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Dynamic Cervix During Pregnancy

dynamic cervix during pregnancyDynamic cervix is a situation where the size of the cervix shortens spontaneously, which turns out to be a very complicated issue for a pregnant woman and her unborn baby.

The current incidents reveal that the diagnosis of short cervix is really turning out to be challenging for the physicians.

Many articles have been published that talk about the diagnosis and management of shortened cervix in women.

However, there is rarely an evidence to assure you with control trials that support and guide you with clinical practice. Some evidences, though appear to have been diagnosed successfully, will contribute ambiguity on best management strategies.

This leaves numerous concerns on the diagnosis part of the issue. This means that the parameters involved in a specific case treatment might vary from patient to patient, depending on various parameters.

Hence, the treatment procedure varies from case to case. Some of the uncertainties include:

  • There is no constant explanation for a short cervix as the cervical length varies with gestation.
  • Every shortened cervix does not result in preterm labor or vice-versa. However, there is a link between short cervix and preterm labor.
  • Women are often not stratified into high or low risk. Hence, you hardly find previous risk factors.

How is it identified?

The issue can be identified through ultrasound techniques, where the measurement of the cervix needs to be checked for stability for at least 3 minutes.

Studies suggest that the process of adding cervical funneling might not prove to improve the accuracy of cervical length measurements. The reason could be due to the wide variations in funnel measurement.

A spontaneously changing cervix has been linked with uterine contractions. When a woman undergoes labor, a contraction can result in cervix shortening of up to 50% of its size.

Some physicians believe that an attempt of fundal pressure can imitate this effect on the cervix. This way of inducing cervical shortening is believed to increase the positive predictive value of the cervical measurement, which is required while treating the preterm labor.

What are the treatments for short cervix?

Answer

Four main treatments suit best for short cervix issues and lower the risk of preterm birth. They are:

  • Tocolytics, Cervical Cerclage, Bed Rest
  • Vaginal pessary and indomethacin treatments
  • Omega-3 fatty acids and folic acid supplementation
  • Progesterone supplementation

Tip – How To Become Pregnant In 60 Days, Different Homemade/DIY Pregnancy Tests That Work

Tocolytics, Cervical Cerclage, Bed Rest

Tocolytic medications are often prescribed with an intention to prevent from preterm birth. However, there are no sure evidences that the treatment will delay the delivery.

At max, it can be delayed from 24 to 48 hours, but there are no clear reports to support the success of the treatment. The treatment will only reduce the anxiety and comforts the patient. But that will not prevent the patient from preterm birth.

Cervical cerclage treatment is a surgical method of approach and has been widely in use to prevent pregnancy loss during the mid of trimester among the women who are said to be at risk with shortened cervix.

Women who have insufficient cervix can benefit with elective cerclage, a treatment where prophylactic placement is made during 13 to 15 weeks of gestation.

Though the method is highly contentious, recent reports suggest that cervical cerclage might low down the risk of preterm birth.

However, the method does not prove to prevent the preterm births in women who have undergone multiple pregnancies.

As an attempt to prevent preterm birth, bed rest and hydration are often suggested while treating women with shortened cervix.

Physicians believe that this avoids high risk, but there are no proper evidences to prove delayed delivery.

Vaginal pessary and indomethacin treatments

Though the actual reasons behind cervix shortening is not known, various management strategies have been suggested in medicine to prevent preterm birth.

The data related to this is limited to understand. For instance, indomethacin may contribute in preventing preterm birth to some extent, especially in high-risk cases.

According to clinical trial, the treatment of indomethacin for women suffering from short cervix has significantly reduced the rate of spontaneous preterm birth, during the second trimester.

However, it did not last its effect for a long time, and could not prevent the patient from having preterm birth before 35 weeks.

When a woman is carrying twins in her womb and is suffering from short cervix, vaginal pessary can be helpful for not more than 32 weeks of pregnancy, but can be helpful until 36 weeks for singleton pregnancies.

Omega-3 fatty acids and folic acid supplementation

Another way of approaching the issue is through dietary manipulation. It included pre-pregnancy supplementation with omega-3 fatty acid and folic acid supplementation throughout the period of pregnancy.

Progesterone

Progesterone is not a treatment, but it is a supplementation that is widely accepted to prevent preterm birth in specific women, though it did not get any FDA approval.

The evidences suggest that the progesterone supplementation when given to a women suffering from shortened cervix, especially during 16 – 20 weeks of gestation through 34 – 36 weeks of gestation, the preterm births were significantly reduced.

However, the approach proved to be ineffective in twin pregnancy cases. Though there are several issues to be addressed, progesterone supplementation can be believed to address the issue to some extent and needs to be carried on until the exact solution and reason behind the issues is really known.

How much can you rely on these treatments?

Short cervix is really a serious issue and might threat a preterm birth. Several treatments have been used as a part of clinical trials and all of them did not work successfully in every case.

Depending on the type of issue, the treatment method varies. However, some of the treatments, though not FDA approved, proved to be successful in some cases.

These treatments can benefit the patient to some extent but cannot prove to resolve the issue successfully.

Until the proper and standard treatments come into existence, these clinical trials will continue, which might help to address the issue partly, though not successfully.

About the Author Rinne Jacob

Rinne Jacob is the founder of MoM-Health.com and is the mother of 2 charming daughters. During the day she’s a freelance health communication professional based in USA and has done her masters in health communication. You can connect with her on Facebook, Twitter. Feel free to engage and ask her any questions...