bedrest at 20w funneling cervix

Hello Twin moms,
This is my first post on this forum. I had been to a routine ultrasound w/ b/g twins last Monday and they told me my cervix had started funneling and had shortened to 1.3cm. I was devastated to hear the news since my 18w ultrasound didn't show anything. Needless to say I broke down immediately. I was admitted into L&D the same day for observation overnight and had an emergency cerclage done by the on call perinatologist the next day. I'm on complete bedrest at home now with no other medications. I am just so scared with the uncertainty ahead. On top of that I read some reports that a cerclage and bedrest don't help Twin moms as much singletons but I can see it has helped some moms on this forum. Has anyone had any success with a cervix as short as mine with an emergent cerclage? My sis in law has a boy with CP due to premature delivery and I'm terrified of that happening to us. I'm trying to keep positive by reading success stories but those medical reports with statistics is so discouraging. I haven't had contractions so far and I'm not taking any medication for them....should I be asking my doctor for them? I hope I have some good news to share after my next appointment this friday.

Best of luck to all expecting twin moms out there! I hope all of us can go full term.

 

Hi there, first off, just want to say THERE IS HOPE!!!

I can understand how scared you are because I have been through something very similar. At 18 1/2 weeks I had an ultrasound which showed beautiful healthy b/g twins - and then I got the scary news - that my cervix was funneled and shortened to 1.3 cm. I had an emergency/rescue cerclage the next day, already dilated to 1.5 cm. One of my OBs was anything but optimistic... saying things like I should really think carefully about whether to get the surgery if it only meant delivering twins at 23 weeks who wouldn't survive... or born a bit later with severe disabilities. He did not recommend bed rest, citing all these studies where it supposedly did not make a difference... adding that there is not a lot of info out there about bed rest with twins in these situations. But my other OB who practices with him said I should spend most of the day sitting or lying down, and get up occasionally for short walks around the house in order to prevent blood clots. Oh, and to use the bathroom and/or shower, or briefly get something to eat.

You know what? I just passed 27 weeks yesterday. My cervix has not softened or dilated any further, despite a bit more funneling above the stitch and more discharge. My docs won't even give me steroid shots yet because they say there's been no significant change in the cervix. It's kind of funny to see my "gloom and doom" OB and hear him say how surprised he is that I've made it this far. You know what though - I truly believe it's because of the bed rest. I just cannot see how it wouldn't help to get all that weight and pressure off the cervix. You mentioned your sister in law has a boy with CP - what is that?

I would say, hang in there, there is definitely hope - I have read that here time and again, even in situations where women have not been able to get cerclage because they are too far along in their pregnancies. In my own case, I am not out of the woods yet, but every day is an accomplishment and that's worth remembering. Just take it day by day. Find distractions to keep you occupied - magazines, DVDs, music, whatever it takes. And remember there are a lot of people on these forums who will support you.

Good luck!! :hug:

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Thank you so much for your words of encouragement congrats on reaching 27w. It just seems like doctors are vague about everything but i must say my perinatologist was more optimistic. By CP I meant cerebral palsy.
I still have some very light brown discharge and when I spoke to a nurse she said it was alright a week after the cerclage. I also have some itching where I urinate.... should I be concerned about an infection spreading? I guess when there is cervical funneling the biggest risks are PROM and infection. I sure have a long way to go. My mom just moved in with us and she's a big relief for my husband right now who is feeling a little overwhelmed with everything.

 

:welcome: Congrats on your twin pregnancy.

Did you mention the itching to your doctor? UTI's can cause you to have a lot more contractions, but the itching is usually caused by yeast. Either way I would definitely get it checked out.

I had some funneling and shortening at week 28, and with strict bedrest(only getting up to use the bathroom for 9 weeks), I was able to carry them until 37 weeks. After just a week of bedrest my cervix had lengthened and the funneling was gone.

My advice, like PP, is to take it one day at a time. Drink TONS of water and then drink more! Lay as flat(on your side) as you can to keep all of the pressure of the babies off of your cervix.

Have they hooked you up to the monitors to see if you are contracting and just not feeling it?

:hug:

 

I will email my peri about the itching tomorrow since i can't access it today. The day I was admitted they hooked me up to monitor contractions. I just had 2 contractions (which i didn't feel) 40 mins apart right after the cerclage which they said was expected. I was then taken off the monitors the next day since I was stable. They put me on Indocin and antibiotics for 3 days while in the hospital. Do u think I should ask about the 17P injections so early (21w)?

 

Hi Sabrina, I'd say definitely ask your doc about the 17P injections. My OB put me on prometrium suppositories, 200 mg nightly before bed, because he said studies of singleton pregnancies had shown it could lessen the risk of preterm labour. That and low-dose aspirin. With twin pregnancies I guess it's a bit more of an unknown, but asking sure couldn't hurt.

I'm sorry about your nephew. That would be a tough thing for him and his whole family to deal with. Good thing your Mom has moved in with you to help out. You really do need that extra set of hands, and emotional encouragement.

Sending positive thoughts.

 

I'm honestly surprised that they did a cerclage. Am I reading your post right that your cervix is at 1.3 cm? Either way, there is so much conflicting information out there about what helps and what doesn't. I think there are so many factors in each case that it's hard to say for sure. You can read my story in the success stories thread, but here's the short of it. Went in for a routine exam at 20.5 weeks and was found to be dilated 3cm with bulging waters in active labor, contractions 2 minutes apart. I was shocked. I felt some cramping, but had no idea that anything was happening. They stopped labor using mag (as well as all the others, but it wouldn't stop until the mag) and the next morning placed an emergency cerclage. It was an extremely difficult next 3 months full of all kinds of rollercoasters, but I carried them until 31.5 weeks and they were in the NICU for 30 days as feeders/growers. No long-term complications whatsoever. When I was on bedrest, I read a lot of PTL and IC and success stories and such. I don't know if this is valid or not, but I became convinced that the single most important thing to have while dealing with these issues is hope. Your body is working really hard with a complicated pregnancy (as well as a non-complicated one) and in some ways it's a battle within yourself. I can't prove that bedrest works, but I highly recommend it. I have no doubt that my kids wouldn't be here today without both the emergency cerclage and the strict bedrest. Everyone's story is different and I hope that you make it full-term and are soon posting your own success story Keep us posted!

 

You probably have a yeast infection from the antibiotics.

 

Looks like it could be a yeast infection. Yes my cervix was last measured at 1.3cm, that's all they've told me. I am still educating myself with all the IC terminology, The doctor didn't say anything about bulging membranes, dilation, effacement, etc. She said any CL below 2.5cm with multiples is taken very seriously and hence the cerclage & bedrest (only bathroom breaks and 10 min showers). I just hope all this bedrest leads to some positive news this friday. I definitely feel a lot better after reading all your supportive posts and I'll keep u all updated.

 

Hey! Congratulations on your twin pregnancy!
I'm glad they were able to do a cerclage on you. I'm in a similar situation, at my 24/25-ish week routine ultrasound, they found that my cervix had shortened to 1.1cm, and was funneled as well. I was too far along for a cerclage. They did admit me immediately to the hospital, where I was on strict bed rest there for about a week. While I was there, the gave me betamethasone steroids for the boys' lungs. I wasnt contracting, and my cervix didnt change much while I was in the hospital, so they sent me home on complete bedrest (like you, bathroom breaks and short showers only). It's almost three weeks later now and I'm still here! My cervix is still about 1.1, I have dilated to about 2cm though. My funnel continues to get bigger, and my baby a's head has descended into the birth canal. But they said this is to be expected. Bedrest is hard, but it's worth it. I'm almost to 28 weeks, which is a huge milestone. So it can be done! Hang in there, we're in this together!

 

I myself just found myself diagnosed with the same thing at the same gestational age. No clerage though: my doc wont' do it due to a history of bleeding and the questionable utility. I am however on progesterone suppositories.

Good luck. Try to stay positive.

 

I also went in for routine visit & placed on bedrest @ 22 weeks. Had surgery done and started funeling 2 weeks later. At 24 weeks put back on strict bedrest. Only this time in the hospital. now 29 weeks & counting. being on strict bedrest in the hospital is insane.i want my boys to stay in there as long as possible but can you imagine what its like being here in this bed 24/7?

 

well some good news today! Went in to see the peri today and she measured my cervix...its 3.1cm now with little funneling. I asked her about medications for contractions but she said since I wasn't contracting it was not needed at this point. I'm meeting her again in 2 weeks. Its been 11 days since the CL check that started all this drama. I followed my bedrest with some restrictions of my own (like stairs once a week and showers every other day) and one of the main factors that inspired me was the 4 days of hellish hospital bedrest. All the twin moms are doing so admirably for so long, I'm optimistic we'll reach full term or atleast close to it.

Anyway I spent way too time outside today- 4hrs, so trying to catch up on rest. I had one contraction that lasted 15sec right after getting back.

happymom, so sorry to hear about your hospital bedrest but the good news is you are very very close and I truly hope you get to spend the rest of your pregnancy atleast on home bedrest.

Thank you twin moms for being so optimistic.

 

Just an update after 6 weeks of home bedrest. After getting the cerclage I have been getting internal u/s for the cervix every 2 weeks and so far the cervical length is holding steady around 3cm. I am so nervous about the next 2 weeks ...I desperately want to go past 28 weeks. I have growth scans and MFM visits every 4 weeks.

I get sporadic contractions every day (about 4) which haven't changed my cervix. Should I be concerned about this since I'm not on any medication?

I feel a lot of vaginal pressure and some pain there when I sit down to pee..... is that normal?

Subtle PTL symptoms like cramping, backache, etc...are you supposed to feel them lying down as well for PTL?

On top of all this I have only gained 15 pounds post pregnancy (I was 20 pounds overweight prepregnancy) and my babies are only in the 30th percentile in spite of the bedrest and protein shakes.

I am sorry this update turned into a bout of whining. This is my first pregnancy so every sensation is new to me. Sometimes I feel like I can't take anymore of this anxiety and uncertainty anymore. I feel guilty about taking clomid, guilty about subjecting my family to a complicated pregnancy....

Anyway thank you all for putting up with me inspite of going through complications yourself. Good luck to all you twinmoms. :thanks:

 

Hi there,

Sorry you are sharing this journey with the rest of us. I have not had a cerclage (I didn't qualify), but IF your cervix has not changed with the tightenings THAT IS EXCELLENT!! I was like that from 24-27 weeks in hospital. I also feel the awful anxiety with this PG and I wish I didn't for the babies sake.

I also felt lots of pressure.

Hang in there hon, you can do it!

 

Good for you for holding out! I'm now 32.5 weeks pregnant and have been in the hospital on bedrest for 5.5 weeks now with not much hope of going home before my babies come. My cervix is only about 2mm (has been since i was admitted to the hospital) but I suppose the bedrest has really kept things in check.

Anyhow, that's great that your cervix is still at 3cm! Of course i don't know with any certainty, but i really don't think 4 contractions a day is a lot or anything to be concerned about. I am on procardia (a drug that relaxes your uterus to prevent contractions) and I usually have 1 or 2 contractions an hour and my drs and nurses say that as long as you have fewer than 4 contractions an hour, it's nothing to be worried about.

In terms of your other symptoms, I haven't had them and would definitely run them by your MFM doctor or call the office and just talk to a nurse, no reason to be worried if you can have your questions answered!

Good luck with everything! It's amazing how time has a way of passing! I know it's hard, but at least you're at home! : )
Take care!

 

Sounds like things are going well for you and thank you for giving me hope as well. I had a rescue cerclage at 22 weeks because I was 4 cm dilated and cervix was measuring 1.7. I was at the cusp of being eligible for a cerclage but the peri took a chance since I wasn't showing signs of infection. I did start to have regular contractions (that I noticed) after the amnio to check for infection but I may have just started noticing them since I was laying there with nothing better to do.

I was discharged to home bedrest after 4 weeks in the hospital and have a T pump to control the contractions. I have 3 or 4 contractions every hour but I'm allowed up to 6. They also don't count a contraction as a "contraction" unless they are longer than 40 secs. They really don't want to use medications if they don't have to since the drugs used for contractions are not w/o side effects. The terbutaline makes my (and the babies) heart race and has cause me to be pre-diabetic. I have only gained 7 lbs in 27 weeks of pregnancy and it's very difficult to try and gain weight when my diet is so restricted. Since I started at 110 lbs, my weight gain is a big issue which I'm trying to figure out. Also, procardia can cause low blood pressure, indocin can cause heart problems in the babies if used too long and mag sulfate makes a lot of women feel flushed (I heard it was more like you were being boiled from other women). Unless you are feeling strong regular contractions that are causing cervical changes, they will probably try to keep you off meds.

3 cm is wonderful! I was discharged even though my CL went from 1.7 to 1.3. The peri said that since the cerclage was holding, CL isn't as big an issue. I imagine that if my CL was longer, I might be allowed out of bed more but for now, it's only the bathroom.

As for the vaginal pressure, I'm told that's normal. The stitch is right by your bladder and the babies are probably sitting pretty low. As they get bigger, it will probably get more uncomfortable unfortunately. My twin A also likes to kick my bladder and cervix which hurts like heck! Whenever they do CL ultrasounds, they see two little feet tap dancing down there.

The back pain for me happens when my contractions get out of control. If it's just back pain w/o contractions, it's usually from lying down in one position too long. If I switch positions, the "normal" back pains will go away.


If you feel like something is wrong, please call your doctor. My OB keeps telling me that it's ok, that they'd rather hear about something vs. having me ignore possible symptoms.

Good luck, hopefully we can all make it to term or close to it!

 

Congrats zsmommy and twinletmommy on making it past 32 weeks, that's a huge milestone.....its currently my no stress milestone. :bubble:

I had a little scare 2 days ago. I found blood in my discharge and went straight to L&D. Anyway it turned out to be nothing but I had THE most painful speculum check ever...it was horrible. My husband has never seen me get one and he had to see this...I thought he was going to cry :shok:. The doctor who treated me was a twin from a b/g pair.

hhc, Looks like we are really close. Thanks a lot for describing your symptoms in such detail...gives me something to compare mine too. If this pregnancy has taught me anything its that things can change in a matter of hours and all we can do is follow doctor's orders and be vigilant about our symptoms.

As always all you have managed to make me feel a lot better. Don't know how I could have maintained my sanity without this forum.

Best of luck everyone!!

 

Hi there,

I am in the same boat as you. I am 27 weeks and 2 days pregnant with boy/girl twins. At 23 weeks the specialist saw funneling and placed me on bed rest, the next week, there was essentially no funneling and measured 3.1. Last week however, the funneling was back, so I am still bed rest bound. I knew bed rest was a possibility, but I never thought it would begin at 24 weeks and I am nervous that it will continue until they arrive. It is VERY hard to be positive all day when you see the 4 same walls, the house is mess and life pretty much has to be put on hold. I also have a 2 year who keeps telling me to 'get off the couch'. My husband is doing his best managing work and being Mr. Mom so I can't really ask him to do any more. I know bed rest is necessary to help have healthy babies and a short time (hopefully none) in the NICU, but it has been very hard emotionally since I feel like I am inconveniencing so many people and living in such an unorganized state. Anyhow, I certainly know how you feel - the nerves, the frustation, etc.

Hang in there and know there are others experiencing the same things! At least this is all temporary!!

 

All I have to say is "WOW" to everyone on bedrest, as someone who knows...it sucks!

However, it is so worth the babies NOT being in the NICU or at least knowing they'll have a shorter stay there. I am still in the hospital on bedrest b/c of my shortened cervix and b/c the babies are both breech (footling...feet/legs over the cervix) and my peri is too worried to let me go home. This coming week will be my 7th week here and although it's the worst and although I only see my 2.5 year old son for an hour a day I just think how much worse things could be and how lucky i am that all is going well. In terms of the house, child, etc...I'm hoping they won't really remember this and that soon it will all be a faded memory. I didn't think I could possibly be on bedrest this long (and can only cringe thinking I may have to be here 5 more weeks) but try to find things to distract you...magazines, visits from friends, email, movies, tv, tv, tv! Hang in there everyone! May this be the hardest thing you ever have to do! Right?! Oh, and if you need to cry...CRY!