When you’re pregnant, you learn a lot about your anatomy that you didn’t know before. And every now and then, you discover something that necessitates special attention during pregnancy. That’s the case with a short cervix! The cervix is the opening at the uterus’s bottom that connects the uterus and the vagina. When you’re not pregnant, it’s usually quite short — about 25 mm on average — and closed. Your cervix takes centre stage during your pregnancy and it will open up and thin out to pass the baby through the birth canal. So, most patients with a short cervix are concerned about how it will affect labour and delivery. Let’s discuss how to diagnose and treat a short cervix during pregnancy.
What does a “short cervix” mean?
There are two openings in the cervix: one internal and one external (also called the internal os and external os). The internal os enters the uterus, while the external os enters the vagina. The cervical ossa close during pregnancy to keep the foetus in the uterus and then opens when it’s time to deliver. The cervix shortens and softens during pregnancy to allow for delivery. Some people are born with a shorter cervix. Their cervix may become too short too soon as it shortens throughout their pregnancy, increasing the risk of preterm labour and premature birth. At 18–24 weeks’ gestation, a short cervix is less than 25 millimetres long. An ultrasound scan is suggested by doctors to determine the length of the cervix.
Read to know the factors determining the mode of delivery – C section or vaginal.
Causes
Several conditions result in an incompetent cervix. They include:
- Abnormally formed cervix or uterus.
- Surgeries like conization or leep biopsies on the cervix
- Short cervix
- Damage to the uterus from a miscarriage or childbirth.
- Exposure to diethylstilbestrol (DES), a synthetic hormone in the previous pregnancies.
Symptoms
If your cervix is incompetent, you may not experience any signs or symptoms during early pregnancy. Some women experience mild discomfort or spotting for several days or weeks between 14 and 20 weeks of pregnancy.
Be on the lookout for:
- A sensation of pelvic pressure
- A new backache
- Mild abdominal cramps
- A change in vaginal discharge
- Light vaginal bleeding
Read to know about labour and child birth.
Treatment for a short cervix
1. Progesterone
If your cervix is less than 25 millimetres long and you are carrying only one baby, progesterone hormone therapy can help prevent premature birth and reduce complications. A vaginal suppository could be prescribed beginning at the time of diagnosis and ending after 37 weeks. If you have a history of preterm labour, your doctor may instead recommend a weekly progesterone injection.
2. Cervical cerclage
If you are less than 24 weeks pregnant or have a history of premature birth, and an ultrasound shows that your cervix is opening, a surgical procedure called cervical cerclage may help prevent premature birth. The cervix is stitched shut with strong sutures during this procedure. The sutures will be removed at the end of the pregnancy or during labour. If you have a history of premature births caused by cervical insufficiency, your doctor may also advise you to undergo cervical cerclage before your cervix opens (prophylactic cerclage). This procedure is usually performed before the 14th week of pregnancy.
3. Arabin pessary
Arabin pessary is a relatively new alternative to cerclage and progesterone. It’s a small ring that wraps around the cervix and closes it without requiring surgery. According to one study that compared cervical cerclage and pessary, if you have funnelling, a cervical pessary may be the better option. A short cervix can exist without funnelling, but funnelling causes it to take on a V- or U-shape.
4. Bed rest
For a short cervix, a doctor may recommend bed rest (or pelvic rest) and continued monitoring. This can range from no sex or strenuous activity to complete bed rest (wake up only to pee and eat). It is important to note, however, that strict bed rest has not been shown to prevent preterm labour.
Hope you got a clear idea on how to diagnose and treat a short cervix during pregnancy. You have no control over a short cervix, so there is nothing you could have done to prevent it. If you do develop this condition, know that there are effective treatments available to help you extend your pregnancy as long as possible so you can have a healthy baby.
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