Questionhello. I have been getting my cervix checked every 2 weeks to check for shortening. The first two weeks my cervix measured 3.89 cm. My doctor said that at my next appointment if there was still no change that I wouldnt have to continue my 2 week ultrasound. To my dismay, at my last appointment my cervix measured 3.5 cm. This scares me because I am only 23 weeks pregnant. My question is that since my cervix shortened by that much in just 2 weeks will it continue to shorten rapidly? This is my 1st pregnancy and I am just so nervous because I have been reading all these things about how an incompetent cervix can lead to a late miscarriage. I would also like to know if in cases where shortening has occured this early is it almost a sure sign that I will go into labor early?
AnswerDear Jaylene,
Every woman and every situation is different. There is absolutely no way to know with any certainty whether you or any other woman will go into labor early under these circumstances. Each case is handled slightly different by their doctor, each may be discovered under different timing or circumstances, each may have totally different demands on their body, etc,.. etc,... So - even though I know you really, really want absolute answers, I just cannot give you that. There are just too many variables. All I can do is give you some additional information which may help you...
The pressure as the baby grows into the 2nd and 3rd trimesters may cause the cervix to start to open before the baby is ready to be born. This condition is called an incompetent cervix or weakened cervix, and it can sometimes lead to a miscarriage or premature delivery. An incompetent cervix happens in only about 1 out of 100 pregnancies.
The use of ultrasonography has been very helpful with the diagnosis, and is made when the cervical os (opening) is greater than 2.5 cm, or the length has shortened to less than 2.0 cm. (Sometimes funneling is also seen, this is where the internal portion of the cervix, internal os (portion of the cervix closer to the baby) has begun to efface. The external os will be unaffected if diagnosed in time.)
A weakened cervix can be caused by one or more of the following conditions:
-Previous surgery on the cervix
-Damage during a difficult birth or multiple births
-Malformed cervix or uterus from a birth defect
-Previous trauma to the cervix, such as a D&C (dilation and curettage) from a termination or a miscarriage
-DES (Diethylstilbestrol) exposure
Often the treatment for an incompetent or weakened cervix is a procedure that sews the cervix closed to reinforce the weak cervix. This procedure is called a cerclage and is usually performed between week 14-16 of pregnancy. These sutures are then removed around the 36-37th week to prevent any problems when you go into labor. Removal of the cerclage does not result in spontaneous delivery of the baby. A woman would not be eligible for a cerclage if:
-There is increased irritation of the cervix
-The cervix has dilated to 4 cm
-Membranes have ruptured
At this point, your cervical dilatation sounds manageable and that your OB is staying right on top of it by evaluating your cervical length frequently. I would suspect he/she will be recommending reduced physical activity (especially no lifting) and possibly pelvic rest as well. However - by all means, you can limit your activity/lifting independently and stay off your feet as much as possible to try to help the situation.
I hope this has helped you and answered your questions a bit. I wish you well.
Brenda
