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Suggest Treatment For Short Cervical Length During Pregnancy

Posted on Fri, 22 Aug 2014

Question: Hello Doctor,

Good Evening, I am XXXXXXX I am 21st week pregnant now, my last month period (LMP) is 1st Mar 2013.

We had a TIFFA scanning on 20th week 5 days time at Diagnostics as per our family doctor, gynecologist, and Report Impression says below

cervix with the length of 2.5 CM and i am little concerned on the length.

Please guide us do we have any issue with the length of 2.5 CM, do we needed to go for the stitching cerclage for my cervix problem.

Here is my question that shall I proceed with cerclage surgery at hospital, I mean can we wait for surgery or it is really an urgent one to make it?

and any more complications or side effects with the cerclage?

What are your recommendations?

Answered by Dr. Richa Agarwal (1 hour later)

Brief Answer:
Hi XXXXXXX You should go for circalage operation.

Detailed Answer:
Hi,
Thanks for writing to us.
If I am your treating doctor then I would suggest you to go for circalage operation to prevent the chances of preterm labour or premature birth of baby.
The reason of my opinion is because your cervical length is short(2.5 cm), you had previous history of misscarriage and you are in your second trimester( usually circalage is done in second trimester).
Usually cervical length is 4-4.5 cm. in 16-20 weeks and circalage operation recommended when cervical length is less then 2.5 cm( but in your case it is borderline).
Usually it's a safe procedure and mostly recommended in second trimester.
It is a surgical procedure so complications are associated with it.
There are some complications which may occur with circalage operation-
1) Cervical infection, laceration, dystocia, stenosis.
2) Vaginal bleeding.
3) Preterm labour and premature contraction.
4) Rupture of the uterus.
5) Fever
6) Rupture of amniotic membrane.
But as I said before it is usually a safe procedure and with your history I would suggest you to go for circalage operation.
Do not get tense. Keep yourself hydrated.
You are already on progesterone support which is good for you and your baby.
I think I have answered your query if you have further questions I will be happy to help you.
Good luck for your safe motherhood.
Regards
Dr. Richa

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Richa Agarwal (18 hours later)

Hello Dr. XXXXXXX

Thanks for the quick reply, i had a discussion with my family doctor and gynecologist and they are suggesting me to have a complete bed Rest, and it is not safe to go for the circalage, let me know how good is that? what are other alternatives for this situation is it okie to manage with full bed rest? do you have any other suggestions for me to manage myself?

My initial cervix length in 6th and 12th weeks is 3.2 CM, and now it is 2.5.
awaiting for your precious reply.

Regards, XXXXXXX

Answered by Dr. Richa Agarwal (13 hours later)

Brief Answer:
Hi,

Detailed Answer:
Hi XXXXXXX
Nice to hear from you.
Sorry! for my delayed response.
In my opinion circalage is the best treatment in your case but if your treating doctor refuses for it, then it might be associated with some complication in your case.
Progesterone is also very effective in this situation which you have already taken.
Complete bed rest is helpful in this situation but you should not totally rely on it.
I can give you one more treatment option that is vaginal pessaries( ring).
It is totally safe, cost effective and easy method in place of circalage, you may think over it.
I think this information is useful to you if you need further help I am always there for you.
Good luck.
Regards
Dr. Richa

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Above answer was peer-reviewed by : Dr. Prasad