In plain words
Cervical insufficiency means the cervix opens too early in pregnancy, usually between about 16 and 24 weeks. It happens without pain or contractions. Clinicians may see it on an ultrasound that shows a short or funneled cervix, or during an exam. You may feel pressure, or notice a change in discharge. It is different from a found on screening, although the two overlap. It is also different from , which involves contractions. If it is found, your provider may talk with you about monitoring, a cervical stitch, or other options. Many people with this diagnosis carry to term with care.
The deeper version
Cervical insufficiency is a clinical diagnosis of painless second-trimester with membrane , distinct from spontaneous preterm birth driven by inflammation or uterine activity. Ultrasound criteria include a cervical length below about 25 millimeters before 24 weeks, with funneling, although the diagnosis is made largely on history and exam. A Cochrane review of cervical cerclage (Alfirevic and colleagues, 2017) found reduced preterm birth in singleton pregnancies at high risk, with less certain benefit in women with a short cervix alone. Transvaginal progesterone trials in women with a short cervix produced mixed results, and ACOG Practice Bulletin No. 234 (2021) addresses progesterone and cerclage in singleton pregnancies with a prior spontaneous preterm birth or a short cervix. The main controversy is how often the diagnosis is made in women without a true history of loss.
Where it comes up
- Short cervix and signs of preterm laborPregnancy: Your Body
- Sex during pregnancyPregnancy: Your Body
- Hand expression and collecting colostrum before birthFeeding Your Baby
What mothers here say about cervical insufficiency
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Sources
- American College of Obstetricians and Gynecologists — Clinical Practice Guideline No. 8: Management of short cervix, 2022
- Berghella V et al. — Cervical cerclage for preterm birth prevention. Cochrane Database of Systematic Reviews 2019