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Short cervix: problems, diagnosis, and treatment

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Short cervix: problems, diagnosis, and treatment

Some problems can complicate labor and delivery, and having a short cervix is one of them. 

Recognizing this potential issue early can make treatment easier and the outcome of the pregnancy favorable.

What short cervix and cervical insufficiency meanA short cervix means having a cervical length that is shorter than normal during pregnancy. This may be observed during a vaginal ultrasound done as a part of routine prenatal care.

How short cervix and cervical insufficiency affect pregnancyWhen the cervix is unusually short, it provides less protection for the fetus and pregnant woman. It also becomes prone to early dilatation, which is known as cervical insufficiency.

In essence, having a short cervix increases the risk of pregnancy loss, preterm labor, and preterm delivery. Preterm labor is a risk for numerous complications, such as stillbirth, low birth weight, intracranial bleeding, and long-term disabilities.

Signs of cervical insufficiency
Many women with cervical insufficiency may not have signs early on in pregnancy. But some women may feel mild discomfort or spotting from around 14-20 weeks of pregnancy.  Some may also experience the following:

Will you be checked for a short cervix?
While being a universal screening protocol in some hospitals, checking for a short cervix is not a routine prenatal test, so your provider may not check your cervical length unless they have a reason to do so. Some of the reasons include:

If your provider thinks you have a short cervix, they may check you with transvaginal ultrasound to know when you start developing cervical insufficiency. This type of ultrasound is considered the gold standard for measuring the cervix, and it is usually done at the beginning of the second trimester — around 16  weeks — if you’ve had previous losses or preterm deliveries, and at this stage of pregnancy, your cervix measures less than 25 mm, your doctor will diagnose you with a short cervix.

Treatments

Your provider may recommend a cervical cerclage. This is a surgical procedure where the doctor uses a strong stitch to keep the cervix closed. The procedure can be done as early as 13 to 14 weeks of pregnancy. The doctor removes the stitch at about 37 weeks of pregnancy when the pregnancy is getting to term. Sometimes Arabin pessary is opted to avoid possible complications from surgery. Progesterone supplement is also another preventive measure under supervision from your obstetrician.

Risk factors

Some of the factors that can affect the length of your cervix and in turn cause cervical insufficiency include:

How to prevent it

It may not be possible to prevent cervical insufficiency, but there are precautions to take to promote a healthy, full-term pregnancy, even if you are at risk. These include the following:

Avoiding risky substances: Avoid cigarettes, alcohol, and illegal drugs. Discuss with your doctor before taking any medications or supplements — even over-the-counter ones.

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