During my 20 week’s anatomy scan, I was devastated by the cruelest information ever! With a cold professional voice, the obstetrician at one of the best hospitals in Philadelphia declared that I wouldn’t be able to keep the baby. She explained in great details what Incompetent or Short Cervix is. And, going one step ahead, she declared that I was about to deliver then and there. As preparations for the imminent termination of my sweetest dream, she instructed the attendant nurse to carry out some examinations.
My husband and I was yet to recover from the initial shock when the nurse approached me with her instrument. I was weeping and my husband’s face was totally blank. I knew he was thinking even though he remained silent till the nurse asked me to follow her instructions. My husband, with an unearthly voice, said, “If she is going to abort, what’s the necessity of these examinations?” “Well, I just want to make sure we are accurate in our assessment,” replied the nurse. I knew he was about to lose control and get into a verbal combat with the doctor. Proving me wrong, he remained exceptionally quiet but firm and said, “We do not consent to any examinations given that these will not benefit us in any ways. And, we demand immediate release.” The doctor, perplexed by his sudden assertiveness, claimed that we wouldn’t even be able to make it home. “You don’t know the future: you’re a doctor, not a psychic reader!” My husband dressed me up and we came out of the hospital with my dream in a wheel chair. And, yes, we made it home: it took 30 minutes to drive just 3 miles.
Dear moms, I know, many of you went through the short cervix nightmares. Those of you who are currently suffering from incompetent cervix, please do change your hospital or obstetrician if they tend to demotivate you in any ways. I got rid of the professionalism of the best hospital and shifted to Bryn Mawr Hospital. The doctors and the nurses in the Maternity department at Bryn Mawr made a serious difference in the way I approached and successfully handled my problem. I was on Hospital Bed Rest for two months, and the moment I was admitted the doctor said, “You are going to keep this precious baby, no matter what it takes.” It has been a long and painful journey, but the amazing nurses did everything possible to make it better. I delivered a healthy and beautiful boy at 32 week. But, before that I made sure a certain things that I am going to discuss below.
What is Incompetent, Short or Weakened Cervix?
From 12 week of pregnancy, the baby grows and gains weight. This weight puts pressure on the cervix. The cervix is a cylinder-shaped neck of tissue that connects the vagina and uterus. This pressure often leads the cervix to open up: the placenta follows the rules of gravity and fails to hold the baby. Miscarriage or preterm labor is what follows.
What causes an incompetent or short cervix?
Although sometimes the causes are undetermined, gynecologists agree that the following conditions cause the cervix to open up:
- Past surgery on the cervix
- Injury while giving birth
- Birth defect: abnormal cervix
- Past D&C (dilation and curettage) from a termination or a miscarriage
How is incompetent cervix diagnosed?
An incompetent cervix can be difficult to diagnose and, as a result, treat. Doctors do not routinely check for an incompetent cervix during pregnancy. If someone has a record of second or third trimester miscarriage and/or D&C, doctors are most likely to investigate the cervix through pelvic exam or by an ultrasound. A vaginal ultrasound provides accurate measurement of the cervix.
What are the symptoms of incompetent or short cervix?
There is no accurate symptom to detect that you are suffering from cervical incompetence. This is why you must not ignore the following symptoms. If you have any of these, talk to your OB and ask for a vaginal ultrasound.
- A sensation of pelvic pressure
- A backache
- Mild abdominal cramps
- A change in vaginal discharge
- Light vaginal bleeding
What are the treatments for an incompetent or short cervix?
If detected earlier, positive and effective interventions can be made to take the pregnancy to full term or close to it. This is why anyone with conditions above must talk to her obstetrician. With the result of the Vaginal Ultrasound, the Doctor may suggest the followings:
- Cervical Cerclage: Also known as cervical stitch. It’s a procedure that closes the cervix with strong sutures. The suture is inserted into and around the cervix early in the pregnancy, usually between weeks 12 to 14, and then removed towards the end of the pregnancy when the greatest risk of miscarriage has passed. Talk to your doctor if you have a history of miscarriage and demand for it during your first prenatal visit. You will not get it if you are more than 14 weeks. I did not get it as I was 20 weeks.
- Progesterone Supplementation.Although there is mixed opinions about the efficacy of this drug, it seemed really effective in my case. Available in the form of vaginal gel or injections, this drug saved my baby. I took the Crinone Progesterone Gel 8% daily before bed time. Ask for it. It does not have any serious side effects. And, Progesterone is the key to maintaining a healthy pregnancy.
- Pessary: It’s a device that fits inside the vagina and is designed to hold the uterus in place. A pessary can be used to help lessen pressure on the cervix. However, if you have any inflammation or bulging of the membrane, you will not get it.
What you can really do to keep the baby cooking?
- Rest: Yes, complete bed rest is the key. I was on hospital bed rest for two months and home bed rest for one month.
- Hydration: Keep hydrated all the time and empty your bladder. If you are in hospital, your caregivers will give you IV fluids each time you start cramping.
- Steroid Shots: No matter what, just get it! Demand it! This will save your baby if you deliver preterm. Get it as soon as you reach 23 weeks. This drug surprisingly accelerates the lung development. Take the first round at 23 or 24 week. And then the second round before 34 week.
- No Stress: Be positive! Get rid of the depressive information on the internet. Do something creative! Start drawing! Keeping a journal is also effective. Bed rest can drive you crazy! Be prepared to accept help!
Thanks to Bryn Mawr Hospital, specially the doctors and nurses in the Maternity department. I never knew that a hospital could be so welcoming and warm to a patient in serious crisis. Right at this moment as I am typing, my son is staring at me!