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Author Topic: UPDATE**Shortening Cervix, Funneling, 21 weeks pregnant with twins  (Read 723 times)

Alexandra429

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Hello everyone, I am new here, pregnant with B/G twins and a first time mom. I went in at 17+6 and my OB wrote a 3.3 cm cervical length with a abdominal ultrasound. I went back this week at 20+4. I mentioned to my midwife that I had felt some pressure and tightness low in my stomach and she decided to do a trans vaginal ultrasound to measure my cervix. It is now down to 2.689 cm and my midwife mentioned I have some funneling. She started me on progesterone suppositories, and told me to cut back on activity, no exercise, rest if I can, cut back on sex, etc. But she never explicitly said bed rest. I am still putting myself on a modified bed rest at least until my next appointment with the OB at 21+6. I am, of course, very nervous about pre-term labor. Anyone in a similar situation or had a similar situation, what was your outcome? I want to keep these babies in as long as possible. Thanks so much!


**Update** Went im at 21+6 and cervix was 2.5, they had me come in the next week for a vaginal swab and another measure. Went back at 22+5 and found out my cervix went down to 1.1 cm and they also found an infection. They admitted me and I received steroid shots at 23 weeks for babies lungs and have been taking magnesium in addition to progesterone and antibiotics to combat infection. I’ve been in here a week already and going crazy (I’m 23+5 now). I have no other signs of labor (cramps, contractions, increased discharge or pain) and they say they may keep me another week but won’t tell me when they will remeasure. I’d really rather be at home if I’m just taking some pills than lying in a hospital bed. THoughts?
« Last Edit: April 05, 2018 at 12:24 PM by Alexandra429 »

OBmom

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Re: Shortening Cervix, Funneling, 21 weeks pregnant with twins
« Reply #1 on: March 16, 2018 at 12:06 PM »
Hi Alexandra.

Congrats on your first pregnancy (with baby bonus :)).
First of all, a quick heads up: transabdominal and transvaginal measurements have a slight difference between them just because of the technique involved. TV is more accurate. But in your case, since you did one and then the other, it might not mean that the cervix has necessarily shortened.
27mm is within the expected CL for 20 weeks (with twins it's normal for cervix measurements to be shorter).  I agree with everything your midwife said about easing up on everyday life. Bedrest at this point shouldn't be necessary. You can have a pretty decent time as a couch potato, and still get to keep bathroom priviledges, shower times, short outings in good company and without you being the driver =)

Ask your doctor if he can do another measurement at 21+6 when you go in. Just keep in mind that the more TV US you have, the more you stimulate the cervix. Every 2 weeks is the normal interval for check-ups.

Good vibes going your way =) Plus, don't forget OBs generally accept shorter pregnancies for twins. If you can make it to 34 weeks you're already on the winners list!

Alexandra429

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Re: Shortening Cervix, Funneling, 21 weeks pregnant with twins
« Reply #2 on: March 16, 2018 at 12:46 PM »
That's so good to hear. My cousin, who is a labor and delivery nurse, seemed to be on the same page as you with outlook on this. My only real concern is the funneling. Does that not change the severity of the situation?

Alexandra429

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Re: Shortening Cervix, Funneling, 21 weeks pregnant with twins
« Reply #3 on: March 16, 2018 at 02:37 PM »
I also wanted to ask, what's your background, if I may ask. Your screen name suggests you are an OB, but I was curious because of your response to my question.

OBmom

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Re: Shortening Cervix, Funneling, 21 weeks pregnant with twins
« Reply #4 on: March 16, 2018 at 04:39 PM »
Hey again.

Yeah, I'm an OB specialist in a big high-risk MFM center in Lisbon, Portugal. To be honest it's been all kinds of interesting finding out the different perspectives and approaches to preterm birth worldwide. Love the forum!
Also on my background are two rounds of dealing with threatened PT labor and one PT birth at 34 weeks. Currently at 28 weeks with a cervix of 18mm, with a pessary in place.  My full story is on the forum in another post, feel free to check it out.

To answer your question on funneling, it's not straightforward. You can have funneling with a really long cervix (good prognosis as long as the length holds, with cerclage or pessary). Bottom line, cervical length determines prognosis for the most part. Funneling is a dynamic event that shows predisposition for a softening of the cervix (the internal orifice of the uterus is more open, a sort of "pre-dilation" if that makes sense). So it is a warning sign, but in most cases we can hold it back if we detect it on US.

Hope this helps =)

Alexandra429

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Re: Shortening Cervix, Funneling, 21 weeks pregnant with twins
« Reply #5 on: March 16, 2018 at 05:22 PM »
Very cool! We actually live in Italy and are hoping to make it out to Lisbon once the babies come! Yeah, I believe my funneling is right around 25%, so I am hoping things at least stay stable. I will rest as much as possible and take it easy. Thanks for your input, it's good to get another opinion!