What is a Shortened Cervix?

Amanda Dean

A shortened cervix, also known as cervical insufficiency, is a condition where the canal between the uterus and vagina measures less than 1 inch (2.5 cm) at 24 weeks of pregnancy. The cervix usually maintains its thickness and stretches out during the third trimester to prepare for dilation and birth. This condition can lead to gestational complications, preterm birth and possibly miscarriage. Treatments for a shortened cervix depend on the severity of the insufficiency.

Normally, the cervix maintains its thickness during pregnancy.
Normally, the cervix maintains its thickness during pregnancy.

During pregnancy, the cervix typically measures 1.2 to 1.4 inches (3 to 3.5 cm) at 24 weeks of pregnancy and stretches thinner as the women approaches the end of gestation. A shortened cervix can become stressed under the load of the baby and amniotic fluid, and it might become dilated prematurely. This is a common cause of miscarriage during the second trimester and might lead to preterm labor in the third trimester.

A moderate shortened cervix is treated with bed rest.
A moderate shortened cervix is treated with bed rest.

Doctors are unsure what causes cervical insufficiency, but some research points to cervical infection or improper nourishment as a possible culprit. The cervix might be shortened by procedures such as a loop electrical excision procedure (LEEP) or damage caused by terminating previous pregnancies. Women who have had previous miscarriages or preterm deliveries should undergo testing to determine whether they have this condition.

Women with a shortened cervix need to find an obstetrician who specializes in high-risk pregnancies.
Women with a shortened cervix need to find an obstetrician who specializes in high-risk pregnancies.

For many years, it was difficult to determine whether a woman suffered from a shortened cervix, but this condition can be detected with a transuterine ultrasound. Women who have been diagnosed with cervical insufficiency should consult with obstetricians who specialize in high-risk pregnancy. A shortened cervix should be treated as an indicator of possible preterm birth, not a guarantee of early labor.

Miscarriage may occur as a result of the premature dilation of a shortened cervix.
Miscarriage may occur as a result of the premature dilation of a shortened cervix.

Doctors determine the best course of action depending on the severity of cervical shortness at a particular point in gestation. If a woman presents with a cervix slightly shorter than typical, a doctor might recommend that she continue her normal activities with a reduction in load-bearing. Moderate shortness usually is treated with bed rest and further observation. In the most severe cases, a shortened cervix might be treated with a procedure called cerclage to add support to the cervix.

A shortened cervix may lead to preterm labor.
A shortened cervix may lead to preterm labor.

A cervical cerclage is an outpatient procedure in which the obstetrician stitches the cervix closed to prevent preterm labor. The procedure is usually done after 12 weeks of pregnancy, and the stitches remain in place until 37 weeks of gestation or until the woman's water breaks and labor begins. The cerclage procedure is risky and typically is done only in extreme cases of a shortened cervix. There is a chance that this treatment could cause infection, contractions or rupture in cervical membranes.

A shortened cervix is a common cause of miscarriage during the second trimester.
A shortened cervix is a common cause of miscarriage during the second trimester.
A cervical cerclage is an outpatient procedure in which the cervix is stitched closed to prevent preterm labor.
A cervical cerclage is an outpatient procedure in which the cervix is stitched closed to prevent preterm labor.
A shortened cervix commonly leads to infant mortality in areas without the medical technology to treat premature babies.
A shortened cervix commonly leads to infant mortality in areas without the medical technology to treat premature babies.
A transuterine ultrasound may be used to diagnose a shortened cervix.
A transuterine ultrasound may be used to diagnose a shortened cervix.

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Discussion Comments

clintflint

@pleonasm - I think it's the sort of thing that brings on squeamishness but isn't actually that bad in practice (I mean in terms of pain, obviously it's a dangerous procedure).

When you compare it to the actual childbirth it's not going to be that bad. People make a lot of jokes around childbirth these days, but it is a really painful thing to go through and if you're pregnant in the first place, you've obviously signed up for it.

What would frustrate me more is that having a short cervix generally means the doctor is going to want you to try and stay bed bound as much as possible and I'd rather keep active.

pleonasm

I didn't realize the cervix was supposed to be that thick. I guess it has to be, since it's one of the things supporting the baby when a woman is pregnant.

I'm really shuddering at the thought of someone having to have cervical stitches though. I guess if you really want a child and you have a shortened cervix during pregnancy you don't have a choice, but the idea of it completely freaks me out. Probably because that doesn't seem like the kind of area that you want to be injured for any reason.

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