Managing Short Cervix and Contractions at 22 Weeks Pregnant

At 22 weeks of pregnancy, there is a short cervix and uterine contractions?

Hello Doctor, I would like to ask for your advice.
I am currently 22 weeks pregnant, but I noticed irregular contractions at 18 weeks.
However, my obstetrician said there was no problem and did not take any action.
It wasn't until I switched to another clinic for a high-level ultrasound (which included a vaginal examination) at 22 weeks that I found out I have a short cervix measuring 1.6 cm along with contractions.
The doctor only prescribed medication to prevent premature labor and advised bed rest.
Will this help reduce the risk of preterm birth? Is it safer to have a vaginal examination at each prenatal visit, or are there other methods? I am really very worried.

Dian Dian, 20~29 year old female. Ask Date: 2015/09/15

Dr. Lü Lizheng reply Obstetrics and Gynecology

A short cervix does indeed increase the risk of preterm birth.
However, cervical measurements can be prone to errors, so it is recommended to use transvaginal ultrasound and consult a medical center.
In addition to increased rest, consideration may be given to administering progesterone and options such as cervical cerclage.
Sincerely, Dr.
Li-Cheng Lu, Taoyuan Hospital.

Reply Date: 2015/09/15

More Info

Managing a short cervix and contractions during pregnancy, especially at 22 weeks, is a critical concern that requires careful monitoring and management. A short cervix, defined as a cervical length of less than 2.5 cm, can increase the risk of preterm birth, particularly when accompanied by contractions. In your case, with a cervical length of 1.6 cm and the presence of irregular contractions, it is understandable that you are feeling anxious about the potential for early delivery.

The management approach typically involves several strategies aimed at reducing the risk of preterm labor. The use of medications, such as tocolytics, can help to suppress contractions and provide a temporary respite from labor. Bed rest or pelvic rest is often recommended to minimize pressure on the cervix and reduce the likelihood of further contractions. While the effectiveness of bed rest is debated, many healthcare providers still recommend it as a precautionary measure.

In addition to medication and rest, your healthcare provider may consider other interventions based on your specific situation. For instance, cervical cerclage, a surgical procedure where the cervix is stitched closed, may be indicated in cases of significant cervical shortening, especially if there is a history of preterm birth. This procedure is typically performed before 24 weeks of gestation and can provide additional support to the cervix.

Regular monitoring is crucial. While internal examinations can provide valuable information about cervical changes and contractions, they are not always necessary at every visit. Your healthcare provider will determine the frequency of internal exams based on your individual risk factors and the stability of your condition. Non-invasive methods, such as transvaginal ultrasound, can also be used to monitor cervical length without the need for internal examinations.

It's important to maintain open communication with your healthcare team. If you have concerns about your symptoms or the management plan, do not hesitate to voice them. Your provider may also recommend lifestyle modifications, such as hydration and avoiding strenuous activities, which can help manage contractions.

In summary, while the presence of a short cervix and contractions at 22 weeks poses risks, appropriate management strategies can significantly reduce the likelihood of preterm birth. The combination of medication, rest, and careful monitoring is essential. Always consult with your healthcare provider for personalized advice and to ensure that you are receiving the best care for your situation. Your health and the health of your baby are the top priorities, and your healthcare team is there to support you through this challenging time.

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