Shortened cervix: when is premature birth at risk?
During pregnancy, there are many checks necessary to monitor the state of things, if all goes well and if the weeks go by there is a normal development of what is necessary for the well-being of the mother and the baby. The length of the neck of the uterus (or cervix) should also be kept under control, which must have certain dimensions depending on the week of pregnancy. Just as the fetus will have them, look here:
If we find a shortened neck of the uterus during pregnancy, the risks of premature birth can be many, which is why it is essential to intervene to ensure that the situation does not get more complicated than it should. uterus? When should you worry? Let's find out together!
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What is the cervix?
The neck of the uterus, or cervix, is the lower part of the uterus and represents the junction point between the vagina at the bottom (vaginal portion), that is the cylindrical part of the female sexual organs that welcomes the penis during sexual intercourse and it allows the passage of both menstrual blood and the fetus during childbirth, and the uterus itself (supravaginal portion), in which the embryo is received to then become a fetus and develop in the weeks up to the time of delivery. The neck of the uterus, therefore, represents a very important channel both for fertilization, because the spermatozoa pass through it, and for menstruation, because it allows blood to flow, both for childbirth, for the passage of the fetus. Precisely in pregnancy, the uterine cervix has a very important mechanical function because it blocks the premature passage of the fetus. It represents a very sensitive part to be kept under control because it is the one that develops one of the most feared female pathologies, namely the cancer of the neck of the " uterus.
How long does the cervix have to be to give birth?
The size of the cervix varies according to the stages of a woman's life. When in the prepubertal stage, the length of the cervix is about half the length of the uterus itself.After the first menstruation and after pregnancy, the length of the cervix decreases. Furthermore, during menstruation, ovulation and childbirth, the cervix is open to allow the flow of blood, the crossing of spermatozoa, respectively. and the descent of the fetus during childbirth The cervix remains closed throughout the rest of the time.
During a pregnancy, the cervix measures on average between 35 and 45 millimeters and has the important function of blocking the escape of the fetus. The shortened cervix instead measures about 25 mm, and in this case there is a risk of preterm birth for which the mother must take absolute rest, and proceed to the 24th week, if suggested by the doctor or gynecologist, with intramuscular cortisone to accelerate the formation of the lungs in the fetus. If the cervix were shortened to 15 mm, the risk of premature birth would be about 60% if before 20 weeks, or 52% if between 20 and 24 weeks Week, so it will be essential for the expectant mother to have bed rest and more than absolute rest!
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How to check the length of the cervix?
During pregnancy, the cervix undergoes changes and its size must be monitored through a transvaginal ultrasound (ie vaginal) called cervicometry, very useful to understand if the size of the cervix is in line with the weeks of pregnancy. , to be carried out between the 19th and 22nd week. Cervicometry is highly recommended if:
- you have had a preterm birth before
- if you have had contractions
- if you have had previous medical conditions
- if the birth is twins
This ultrasound performed vaginally, in addition to allowing us to understand if the cervix is shortened, helps us to understand if:
- you are at risk of giving birth prematurely
- if there is a need to do a cervical cerclage
- if there is placenta previa.
Furthermore, a transvaginal ultrasound is recommended even if you are not pregnant because it allows you to evaluate the state of health of the neck and the uterus itself. The shortening of the cervix can also be due to the premature rupture of the membranes, which also causes premature birth.
Shortened cervix and premature birth
As we could understand, the shortened cervix can be very risky because it can lead to preterm birth. Basically, if the cervix starts to shorten before 37 weeks or to open, the risk is very high. If you also experience symptoms such as premature contractions, severe back pain similar to menstrual ones, it is essential to contact your obstetrician or gynecologist immediately to understand what to do.
To reduce the risks of preterm birth, it is possible to intervene preventively with various treatments that the gynecologist will have to evaluate. Among these we have:
- cervical cerclage, which is a surgery that closes the cervix and then reopens it near birth. This surgery can be performed already between the 13th and 14th week of pregnancy
- progesterone therapy, in case the shortened cervix presents between week 20-24.
In the event that cerclage or progesterone therapy are not necessary, it is still essential for the expectant mother to have absolute rest, stay in bed as much as possible to take care of herself and the baby, avoiding risks.
