Posts Tagged ‘short cervix’

What does it mean to have a short cervix?

Wednesday, November 15th, 2017

A short cervix means the length of your cervix is shorter than normal. To be more specific, a short cervix is one that is shorter than 25 millimeters (about 1 inch) before 24 weeks of pregnancy.

Why is the length important?

If you have a short cervix, you have a 1-in-2 chance (50 percent) of having a premature birth, before 37 weeks of pregnancy. So if you have a short cervix and you’re pregnant with just one baby, your health care provider may recommend these treatments to help you stay pregnant longer:

  • Cerclage
  • Vaginal progesterone. Progesterone is a hormone that helps prepare your body for pregnancy. It may help prevent premature birth if you have a short cervix and you’re pregnant with just one baby. You insert it in your vagina every day starting before or up to 24 weeks of pregnancy, and you stop taking it just before 37 weeks.

If your provider thinks you have a short cervix, she may check you regularly with ultrasound.

How do you know if you have a short cervix?

Checking for a short cervix is not a routine prenatal test. Your provider probably doesn’t check your cervical length unless:

  • She has a reason to think it may be short.
  • You have signs of preterm labor. This is labor that begins too soon, before 37 weeks of pregnancy.
  • You have risk factors for premature birth, like you had a premature birth in the past or you have a family history of premature birth (premature birth runs in your family).

What makes a cervix short?

Many things can affect the length of your cervix, including:

  • Having an overdistended (stretched or enlarged) uterus
  • Problems caused by bleeding during pregnancy or inflammation (irritation) of the uterus
  • Infection
  • Cervical insufficiency

Read about our own Health Education Specialist Juviza’s personal experience being pregnant with a short cervix and her new connection to the March of Dimes’ mission.

Have questions? Text or email us at AskUs@marchofdimes.org.

Thinking about pregnancy after premature birth

Wednesday, November 8th, 2017

Even if you do everything right, you can still have a premature birth. We don’t always know what causes premature birth, but we do know that if you’ve had a premature baby in the past, you’re at increased risk of having a premature birth in another pregnancy. If you have given birth early, here are some ways you may be able to reduce the chances of premature birth in another pregnancy:

Wait 18 months between giving birth and getting pregnant again

Waiting at least 18 months between pregnancies gives your body time to recover from one pregnancy so that is it ready for the next one. Use birth control so you don’t get pregnant again too soon. Talk to your provider about the best birth control option for you.

Schedule a preconception checkup

Being as healthy as possible when you get pregnant can help you have a healthy, full-term pregnancy. At your preconception checkup you and your provider can talk about:

Talk to your provider about progesterone shots

Progesterone is a hormone that helps your uterus grow and keeps it from having contractions. Progesterone shots may help prevent you from giving birth early again if:

  • You’re pregnant with just one baby.
  • You were pregnant before with just one baby and had spontaneous premature birth.

Get treatment for short cervix

Your cervix is the opening to the uterus that sits at the top of the vagina. The cervix opens, shortens and gets thinner and softer so your baby can pass through the birth canal during labor and birth. Having a short cervix increases your risk for giving birth early. Talk to your provider about cerclage and vaginal progesterone.

Take low dose aspirin to help prevent preeclampsia

Preeclampsia is a kind of high blood pressure some women get after the 20th week of pregnancy or after giving birth. If not treated, it can cause serious problems during pregnancy, including premature birth. If you have risk factors for preeclampsia, like you’ve had it before or you have high blood pressure or other health conditions, your provider may want you to take low-dose aspirin during pregnancy.

Quit smoking, drinking alcohol, using street drugs and misusing prescription drugs.

All of these can put your health and your baby’s health at risk and make you more likely to give birth early. Quitting or getting help to quit is the best thing you can do. Talk to your provider about programs that can help.

Learn the signs of preterm labor

Learning the signs and symptoms of preterm labor doesn’t reduce your risk of premature birth. But if you know them and know what to do if you have them, you can get treatment quickly that may help stop your labor. If you have any signs or symptoms of preterm labor, call your provider right away or go to the hospital.

Have questions? Text or email AskUs@marchofdimes.org.

Study shows progesterone shots do not reduce preterm delivery in twin pregnancies

Friday, February 22nd, 2013

While 17P, a form of progesterone, has been shown to prevent premature delivery among about one-third of women who are pregnant with a single baby and who have experienced a prior preterm delivery, the latest research shows that 17P prescriptions can’t do the same for moms having twins.

“Twins are very high risk for preterm delivery, in fact, 60 percent of twins are born too soon. We can’t assume that what works for singleton pregnancies will work with multiples such as twins or triplets,” says Edward R. B. McCabe, MD, PhD, March of Dimes senior vice president and medical director. “This research finding is valuable because it will guide the care of women with a multi-fetal pregnancy, and highlights the need to better understand how to prevent preterm births for multiples.”

“We found that 17P was not effective in women with twin pregnancies and a short cervix (defined as less than 25 mm between 24 and 32 weeks),” says Philippe Deruelle, MD, with the Department of Obstetrics and Gynecology at Hôpital Jeanne de Flandre, Université Lille 2, France, and one of the study’s authors. “We actually seemed to have found an increase in the rate of preterm delivery before 32 weeks in the treatment group when compared to the non-treatment group.”

For the study, Dr. Deruelle and his colleagues conducted their trial on 165 women over the age of 18 at 10 university hospitals between June 2006 and January 2010. Outcome data was available for 161 of the 165 (97.6%) women. (The study’s title is Prevention of preterm delivery by 17 alpha-hydroxyprogesterone caproate in asymptomatic twin pregnancies with a short cervix: a randomized controlled trial, and was presented at the Society for Maternal-Fetal Medicine’s 33rd annual meeting last week.)

Dr. Deruelle recommends that women who know they are pregnant with twins get an ultrasound to measure their cervical length, as this factor has shown to predict which women with twins are at higher risk for premature pregnancy.

Hopefully, future research will help to shed light on ways to prevent pretem births for women who are pregnant with multiples.

What is cervical insufficiency?

Monday, August 16th, 2010

Cervical insufficiency (sometimes called incompetent cervix) refers to a cervix that opens too early during pregnancy, usually without pain and contractions. This most often occurs in the second or early third trimester of pregnancy, resulting in late miscarriage or premature birth. A woman may be diagnosed with cervical insufficiency based largely on this history. There is no specific diagnostic test.

Medical experts don’t always know why cervical insufficiency occurs. Factors that may contribute include:
• Uterine defects: Women with certain uterine defects, such as bicornuate uterus (two cavities), are more likely to have cervical insufficiency than women without these defects.
• History of surgical procedures involving the cervix: These include LEEP (loop electrosurgical excision procedure), which is used to diagnose and treat abnormal cells found during a Pap test.
• Injuries during a previous birth.
• Short cervix: The shorter the cervix, the more likely the woman is to have cervical insufficiency. In some cases, a short cervix can be congenital.

Miscarriage and premature birth due to cervical insufficiency frequently happen again in another pregnancy. These problems can sometimes be prevented with a procedure called cerclage, in which the provider places a stitch in the cervix to keep it from opening too early. The provider removes the stitch when the woman is ready to give birth.

It is not always clear which women will benefit from cerclage. This is because there is no specific test for cervical insufficiency, and many women who have had a late miscarriage or early premature birth go on to have normal pregnancies without treatment. Some studies suggest that cerclage is most likely to be beneficial in women who have had three or more late miscarriages or premature births. In some cases, providers may monitor a woman suspected of having cervical insufficiency with repeated vaginal ultrasounds to see if her cervix is shortening or showing other signs that she may give birth soon. The provider may recommend cerclage if these changes occur.

Some women learn that they have a short cervix during a routine ultrasound. Most of these women do not end up having a premature birth. However, short cervix, especially a very short cervix (less than 15 millimeters), does increase her risk of premature birth. Studies suggest that treatment with the hormone progesterone (17P) may help reduce the risk of premature birth in women with a very short cervix. According to the American College of Obstetricians and Gynecologists (ACOG), progesterone treatment may be considered for these women. However, ACOG does not recommend routine cervical-length screening for low-risk women.