What is the problem?
During your recent ultrasound scan we have found that either your cervix is short (less than 25mm) or there has been significant reduction in the length of your cervix since your previous scan (greater than a 10mm reduction).
We may have also told you that your cervix has started to open (known as funnelling).
What does this mean?
We know that having a short cervix puts you at greater risk of having your baby early (before 34 weeks). We also know that 50% of women and birthing people with a short cervix will go on to have their baby at term (after 37 weeks). The difficulty we have is predicting who will have their baby early and which will carry their baby to term.
What happens next?
You will have the opportunity to discuss your scan result in the
Preterm Surveillance Clinic. Management options will be discussed
with you as per NICE guidelines.
1) Progesterone (hormone) - suppositories which you put into your vagina or your rectum. Some studies have shown that taking progesterone can help maintain the pregnancy and prevent preterm delivery.
2) Cervical cerclage – where a stitch is put around the neck of the womb. This has also been shown to be an effective way of preventing preterm delivery but does carry a small risk of infection or bleeding. There is also a small possibility of rupturing the sac around baby. If your cervix measures less than 15mm the most effective way of prevent preterm birth is cervical cerclage
If you choose the progesterone suppositories you will take these once a day until 34 weeks of pregnancy at which time you will be reviewed in antenatal clinic.
We will continue to monitor your cervix closely with regular ultrasound scans until 24 weeks. If you’re cervical length is found to be shortening during your surveillance or while you are on progesterone you will be offered a cervical suture.
We will not routinely measure your cervical length after 24 weeks as beyond this stage of pregnancy it is not an effective way of identifying those at risk of preterm delivery.
You will be given an opportunity to discuss your treatment at each visit is you wish.
Is there anything you should do?
Due to your increased risk of having your baby early we recommend that you avoid high impact exercise, prolonged standing (for more than four hours). We also advise against vaginal douching and sexual intercourse until 34 week gestation.
A healthy diet is recommended and no smoking is advised.
Non-urgent advice: If you have any of the following symptoms please phone the hospital on 01223 217217
1) A slow trickle or a gush of clear or pinkish fluid from your vagina or a smelly discharge
2) Feeling unwell with a raised temperature
3) Any vaginal bleeding
4) Sudden onset of backache
5) Cramps like strong period pains
6) Increased frequency of urination
7) A feeling of pressure in your pelvis
8) Vomiting or diarrhoea
Don't delay in seeking advice if you have any of these symptoms as you may need urgent medical attention. The assessment line is open 24 hours a day, 7 days a week.
Please contact us on 01223 217217
We are smoke-free
Smoking is not allowed anywhere on the hospital campus. For advice and support in quitting, contact your GP or the free NHS stop smoking helpline on 0800 169 0 169.
Help accessing this information in other formats is available. To find out more about the services we provide, please visit our patient information help page (see link below) or telephone 01223 256998. www.cuh.nhs.uk/contact-us/accessible-information/
Cambridge University Hospitals
NHS Foundation Trust
Hills Road, Cambridge
Telephone +44 (0)1223 245151