Pregnancy After a Cold Knife Conization: First Trimester

As if a cold knife conization to treat adenocarcinoma in situ isn't scary enough, pregnancy after a cold knife conization is even worse. As women we all know the reasons that a doctor opted for a conization in the first place: we wanted to have children, and a hysterectomy would eliminate that possibility from our lives. Our cancer, or cervical dysplasia, was detected early enough to preserve our reproductive organs.

As wonderful as that is, nothing is scarier than the risks doctors tell you about after you have a cold knife conization. If you don't see pregnancy in your immediate future, you will realize how scary the whole deal is until you see your doctor for your first antenatal visit.

I went in to my first antenatal visit back in October. I had a cold knife conization in March of the same year, leaving only 6 months between my surgery and my pregnancy. I was excited at the prospect of having a child. However, as the doctor was checking my heart rate and my blood pressure she started rattling off risks. Incompetent cervix, cervical stenois, preterm labor, and late term miscarriage. As my head tried to grasp all these medical terms, I began to wonder if I would ever get to meet the little life growing in my belly.

A conization of the cervix affects the portion of your reproductive organs that holds your baby in during your pregnancy. Because a portion of your cervix is removed, there's a chance that it's not strong enough to sustain a pregnancy. However, doctors can monitor you closely and put in a cerclage and put you on bed rest if necessary.

When I found out I was pregnant, I immediately stopped my 6-can-a-day Diet Coke/Coke Zero habit. In addition to coming down off from caffeine cold turkey, I was very tired all the time. The doctor told me this was completely normal. I was scared because I had cramping and spotting, but it turns out that it was caused by a bladder infection - a 7 day course of antibiotics fought that off.

I had my first ultrasound at 7 weeks to assess fetal viability. Of course, the baby was about the size of a corn kernel so it wasn't putting much - if any - pressure on my cervix. I had little to no nausea, a little breast tenderness, and that was about it as far as my symptoms.

Time went on and I went to my second visit at 12 weeks. I got an ultrasound to screen for downs syndrome (trisomy 21) and trisomy 18. The ultrasound tech also used the ultrasound to measure my cervix.

I did not have any funneling, my cervix was at 3 cm, and the baby looked great. Funneling is where the baby's amniotic sac is descending in to the cervix. This can cause it to rupture. He or she was wiggling around and doing some sort of water aerobics that almost made it impossible for the ultrasound tech to do her job. Unfortunately, the baby didn't move into the right position for the tech to be able to see what he or she is...I will have to wait until my next ultrasound for that.

So far, my first trimester has been a breeze. I am now in my early second trimester. I work at a desk, so I don't put a lot of strain on my cervix everyday anyways. I feel pretty good, I am just extra careful not to over exert myself.

Hopefully your first trimester of pregnancy after a cold knife conization is as easy as mine was. I am keeping my fingers crossed for another uneventful trimester.

Here are some sources that I found helpful:

All Experts

Pregnancy Today

In addition here are some tips to help you ease your mind during a pregnancy after cervical conization:

1) Follow all your doctors instructions

2) Follow your gut. If you feel uneasy, seek a second opinion

3) Speak with your gynecological oncologist if you have questions. Although they don't usually perform antenatal functions, they will answer questions about your risks

4) If your doctor seems unconcerned, and doesn't address your conization as a potential risk, directly ask about it.

5) Consider seeing a high-risk pregnancy specialist if you still have unaddressed concerns

6) Take your vitamins!