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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Scan At 22 Weeks Showed Low Cervical Length, Advised Completer Bed Rest, Injections. Guidance?

My wife has been scanned in 22 weeks and it has been mentioned as 4cm cervical length. Due to some emergency we have been to native in train( safe journey - 10 hours). We have consulted a doctor there with the scan report. But the doctor was telling us The cervical length is almost 1 - 1.5 sms only. Your baby s head is on the cervix . Its very risky now. you have to be in complete bed rest. You should not travel, lift heavy things. You should sleep in a bed by keeping the legs little upper than the head.(i.e keep two bricks below the cot legs so that the bed will be tilted lower at the head side and the legs will be at the upper end) .She suggested for an Injection for every week ( injection name prescribed in the bill:Naturogest 200/2 ml INJ). we have taken the scan in the next week and it was 2.6 cm. By. 24 week check up she was telling the cervix length is 3 cm. but we cannot be happy. we have to follow the same procedure. To be in complete bed rest and every week injections .she also scared us that the baby may born any time in this condition if we are not in bed rest. she also told we are very late and she cannot do a cervical circlage also.
Wed, 9 Jan 2013
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OBGYN,  's  Response
Hello
thanks for your query.
A cut off of 2.5 mm is considered critical as a predictor for preterm labour.
Please understand that this is measured by transvaginal sonography, and a difference of few mm between observers is common, as it is pretty subjective.
However, at a length of 1 - 1.5 cm, preterm labour is imminent, and all the precautions given to you were rightly given.
At 3 cm, however, you need not have complete bed rest, or very rigorous precautions, but you need to be vigilant and careful, and have relative bedrest.
The weekly injections are given as progesterone is a tocolytic ( prevents preterm labour ).
Cervical encirclage is rarely performed after 22 - 24 weeks, unless exceptional circumstances are there.
however, it is not indicated at present at the cervical length of 3 cm.
You still have a long way to go , as far as the pregnancy is concerned, so you have to continue taking the medical advice and hope for the best results.
Take care.
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Scan At 22 Weeks Showed Low Cervical Length, Advised Completer Bed Rest, Injections. Guidance?

Hello thanks for your query. A cut off of 2.5 mm is considered critical as a predictor for preterm labour. Please understand that this is measured by transvaginal sonography, and a difference of few mm between observers is common, as it is pretty subjective. However, at a length of 1 - 1.5 cm, preterm labour is imminent, and all the precautions given to you were rightly given. At 3 cm, however, you need not have complete bed rest, or very rigorous precautions, but you need to be vigilant and careful, and have relative bedrest. The weekly injections are given as progesterone is a tocolytic ( prevents preterm labour ). Cervical encirclage is rarely performed after 22 - 24 weeks, unless exceptional circumstances are there. however, it is not indicated at present at the cervical length of 3 cm. You still have a long way to go , as far as the pregnancy is concerned, so you have to continue taking the medical advice and hope for the best results. Take care.