Resolved question:
Hello;
I am a pregnant woman that arrives soon to her 26th week (next saturday). Since the 19th week, I have many contractions, that are painful for the most. I went to the hospital, and the contractions have been monitored twice, with a average of 10mmHg,
The first time I went to the hospital (end of the 19th week), I had a vaginal echography, and the length of the cervix was 46mm. The hospital sent me home with some morphine to calm down contractions on need.
I went to the hospital for a second time (on the start of the 22nd week) because I had a echo planned for the cervix length, and it was measured at 43mm.
I went to see an OB GYN (outside of the hospital) last week to have a second cervix length since my contractions have not stopped. The cervix length was 41mm (end of 24th week).
For the last OB GYN I saw, the cervix haven't changed, What do you think ?
For a second question, it is about progesterone. I had a miscarriage at 11 weeks, and I have a low level of AMH (0.87 I think). I took progesterone for the first trimester for this pregnancy, Actually, the doctor doesn't want to prescribe progesterone because my cervix length seems normal, but I got a diasgnosis of irritable uterus. I have read that progestrone can help stopping the contractions. What do you think ?
Submitted:
4 Days
Category:
OBGYN
Hello,
Thanks for your query at DoctorSpring.
At 24 weeks, you are considered at risk for preterm labour only if the cervical length is less than 25 mm.
With each visit, the cervical length is dynamic, so you would not get the exact measurement each time, also, interobserver variation exists, so as long as the length is above 25 mm, do not worry.
Also, the difference would be significant, if the length decreased dramatically ( at the rate of 5 mm per week or more , which is not the case ).
In such a scenario, I can understand that progesterone was not given to you, as the cervical length was okay. However, in view of previous miscarriage, and the irritable uterus, you SHOULD continue taking progesterone.
Progesterone therapy to prevent preterm labour can be continued as long as 34 weeks of gestation,as you are frequently having mild uterine contractions.
Also, take adequate rest, lots of water, as hydration is important ( to prevent urinary tract infections which can lead to preterm labour ) , and avoid stress, hectic travelling and intercourse.
Please consult your gynecologist regarding prescription for progesterone vaginal gels / capsules to prevent preterm labour in your case.
All the best.
Please feel free to ask any further follow up questions.
Hello;
I know that progesterone is supposed to protect changes of the length of the cervix. But does it have a chance to stop my contractions ?
And is there any danger or side effects to be aware of to take progesterone at this stage of my pregnancy ?
Hello again,
That is what my previous answer indicated, but now I will state so even more clearly.
Even IF the cervical length is alright, progesterone IS recommended as you have uterine contractions and previous miscarriage.
Progesterone is known to inhibit and stop the uterine contractions associated with preterm labour. That is the reason I recommended its use for you.
Natural progesterone gel / vaginal capsules are quite safe for use, and have no major side effects.
Take care.