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 Short Cervix
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The cervix is the narrow, lower end of the uterus that opens into the vagina. During pregnancy, the cervix holds the baby in the uterus. The cervix is usually about 35 millimeters or 1 1/2 inches long , firm, and closed The cervix is considered to be short when it measures less than 25 millimeters (1 inch)  long before 24 weeks of pregnancy. A short cervix is more  likely to open and  lead to premature birth  before 37 weeks.

The cervix may be  shortened  because of  progesterone deficiency, inflammation , damage to the cervix from a previous pregnancy,  some inherited  disorders, or previous surgery such as a cone biopsy or loop electrosurgical excision procedure (LEEP).

Two treatments to prevent preterm birth with a short cervix are
  • Natural progesterone 200 mg suppositories or capsules placed in the vagina every night until 36 to 37 weeks to prevent the cervix from shortening further. Progesterone is usually started before 24 weeks.
  • Cervical cerclage. Cerclage is  a procedure used to temporarily stitch the cervix closed most often  by way of the vagina under anesthesia The cerclage is usually placed before 24 weeks and removed around  36 to 37 weeks of pregnancy.

    If you have never had a premature birth before 37 weeks gestation  and have a cervical length less than or equal to 25 mm with only one fetus: your doctor may recommend you use vaginal progesterone . If your cervix is less than 10 mm your doctor may also discuss  placement of a cerclage .

    If you have had a premature birth and have a cervical length less than  25 mm  with only one fetus your doctor may recommend you use vaginal progesterone suppositories or capsules every night AND/OR  you have a cerclage placed

    If you have a pregnancy with more than one fetus and cervical length less than or equal to  25 mm there is limited evience that your pregnancy  may  benefit from using vaginal progesterone.

    If you are pregnant with one or more fetuses and have an open cervix to 1 cm or more detected on physical examination your doctor may discuss placement of a cerclage
    		•    Normal cervix
    Normal Cervix

       Short cervix
    Short Cervix

     Cerclages 
     Cervical Cerclage

    By Mark Curran, MD FACOG Updated  12/07/2023 > 

    REFERENCES


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