- Symptoms of Cervical Insufficiency
- How to treat cervical insufficiency
- How to prevent cervical insufficiency
Cervical insufficiency is when the cervix is less than 2.5 cm during pregnancy, which can have serious complications such as increased risk of miscarriage or facilitating premature delivery.
The cervix is the final part of the uterus and is formed by a cartilaginous tissue that separates the body from the uterus from the vagina. The cervix has a small opening that opens allowing the exit of menstruation and the entry of sperm, but is usually completely closed. During pregnancy it is expected that it is completely closed so that the baby can grow properly and only at the end of the pregnancy should it decrease in size because it will gradually open or be left out so that it can allow the baby to pass through the birth.
Thus, when a woman discovers that her cervix is open, erased or decreased during pregnancy, this means that the cervix is not being sufficient to keep the baby in the womb and this is a serious complication that can facilitate birth before the scheduled date.
Symptoms of Cervical Insufficiency
The insufficiency of cervical isthmus, as it is also known, does not generate symptoms and therefore can only be discovered during ultrasound. A sign that the cervix is insufficient is that the cervix is dilated without any contraction. Some situations that favor this failure are:
- History of abortion or previous premature birth; Having performed the conization of the cervix; Dilatation of the cervix during a uterine curettage.
The doctor identifies that the cervix is deficient when it measures less than 2.5 cm at any stage of pregnancy. The tests that can identify this alteration are the transvaginal ultrasound performed in the 13th gestational week or the morphological ultrasound performed in the 20 weeks of gestation. Although less common, the doctor may also perform another test called the number 8 hegar candle.
How to treat cervical insufficiency
Treatment must be indicated by the obstetrician who is accompanying the pregnancy and aims to postpone the baby's birth as much as possible, and can be done with:
- Use of progesterone that can be inserted into the vagina daily, such as utrogestan; Resting as long as possible to decrease the baby's pressure on the cervix; Taking corticosteroids to mature the baby's lungs, decreasing the risk of pulmonary complications if it is born before the expected date; Cerclage that consists of closing the cervix with stitches.
Cerclage is a surgical procedure that can be performed urgently with spinal anesthesia and sedation, but it is more indicated to be performed between 12 and 20 weeks of gestation. However, it should only be done in women who have no infection and still have some risks such as uterine infection, rupture of the aminotic sac and contractions that can give rise to childbirth. Find out how recovery is from this surgery.
Cerclage can be performed in any pregnancy when there is a need, but after a history of premature birth or previous abortion, when the woman becomes pregnant again, the doctor may decide to cerclage soon after performing the morphological ultrasound and discovering that the baby is developing good. There is an indication for cervical cerclage in these women because after a previous case, there is a 24% chance that the woman will have the same problem in the next pregnancy.
Find out everything you need to know to care for your premature baby.
How to prevent cervical insufficiency
There is no way to avoid cervical insufficiency but performing gynecological exams annually and following prenatal care during pregnancy are the best ways to discover any changes in the reproductive system by carrying out any treatment that is necessary.
In women who have already had an abortion or premature birth due to insufficiency of the uterine cervix in a previous pregnancy or who have undergone curettage or conization of the uterus, the obstetrician may indicate the performance of uterine cerclage even if the cervix is not yet under 2.5 cm just to prevent this complication because it can appear suddenly and the treatment is not always a success.
