ENDO Messages for September, 2003: Possible incompetent cervix, complications that indicate another pre-term, what can we do?

Possible incompetent cervix, complications that indicate another pre-term, what can we do?

From: anonymous (anonymous@obgyn.net)
Fri Sep 26 00:27:23 2003

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My wife has been on bedrest for 10 days now. She visited her OB with lower back pain, painful contractions, and the feeling that something just wasn't right. They examined and found short cervix (2.5cm) and mentioned they could "stick a finger in her cervix". I know it has to do with dilation, but no idea if it's bad or not. Anyway, on the follow-up visit, her cervix had shortened between 1.8 to 2.3cm but the bedrest seemed to help with the contractions. She's trying to push as many fluids as possible but still has severe lower back pain and can barely walk. During the second vaginal ultrasound the baby's head was practically buried in her cervix already and when the doctor had her "bear down", noted shortening on ultrasound readings. History--First child born 4 weeks premature, no complications, healthy today. Second child delivered at 32 weeks pre term after major car accident that put her into immediate labor. No other complications noted. 5 weeks in NICU but perfectly healthy today. This third pregnancy comes only a year after delivering Matthew and the car accident. Questions: Does previous traumatic delivery indicate possible incompetent cervix or pre term delivery? With the baby at only 22 weeks, should she be positioned for delivery? Note: past ultrasounds she was active and jumping all over her uterus :) With the baby positioned with her head at the cervix, is this causing the discomfort? Silly question, but is there any way to move the baby and alleviate the pain? To my wife it feels like she has not moved from the birth canal in three days. What are our options, this forum is the first I read of fetal fibronectin and cerclage, are those effective in our case? Any advice would help, thanks.

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