What happens if I have a short cervix?

Having a short cervix during pregnancy means a higher risk of a premature birth. If you have a short cervix, your provider will recommend a type of treatment based on factors like your medical history and how far along you are in pregnancy. This treatment is designed to help delay delivery and prevent preterm birth.

Managing a short cervix

Here are some of the more common ways that women are treated for a short cervix in pregnancy.

  • Your provider will make sure you know the signs of preterm labor: Labor before 37 weeks is considered preterm, and even though many women with a short cervix do not deliver preterm, it’s still good to know the signs of preterm labor. Cramps that feel like menstrual cramps, vaginal or pelvic pressure, and a lower backache are all potential signs of premature labor. Your healthcare provider will go over these with you, and tell you what to do if you notice them.
  • Your provider might have you come in regularly for an ultrasound: If he or she thinks it’s appropriate, your provider might schedule frequent checkups to monitor your cervical length. This is especially likely if you have a history of preterm birth.
  • You may be given progesterone: Progesterone treatment can significantly help in preventing preterm birth, especially for women who have a history of spontaneous preterm birth, or those who have a short cervix. If you’ve been diagnosed with a short cervix, you might be given progesterone suppositories or gel, up until your 37th week of gestation.
  • You may have a cerclage placed: A cerclage is a stitch that is placed around the cervix and then removed at around 37 weeks of pregnancy. It helps prevent the cervix from opening too early in pregnancy. This kind of treatment may be an especially good option for women who are diagnosed with a short cervix very early in pregnancy. It may also be a good option for women who had a short cervix in a previous pregnancy, or who previously experienced a preterm birth.
  • Your provider might recommend certain lifestyle changes: Sometimes, especially if a woman has had a previous preterm birth, her provider may recommend that she reduce physical activity and try to remain sedentary for the remainder of her pregnancy. The provider may also recommend that she avoid intercourse. While these kinds of interventions aren’t as common as a cerclage or progesterone, they are definitely a possibility for treatment depending on circumstance.

Cervical length and pregnancy

Cervical length at weeks 16-24 weeks of pregnancy is one of the best predictors of a woman’s risk of preterm birth, but it isn’t routine for providers to check cervical length if their patient doesn’t have a history of preterm birth. If your provider hasn’t measured yours, it might be worth requesting at your next appointment. If you do have a short cervix, your provider will likely help you manage your pregnancy using one or a few of the techniques listed above.


Sources
  • “Cervical insufficiency and short cervix.” MarchofDimes. March of Dimes Foundation, Aug 2015. Web.
  • Joseph R Wax, MD. “How to manage a short cervix to lower the risk of preterm delivery.” OBG Manag. 22(5):36-50. Web. 2010 May.
  • Vincenzo Berghella, MD. “Cervical insufficiency.” UptoDate. UpToDate, Inc., 2017. Web.
  • Hee Joong Lee, MD, PhD, et al. “Management of Pregnancies With Cervical Shortening: A Very Short Cervix Is a Very Big Problem.” Rev Obstet Gynecol. 2(2):107-115. Web. Spring 2009.
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