nothing compared to carrying in our hands few months later the babies that God "cooked" in our womb during those months, right?


Yes! Absolutely!

Good luck at your appointment today, let us know how it goes. :hug:

 

Bedrest is tough, I was on mine for 16 weeks. My doctor would only do a cerclage until I was 22 weeks with my son (which I was when I got it put in) I still had the funneling and such but no more dilation thanks to the Lord and the pessary cerclage. Having had a previous infant loss, I was going to do anything I could to bring a healthy baby home.

 

I'm in a similar situaiton.... I have been on bedrest since 24 weeks but today they discovered my cervix had shortened to 2.2 and had "softened" so I am on STRICT bedrest with the treat of hospitalization if things do not change. I'm not sure really what the terms mean.. am I effaced? What is softened? Boy am I confused.

 

QUOTE(NicoleMarieLG @ Jan 19 2009, 09:20 PM) [snapback]1153882[/snapback]
I'm not sure really what the terms mean.. am I effaced? What is softened? Boy am I confused.


Your cervix is normally firm, long, and closed. Softening happens first, allowing the cervix to shorten, which is what is happening to yours. Dilation is when the cervix begins to open at the bottom. :hug:

 

Hi everybody,

My appointment with the Dr. went fine. the measurement improved from 1.3 cm on January 8 to 1.82 cm yesterday. so the bed rest is beginning to pay off . the Dr. told me that my cervix is a bit "effaced" which is of concern, yet no dilatation whatsoever thanks God. I asked him whether it's better that he performs a cerclage, his answer was that it carries risks of infection or that the water of one of the Babies might break, and that at this stage complete bed rest would hopefully do the job until the Babies reach the safe stage of minimum 28 weeks. And the more they remain in the womb the better it will be.

the most joyful news for me was that I'll remain in home. NO HOSPITAL bed rest. Ouf what a relief!

I guess I've been having disturbed night sleep because of fear of going to hospital. yesterday I had a good night sleep finally. I did some "spirometer" exercises for the lungs and yesterday my husband did some shiatsu massage for my legs which helped the blood circulation, in addition while in bed rest, I did some exercices for my arms and shoulders. anyhow my Dr. told me also to keep moving my legs during bed rest every half an hour or so to avoid "flebite".

 

QUOTE(atina @ Jan 20 2009, 01:08 AM) [snapback]1154053[/snapback]
My appointment with the Dr. went fine. the measurement improved from 1.3 cm on January 8 to 1.82 cm yesterday.


:yahoo: Great job momma!

 

Thats great!!! And thanks for the info!

 

Hi ladies,
What are spirometer exercises for the lungs (as in Atina's post?). I've been feeling horribly short of breath, much worse than my past pregnancies, and a friend told me it's because of the bed rest. I sometimes feel like I'm gasping for air, and even wake up at night feeling like I need to take deep breaths!
I'm now 25 weeks and stable at 1.8cm, so the doctor is keeping me at home for now doing strict bed rest. It's been 7 weeks of bed rest (2 weeks of strict, the others modified) and it is SO hard. I'm glad I have this forum for encouragement. At least the babies seem to be doing great so far--one boy is 1lb 9oz and the other 1lb 11 oz. They are starting to run out of space--I can feel it!
Good luck to all of you ladies and keep posting!