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Managing pregnancy with cervical shortening

Carrying a precious life within you is a joyous journey but sometimes unexpected hurdles can arise. You learn new things about your anatomy that you never knew before. Cervical shortening, a condition where the cervix thins and shortens prematurely, is one such concern for pregnant women. But remember, managing pregnancy with cervical shortening is possible with knowledge, support and the right care.

Understanding cervical shortening

  • The cervix, the lower part of the uterus, connects the uterus to the vagina. During pregnancy, it gets longer and creates a distance between the outside and your baby. Towards the end of the pregnancy, the cervix can shorten again to prepare for the delivery.
  • Cervical shortening occurs when your cervix weakens, shortens or opens up too early during the pregnancy. Untimely cervical shortening or cervical insufficiency, can lead to premature opening of the cervix, increasing the risk of preterm birth.
  • While cervical shortening can occur at any stage of the pregnancy, it is most common in the second trimester, i.e. between 14 to 27 weeks of pregnancy.

Who is at the risk of having cervical shortening?

  • Unusual cervix shape: Women with irregularly shaped uterus or cervix can be more susceptible.
  • Previous preterm birth: Women who've delivered early before are at higher risk.
  • Multiple pregnancy: Carrying twins or triplets puts extra strain on the cervix.
  • Cervical infections: Certain infections or previous injuries can weaken the cervix. Previous surgeries on the cervix can also weaken it.
  • Congenital malformations: Some women naturally have a shorter cervix.
  • Genetic disorder: Genetic conditions like Ehlers-Danlos syndrome can also cause cervical trauma.

Symptoms of cervical shortening

  • Pelvic pressure or heaviness
  • Vaginal discharge or spotting
  • Frequent Braxton Hicks contractions
  • Pain in your belly

Diagnosis and management

  • Transvaginal ultrasound (TVS): This scan measures the cervical length accurately. Your healthcare provider can monitor using ultrasound till the 24th week of pregnancy.
  • Cervical cerclage: In some cases, surgical stitches might be placed around the cervix to keep it closed. However, women with twin or other multiple pregnancies doctor advise cerclage for safer confinement.
  • Progesterone s1upplementation: Vaginal progesterone helps support cervical strength.
  • Pelvic rest: Limiting strenuous activity and avoiding heavy lifting is crucial.
  • Regular monitoring: Close follow-up with your doctor is vital for assessing progress and adjusting care.

What can cervical shortening lead to?

While miscarriage and premature birth can be caused by cervical shortening, it can also lead to:
  • Infection
  • Cuts and tear on the cervix
  • Internal bleeding
  • Uterine rupture

How to prevent cervical shortening?

As cervical shortening is an unprecedented medical condition, there's no sure way to prevent it. However you can take the following steps to ensure a healthy pregnancy:
  • Have a healthy and well-balanced diet.
  • Take all your prenatal appointments seriously.
  • Gain a healthy weight during pregnancy in consultation with your healthcare provider.
  • Avoid alcohol, recreational drugs and tobacco products at all costs.
  • Don't take any medication without medical approval.

Regular prenatal checkups are crucial for detecting cervical shortening early. Your healthcare provider will measure your cervical length through transvaginal ultrasound. If shortening is detected, they can instantly administer the required support.

Mayo Clinic
Medical News Today