Incompetent cervix / first trimester??

[Birdface]

Unfortunately I miscarried early this morning and managed to save my embryo/fetus to say goodbye etc. I saw a little wee wee too, so I’m sadder to know it’s the boy I had much wanted.

I would have just reached 10 weeks 0 days. Last scan was 8w3d and all was good. I was due for my very first obgyn appointment tomorrow at 10w 2days.

It’s now with the labs for testing. I doubt the result will tell us much given it’s a PGD tested embryo and the top quality of the batch.

I suspect it’s my cervix which may have caused the Bub to fall out. I had no symptoms worth noting but in retrospect, I had mild cramps a week ago and a little dizzy, just on that one day, then few days ago black brown clots when wiping for a day. No liquid spotting at all until it all happened from cramps last night while I was sleeping.

My miscarriage is nearly over in 2 hours. 3am gush, many large clots and by 5am ish, I was cramp free and lying in bed trying to get to sleep again.

Anyway.....

With incompetent cervix, it appears to be an issue from late second trimester. Mine is way too early it seems.

Has anyone had incompetent cervix issues in late FIRST TRIMESTER? And how did you fix and see through the baby to delivery?

Thanks. Id like to learn so I can fix for my next transfer, hopefully in a couple of months.

[SJ565]

I have no experience with this but just wanted to say I'm sorry for your loss x

[MLadyEm]

I am sorry to hear about your loss. Was your cervical length measured at your 8 week scan? Cervical incompetence isn’t really something that is that “common” and is usually made after a diagnosis of a short cervix. Unless you had a cervical length measured at your scan and it was identified to be short, then it’s unlikely going to be the cause. Up to 1 in 4 pregnancies end in a miscarriage, so unfortunately it might just be one of those things. It doesn’t make it any easier to process and sadly most causes of miscarriage are never found. It is suspected that most miscarriages are due to bubs having some chromosomal abnormality making them incompatible with life. With a PGD tested embryo though, I’m not sure whether this will be the case, but obviously they can’t test for everything.

If it truly is a case of short cervix (ie your cervix was less than 2cm in length) then your obstetrician can place a transvaginal suture next pregnancy to keep the neck of your cervix closed. But these are only done in situations where there are changes to the cervix.

Most cases of short cervix we see are indeed diagnosed well into the second trimester. I have never seen anyone diagnosed with a short cervix so early in their pregnancy. Not saying it doesn’t happen, but is highly unlikely.

[Birdface]

Thanks for your response. I didn’t get the cervix measured, at least it’s not in the report. I’ll make sure I do moving forward, just in case.

Anyone know about first trimester risks with incompetent cervix?

[mawright91]

Hi Birdface, it’s definitely possible to have it occur early.

My first was born spontaneously at 32+3. No diagnosis due to no scans after 20w so cervix wasn’t measured.

My second was born spontaneously at 14+6 & I was told my cervix was normal at my 13w scan, however I don’t actually know the measurements. I also didn’t have a dating scan that pregnancy for comparison.

This pregnancy it was determined I have incompetent cervix given my history, as I never had a detectable reason for the spontaneous births.
At 11+2 (last week) I passed what appeared to be a mucous plug & a scan the next day showed 5mm of shortening since 7+2. I’m now on progesterone pessaries until my stitch can be put in at 13+1 & will likely need to continue it afterward also to prevent further shortening. I have since joined a support group & discovered it happens quite a bit early & really requires specialist care to identify & take it seriously.

[Birdface]

Thanks for sharing @mawright91. I’ll love to know how you go, hang in there and hope the bub stays put!!

I’m still waiting for my appointment with the obgyn to find out the fetal tissue test result. I’d like to learn what to fix for my next FET. I’m digging up my previous gynaecological records for the obgyn too.

I was still actually on crinone and Progynova when I passed at 10w. The dose did drop to once a day around the 9w + mark. I hope that wasn’t a trigger.

Can you please elaborate what you mean by 5mm shortening since 7w? Why can’t they stitch one but have to wait till 13w?

[mawright91]

Thanks for sharing @mawright91.

Can you please elaborate what you mean by 5mm shortening since 7w? Why can’t they stitch one but have to wait till 13w?

I’m pretty new to all the fertility related stuff as I haven’t had to go down that track, it mostly the after conception stuff I have trouble with.

Hopefully you get some information. The most frustrating part I had last time was it was unexplained with the possibility of IC because I hadn’t been monitored to detect it.

This time around I had a dating scan at 7w & cervical length was measured at 3.25cm. Then I passed bloody mucous that resembled a show (mucous plug) at 11w. My OB did a scan in her office the next day & cervical length was 2.74cm, so it had shortened 0.5cm/5mm in that 4 weeks between scans. From everything I’ve read, normal length is around 3.5-5.0cm around 11-14w. The earliest they do a TVC is 13w. So fingers crossed the progesterone keeps things stable until the stitch is placed & then we just have to keep the baby in the right place for the next 5-6 months.