Short Cervix and Preterm LaborBradley G. Goldberg, M.D.
A Until recently the only way to determine if a woman was at risk for premature labor was for the doctor to manually check her cervix. Currently, many obstetricians now use ultrasound to more precisely measure the length of a pregnant woman's cervix. Not all women need this cervical length ultrasound study, just those who are felt to be at high risk for premature labor.
The data from these ultrasound studies is still growing, and we are constantly trying to decide the best ways to both monitor and treat this condition. We do however, have a good idea as to what length a pregnant woman's cervix should be by these ultrasound measurements. When the cervix shortens significantly from these normal values, treatment can be considered but it is highly individualized.
Newer tests, such as the "fetal fibronectin" test are also sometimes used to augment the predictive value of these ultrasound measurements, but these tests also are new and not yet available in all locations.
Possible treatments for a shortening cervix depend upon how far along in the pregnancy a woman is. These treatments include placing a "cerclage" or stitch in the cervix to help prevent further dilitation. Also, use of 'tocolytics" which are medications to decrease contractions are sometimes used; and for pregnancies between 24 - 34 weeks, administration of steroids to aid in the development of the baby's lungs can also be considered.
In my opinion, some of the greatest advances in modern medicine have been in the fields of Obstetrics and Neonatology. We have significantly reduced the risk of maternal mortality (which is the risk of a mother dying in childbirth), and our ability to successfully care for premature infants improves every year. Unfortunately, there are still many questions to be answered as to what causes premature labor and what we can do to prevent it. For now, your best course of action is close monitoring with your Obstetrician, and possible consultation with a perinatologist which is a doctor who specializes in these high-risk pregnancies.
Bradley G. Goldberg, M.D.
Coffee Women's Center, P.C.
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