QuestionHi, I am currently 14 weeks 5 days pregnant with my second child. After I had my daughter in 2004 I had a LEEP performed due to abnormal pap smears. When I found out I was pregnant this time they told me that I would be at a higher risk of having an incompetent cervix and needing a cerclage and bedrest. My question is I had 2mm of my cervix removed and therefore it is not fully closed, my OBGYN is not sending me to have my cervical length checked until 18 weeks into my pregnancy. Do I have a high risk of actually needing a cerclage? All the info I have read said this is normally checked around 13 weeks and forward, not so late into the pregnancy. I'm not sure if 2mm is something that I should be worried about, I'm so paranoid that I'm going to lose my baby, that's something that I just couldn't handle.
AnswerDear Brittany,
The cervix is the narrow, tubular, lower end of the uterus that extends into the vagina. When you're not pregnant, the cervical canal remains open a tiny bit to allow sperm to enter the uterus and menstrual blood to flow out. Once you become pregnant, secretions fill the canal and form a protective barrier called the mucus plug. During a normal pregnancy, the cervix remains firm, long, and closed until late in the 3rd trimester. At that point it usually starts to soften, efface (grow shorter), and dilate (open up) as your body prepares for labor.
If your cervix is softer and weaker than normal, which will sometimes happen after a LEEP procedure, it may efface and dilate without contractions in the 2nd or early 3rd trimester as the weight of your growing baby puts increasing pressure on it. This condition - called cervical insufficiency or "incompetent cervix" - can sometimes result in 2nd trimester miscarriage, premature rupture of the membranes (when your water breaks before you're full-term and before you're in labor), or pre-term delivery (before 37 weeks).
When women are at risk for this condition, the doctor may order regular trans-vaginal ultrasounds beginning at about 16 to 20 weeks to measure the length of the cervix and to check for signs of early effacement (shortening). The more significant changes there are or the shorter your cervix, the greater the risk. If ultrasound shows you have an abnormally short cervix and you're less than 24 weeks pregnant, your doctor may recommend a cerclage, a procedure in which he/she stitches a band of strong thread around your cervix to reinforce it and help hold it closed.
These are fairly standard dates, so I would not be overly concerned with the timing. Your doctor really has to wait a bit to see if the weight of the baby is going to affect your cervix and when.
I hope this information has helped you and answered your question. I wish you well.
Brenda
