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What Causes Cervical Length Shortening In Pregnancy?

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Posted on Mon, 8 Sep 2014
Question: Hello Doctor,

Good Evening, I am XXXXXXX I am 19th week 5th day pregnant now, my last month period (LMP) is 25th Mar 2013.

We had a TIFFA scanning on 19th week 2nd day at Diagnostics as per gynecologist, and Report Impression says below

my cervix length was 3.9 CM AT the time of 16th week 2nd day and at 19th week 2nd day TIFFA scanning it has reduced to 3.3 CM and i am little concerned on the length reduction.

Please guide me, do we have any issue with the length of 3.3 CM, how come it has reduced so much, and what percent of the chances that it might reduce more.

Here is my question that what are the precautions that we have to take?

What are your recommendations?
doctor
Answered by Dr. Vivek Chail (1 hour later)
Brief Answer:
Length reduction is important if Transvaginal scan

Detailed Answer:
Hi XXXXXXX
Thanks for writing in to us.

I have read through your query in detail. This is Dr.Vivek, Radiologist replying to you. I regularly do pregnancy scans and in many patients cervical length shortening is a matter of controversy when detected by transabdominal scans.

The average cervical length at 20 weeks pregnancy by transvaginal ultrasound (through the vagina) is about 40 mm. This is important because the transvaginal approach is more reliable. In the transabdominal ultrasound (through the "stomach") there are many factors which can cause apparent shortening of the cervical length. If you had transvaginal scan and got these results then you must strictly follow the orders of your doctors. If you have got only a transabdominal scan then it is important to know if the bladder distension was adequate while taking the cervical measurement.

Before commenting about the decrease in cervical length in the future I would like to know if you got transvaginal scan or trans abdominal scan done. Because if it was a trans abdominal scan then the chances of an error are more and if it was through transvaginal ultra sound then the situation is more delicate

In not so serious situations, bed rest during pregnancy simply means decreasing your activity level for a period of time. You might be free to move about the house, as long as you avoid lifting more than 3 kg weight and doing heavy housework. Depending on the demands of your job, you might even be able to continue working few hours each day.

If the situation is serious, bed rest guidelines are stricter. You might need to remain in a sitting or reclining position most of the time, only getting up to use the toilet or shower. You might not be allowed to work or do even light household chores until the baby is born.

Right now you fall in the not so serious group and can continue doing light work if you do not have any pain, spotting and bleeding.

Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have further doubts.

Regards,
Dr.Vivek
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Vivek Chail (2 hours later)
Thanks for your quick reply XXXXXXX

I had trans-abdominal ultrasound (through the "stomach"). and got those results, as per your communication do you think that i might have to go for trans-vaginal ultrasound scan once again to confirm the situation?

let me know your recommendations?

Best Regards, XXXXXXX
doctor
Answered by Dr. Vivek Chail (15 minutes later)
Brief Answer:
You may get transvaginal scan done to confirm

Detailed Answer:
Hi XXXXXXX
Thanks for writing back to us.

Since you have had a miscarriage last year, this is a precious pregnancy for you. The risk for miscarriage is more if there is twins or multiple pregnancy. Since I think this is a single pregnancy the chances of a miscarriage are lesser but you should not take chances because of earlier complications and the fact that you have also had thyroid problems.

I recommend that you may get a transvaginal ultra sound scan specifically to know the length of cervix and discuss the results with your doctor. Any measurement less that 40 mm needs discussion and medical supervision.

Please not that taking adequate rest as mentioned earlier is also important.

Hope your query is answered.
Do write back if you have further doubts.

Regards,
Dr.Vivek
Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
Dr.
Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6874 Questions

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What Causes Cervical Length Shortening In Pregnancy?

Brief Answer: Length reduction is important if Transvaginal scan Detailed Answer: Hi XXXXXXX Thanks for writing in to us. I have read through your query in detail. This is Dr.Vivek, Radiologist replying to you. I regularly do pregnancy scans and in many patients cervical length shortening is a matter of controversy when detected by transabdominal scans. The average cervical length at 20 weeks pregnancy by transvaginal ultrasound (through the vagina) is about 40 mm. This is important because the transvaginal approach is more reliable. In the transabdominal ultrasound (through the "stomach") there are many factors which can cause apparent shortening of the cervical length. If you had transvaginal scan and got these results then you must strictly follow the orders of your doctors. If you have got only a transabdominal scan then it is important to know if the bladder distension was adequate while taking the cervical measurement. Before commenting about the decrease in cervical length in the future I would like to know if you got transvaginal scan or trans abdominal scan done. Because if it was a trans abdominal scan then the chances of an error are more and if it was through transvaginal ultra sound then the situation is more delicate In not so serious situations, bed rest during pregnancy simply means decreasing your activity level for a period of time. You might be free to move about the house, as long as you avoid lifting more than 3 kg weight and doing heavy housework. Depending on the demands of your job, you might even be able to continue working few hours each day. If the situation is serious, bed rest guidelines are stricter. You might need to remain in a sitting or reclining position most of the time, only getting up to use the toilet or shower. You might not be allowed to work or do even light household chores until the baby is born. Right now you fall in the not so serious group and can continue doing light work if you do not have any pain, spotting and bleeding. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements. Hope your query is answered. Do write back if you have further doubts. Regards, Dr.Vivek