Materiały źródłowe

• #1 Cervical Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525954/

  Cervical insufficiency is a condition in which the cervix painlessly dilates during the second or early third trimester due to a functional or structural defect. This condition can potentially lead to preterm premature rupture of membranes (PPROM), second-trimester pregnancy loss, or spontaneous preterm birth. […] Treatment options include cerclage (suturing the cervix to prevent dilation) and vaginal progesterone. The approach depends on the severity and timing of the diagnosis, with individualized care for high-risk patients. […] The primary treatment options for cervical insufficiency include cerclage placement and vaginal progesterone. […] A cerclage is a nonresorbable suture placed around the cervix to improve mechanical strength and prevent premature dilation. […] Vaginal progesterone is associated with a decreased risk of preterm birth in select patients, including patients with an incidentally discovered short cervix with a cervical length of less than 25 mm who lack a history of prior preterm birth.

• #1 Incompetent cervix – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/incompetent-cervix/diagnosis-treatment/drc-20373842

  In a cervical cerclage, strong stiches, called sutures, are used to close the cervix during pregnancy to help prevent premature birth. Often, the stitches are removed during the last month of pregnancy. […] Treatment options or ways to manage an incompetent cervix include: […] Cervical cerclage. During this procedure, the cervix is stitched tightly closed. The stitches are taken out during the last month of pregnancy or just before delivery. You may need a cervical cerclage if you are less than 24 weeks pregnant, you have a history of early births and an ultrasound shows that your cervix is starting to open. […] Sometimes, cervical cerclage is done as a preventive measure before the cervix starts to open. This is known as a prophylactic cervical cerclage. You might have this type of cervical cerclage if you’ve had an incompetent cervix with past pregnancies. This procedure often is done before 14 weeks of pregnancy.

• #1 Cervical Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525954/

  Management depends on how cervical insufficiency was diagnosed (history, exam, or ultrasound), cervical length, and whether or not the patient has a history of a prior spontaneous second-trimester loss or preterm birth. […] An exam-based cerclage, also known as an emergency or rescue cerclage, should be considered in patients less than 28 weeks gestation presenting with cervical dilation between 1 cm and 4 cm in the absence of labor and other contraindications. […] The American College of Obstetricians and Gynecologists (ACOG) recommends a history-indicated cerclage in patients who have either a history of an exam-indicated cerclage or at least 1 prior loss or preterm birth at less than 28 weeks gestation related to painless cervical dilation in the second trimester. […] Ultrasound-indicated cerclage is recommended in patients with a singleton gestation and a history of a prior spontaneous preterm birth or second-trimester loss who are found to have a cervical length less than 25 mm before 24 weeks gestation but do not meet criteria for a history-indicated cerclage.

• #1 Cervical Insufficiency Treatment & Management: Cervical Cerclage, Progesterone Supplementation, Cervical Pessary

  https://emedicine.medscape.com/article/1979914-treatment

  Conversely, cerclage placement has not been shown to be beneficial in women with a short cervix who do not have a history of preterm delivery. […] In women with multiple gestations and a short cervix, cerclage placement is not recommended, as this has actually been associated with an increased risk for preterm delivery. […] Preoperative evaluation prior to cerclage placement should include ultrasound assessment to ensure fetal viability, confirm gestational age, and rule out any clinically significant fetal anatomical abnormalities. […] A review and meta-analysis by Ehsanipoor et al found that physical examination-indicated cerclage significantly increases neonatal survival and extends pregnancy by an average of 33.98 days compared with expectant management. […] The American College of Obstetricians and Gynecologists (ACOG) recommends that women with a prior spontaneous preterm birth should be offered progesterone supplementation (ie, weekly 17-alpha-hydroxyprogesterone caproate), starting at 16-24 weeks gestation and continuing up to 36 weeks gestation, in order to reduce the risk of recurrent preterm birth.

• #1 Cervical Insufficiency > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/cervical-insufficiency

  Treatment includes monitoring, progesterone supplement, and surgery (cervical cerclage) […] Cervical cerclage, a minor surgical procedure, is an effective and safe treatment option that can help prolong the pregnancy, ideally to full term. […] If the physician and patient are in agreement, her cervical insufficiency can be treated with a simple surgical procedure called cervical cerclage, which can help prolong the pregnancy. […] Dr. Kohari notes that cervical cerclage is most often used for women with a history of at least one early loss in the absence of labor. […] According to Dr. Kohari, cervical cerclage stitches the cervix closed, helping to keep the baby safely in the womb. […] Cervical cerclage is an outpatient procedure, done in the hospital under regional anesthesia. […] For complicated cases, including those in which the cervical cerclage hasn’t worked in the past, another technique called transabdominal cerclage is an option.

• #1 Surgical treatment of Cervical Insufficiency – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/obgyn/minimally-invasive-gynecologic-surgery/for-medical-professionals/cervical-insufficiency-treatment

  Cervical insufficiency is defined as the repeated inability of the cervix to maintain an intrauterine pregnancy until term. Presently a variety of effective medical and surgical interventions exist to treat patients with a history of cervical insufficiency. However, patients with multiple losses have traditionally been offered placement of a cerclage, or cervical stitch, during subsequent pregnancies. Cerclage placement has typically been performed transvaginally and this has been effective for many patients. […] The transabdominal approach offers several advantages to the transvaginal route: higher placement relative to the level of the internal os, lack of slippage, and lack of foreign body material in the vagina. Transabdominal cerclage placement has been reported in the literature to carry a very high success rate, with neonatal survival rates estimated at greater than 90%.

• #1 Surgical treatment of Cervical Insufficiency – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/obgyn/minimally-invasive-gynecologic-surgery/for-medical-professionals/cervical-insufficiency-treatment

  We strongly prefer to place the cerclage prior to pregnancy since placement is easier and less risky since there is no risk of fetal compromise. However we can also perform these procedures during pregnancy. […] We have had excellent pregnancy outcomes in our patients, both before and after the implementation of placement of a laparoscopic cerclage, with an estimated success rate of over 95%.

• #1 Incompetent Cervix: Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17912-incompetent-cervix

  If youre at risk for an incompetent cervix or your cervix shows signs of opening too soon, your pregnancy care provider may recommend preventative treatment to avoid pregnancy complications. […] The goal of treating incompetent cervix is to help you stay pregnant as long as possible. […] A procedure called a cervical cerclage is one way pregnancy care providers try to prevent premature labor. It involves sewing your cervix shut. […] Your provider may recommend cerclage if: […] If you have risk factors for incompetent cervix, your provider may recommend taking progesterone supplements beginning in your second trimester. […] If you have risk factors for cervical insufficiency, your pregnancy care provider may decide to monitor the length of your cervix using ultrasound up until about 24 weeks of pregnancy. […] Incompetent cervix can cause complications, including miscarriage and premature birth. […] Cerclage treatment for incompetent cervix is successful in nearly 90% of cases. […] In most cases, this condition is treatable with a procedure called a cerclage.

• #1 Cervical Cerclage | ACOG

  https://www.acog.org/womens-health/faqs/cervical-cerclage

  A transvaginal cerclage is typically removed around 37 weeks of pregnancy. A transabdominal cerclage is typically left in place until delivery through cesarean birth. A transabdominal cerclage can also be left in place between pregnancies, to prevent future preterm birth or pregnancy loss. […] Overall, there is a low risk of complications from a cerclage. Possible complications include preterm prelabor rupture of membranes (PPROM), infection of fetal membranes and the uterus, tears in the cervix, the stitch moving from the correct place, bleeding during or after the procedure.

• #1 Cervical Cerclage: Purpose, Procedure, Risks & Results

  https://my.clevelandclinic.org/health/treatments/17970-cervical-cerclage

  But if you have a weakened cervix, a cervical cerclage procedure is the best way to prevent preterm labor (labor that begins before 37 weeks). The advantages are clear. […] Your healthcare provider will only recommend a cerclage procedure if the benefits outweigh the risks. But, as with almost any medical procedure, there are some risks to be aware of with a cervical cerclage procedure. […] Your healthcare provider will want you to take it easy for a week to 10 days after your cerclage procedure to allow time for your cervical stitches to heal properly. […] Your healthcare provider will want you to abstain from sexual activity for a week before your cervical cerclage procedure and probably for a week to 10 days after your procedure to allow your cervical stitches time to heal. […] Your cerclage will stay in place until your pregnancy reaches full term or about the 37th week of pregnancy. […] While it might be scary to consider cerclage treatment, this procedure is successful in nearly 90% of cases.

• #1 Cervical Insufficiency Causes, Symptoms, and Treatments

  https://www.upmc.com/services/womens-health/conditions/cervical-insufficiency

  If you have cervical insufficiency, your doctor will watch your cervix carefully with ultrasounds or pelvic exams. […] If they decide you need treatment, they’ll either do surgery or prescribe medicine. Both can help prevent your cervix from dilating too early, so you can carry your baby to term. […] The hormone progesterone not only helps your uterus grow during your pregnancy, but it can also prevents contractions from starting. […] If you’re carrying only one baby, taking progesterone supplements can reduce your risk of having a miscarriage or premature labor. Your doctor might prescribe progesterone until you’re 36 weeks pregnant. […] With a cervical cerclage, your doctor goes in through your vagina and stitches your cervix closed. Cerclage helps strengthen your cervix, so it’s less likely to shorten and dilate. […] This procedure is done as outpatient surgery. You’ll get medication so you won’t feel any pain during the surgery. […] Your doctor can do a cervical cerclage early in your second trimester. They’ll remove the stitches when you’re about 36 weeks pregnant, or when it’s safe to have your baby.

• #1 Incompetent cervix | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/incompetent-cervix?content_id=CON-20373818

  An incompetent cervix can be a hard problem to diagnose and treat. If your cervix begins to open early, or if you’ve had cervical insufficiency in the past, you might benefit from treatment. This might include having a procedure done to close the cervix with strong sutures, called a cervical cerclage. You also may take medicine to help the incompetent cervix and have ultrasound exams to check how things are going. […] In a cervical cerclage, strong stiches, called sutures, are used to close the cervix during pregnancy to help prevent premature birth. Often, the stitches are removed during the last month of pregnancy. […] Treatment options or ways to manage an incompetent cervix include: Progesterone supplementation. If you have a short cervix with no history of a preterm birth, vaginal progesterone may lower your risk of having your baby too early. This medicine comes in the form of a gel or a suppository that gets placed in the vagina each day.

• #1 Short cervix: Diagnosis and treatment

  https://www.medicalnewstoday.com/articles/short-cervix

  Having a short cervix can complicate labor and delivery. If a doctor recognizes someone has a short cervix early on, it can make treatment easier and more effective. […] Receiving treatment can prevent complications associated with having a short cervix. […] There are generally two treatment options for a short cervix. […] For some women, a doctor may recommend a cerclage. This is a stitch in the cervix that reinforces it, reducing the risk of pregnancy loss or preterm labor. […] A 2017 review of 15 studies concluded that while cerclage reduces the risk of preterm birth in women at high risk it is still unclear whether other options may be more effective, particularly vaginal progesterone. […] Vaginal progesterone can be administered with suppositories or injections. A doctor may, for example, recommend suppositories for a woman who has a short cervix but no history of preterm delivery. According to a 2013 study, vaginal progesterone reduces the risk of delivering before 33 weeks by 44%.

• #1 Cervical Insufficiency Treatment & Management: Cervical Cerclage, Progesterone Supplementation, Cervical Pessary

  https://emedicine.medscape.com/article/1979914-treatment

  Of note, cervical cerclage has not been shown to offer additional benefit for the prevention of recurrent preterm delivery in these women. […] A meta-analysis showed that combined therapy with vaginal progesterone and cervical cerclage lowered the risk of preterm birth (at 37 weeks) to a greater degree than either progesterone or cerclage alone in patients with a cervical length of less than 25 mm or a history of preterm birth. […] The cervical pessary has been studied as a potential noninvasive treatment for cervical insufficiency in small series of patients for the past 50 years, but data from randomized controlled trials are limited. No high-quality evidence is available to support the effectiveness of pessaries for the treatment of cervical insufficiency. […] A multicenter randomized trial sponsored by the National Institutes of Health showed that the use of a cervical pessary did not decrease the risk of preterm birth in patients with a shortened cervix (20 mm or less). Additionally, pessary use was associated with a higher rate of fetal or neonatal/infant death (13.3% in the pessary group vs 6.8% in the usual care group).

• #1 Incompetent cervix – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/incompetent-cervix/diagnosis-treatment/drc-20373842

  Cervical cerclage isn’t the right choice for everyone at risk of premature birth. For instance, the procedure isn’t recommended if you’re pregnant with twins or more. Be sure to talk to your doctor about the risks and benefits cervical cerclage may have for you. […] A device called a pessary fits inside the vagina and holds the uterus in place. A pessary may help lessen pressure on the cervix. But more research is needed to see if a pessary will work well for treating an incompetent cervix.

• #1 How to Diagnose And Treat A Short Cervix During Pregnancy | KJK Hospital

  https://kjkhospital.com/how-to-diagnose-and-treat-a-short-cervix-during-pregnancy/

  Arabin pessary is a relatively new alternative to cerclage and progesterone. It’s a small ring that wraps around the cervix and closes it without requiring surgery. According to one study that compared cervical cerclage and pessary, if you have funnelling, a cervical pessary may be the better option. A short cervix can exist without funnelling, but funnelling causes it to take on a V- or U-shape. […] For a short cervix, a doctor may recommend bed rest (or pelvic rest) and continued monitoring. This can range from no sex or strenuous activity to complete bed rest (wake up only to pee and eat). It is important to note, however, that strict bed rest has not been shown to prevent preterm labour.

• #1 What is cervical insufficiency (incompetent cervix)?

  https://www.babycenter.com/pregnancy/health-and-safety/cervical-insufficiency-incompetent-cervix_1425796

  Cervical insufficiency can result in miscarriage or preterm delivery. […] Treatments include: […] If an ultrasound shows your cervix is shorter than 25 mm, you’re less than 24 weeks pregnant, you’re carrying a single baby, and you have other risk factors for cervical insufficiency, such as a prior preterm birth, your practitioner may recommend a cerclage to reduce your chances of preterm delivery. […] Cerclage is a procedure in which a band of strong thread is stitched around your cervix to reinforce it and help hold it closed. […] A cerclage may also be helpful for women whose cervix is found to have opened one or more centimeters before 24 weeks when examined manually or by speculum. […] For women with or without a history of prior spontaneous preterm birth, practitioners typically recommend a daily dose of progesterone that you can insert vaginally to help lower the risk of preterm birth. […] Some caregivers used to prescribe bedrest in addition to or instead of cerclage. But there’s no evidence that staying in bed or limiting your activity prevents preterm labor or birth, and in many cases the American College of Obstetricians and Gynecologists (ACOG) advises against it.

• #1 Cervical Insufficiency: Reasons, Signs & Treatment

  https://parenting.firstcry.com/articles/cervical-incompetence/

  This is a surgical procedure, administered by doctors on women whose cervix is likely to open up prematurely. In this procedure, the doctor stitches the mouth of the cervix together, in such a way that it withstands the pressure of the developing foetus in the uterus. This greatly helps in containing the baby inside the womb. Doctors even perform this procedure on women with a previous history of this condition, before their cervix becomes weak. This is done as a precautionary measure. However, this treatment option has some restrictions. […] Proper care and support from the doctor and the concerned family members can go a long way in keeping the woman stay positive through the pregnancy. If you have an incompetent cervix, cervical cerclage can help. It is a very effective strategy for dealing with an incompetent cervix and the success rate of these methods are very high in successfully delivering full-term babies.

• #1 Treatment of cervical insufficiency and/or a short cervix with antimicrobial agents can restore cervical length and lead to pregnancy prolongation and term delivery – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38749767/

  Treatment of cervical insufficiency and/or a short cervix with antimicrobial agents can restore cervical length and lead to pregnancy prolongation and term delivery […] Uterine Cervical Incompetence* / drug therapy.

• #1 What Is Cervical Incompetence?

  https://www.icliniq.com/articles/womens-health/cervical-insufficiency

  A cerclage may also be helpful if the cervix is opened one or more centimeters before 24 weeks when examined manually by a speculum. […] Progesterone Supplements – Women with a history of premature birth may be given extra weekly shots of a form of the hormone called Progesterone during their second and third trimesters to reduce the risk of recurrence. […] Steroids – If an ultrasound shows that the cervix is short and a woman is experiencing signs of premature labor, usually after 22 weeks, the health care practitioner may provide steroids. […] Bed Rest – If the doctor rules out cervical incompetence in the later stage of pregnancy, they may recommend bed rest for the rest of the pregnancy. […] Repeated Ultrasound – If women have a history of early premature birth or a history of cervical incompetence, the doctor might begin carefully monitoring the length of the cervix by ultrasound examination every two weeks from 16 to 24 weeks of pregnancy. If the cervix becomes shorter than a certain length or begins to open, then the doctor might recommend cervical cerclage.

• #1 Incompetent Cervix – What You Need to Know

  https://www.drugs.com/cg/incompetent-cervix.html

  You may need to rest in bed during the last several months of your pregnancy. You may need to rest on your left side most of the time. This may help prevent premature labor or delivery. You may also need any of the following: […] Medicines may be used to prevent or stop labor contractions. […] A pessary is a plastic or rubber device that is placed into your vagina to elevate and support the cervix. […] Surgery called cervical cerclage may be needed to stitch the cervix closed until you are closer to delivery.

• #1 Short cervix: Diagnosis and treatment

  https://www.medicalnewstoday.com/articles/short-cervix

  Treatment for a short cervix is most effective if it begins before 24 weeks of pregnancy. […] Pregnant women who receive this treatment often have uncomplicated pregnancies and delivery. […] Even when a woman goes into premature labor, progesterone or cerclage may still delay labor by several weeks, giving the fetus more time to develop. This decreases the risk of complications.

• #1 Transabdominal Cervical Cerclage (TAC) – UChicago Medicine

  https://www.uchicagomedicine.org/conditions-services/pregnancy-childbirth/high-risk-pregnancy-maternal-fetal-medicine/conditions/incompetent-cervix-cervical-insufficiency/transabdominal-cervical-cerclage

  Transabdominal cervical cerclage (TAC) is a surgery performed to prevent pregnancy loss in patients with the most challenging cases of incompetent cervix (cervical insufficiency). […] TAC surgery is effective in at least 95% to 98% of our patients. […] Yes, TAC is safe. TAC surgery carries less risk than a simple C-section, particularly since placement is often performed as an outpatient procedure. […] Patients with a TAC are not at an increased risk for common pregnancy complications, such as miscarriage or preterm delivery. […] One misunderstanding surrounding TAC is that it increases the risk for miscarriage. This is entirely false based on decades of patient outcomes. […] Several health insurance companies cover the cost of a transabdominal cerclage as a primary treatment for incompetent cervix.

• #1 The shortened cervix in pregnancy: Investigation and current management recommendations for primary caregivers

  https://www1.racgp.org.au/ajgp/2019/march/the-shortened-cervix-in-pregnancy

  If CL is 20 mm, vaginal progesterone pessaries should be started, as multiple randomised control trials have shown a significant risk reduction of PTB and improved neonatal outcomes. […] For women deemed to be high risk, cervical cerclage should be considered if there is cervical dilatation pre-viability or if the cervix continues to shorten during surveillance. […] Progesterone is generally the preferred treatment because of the lower risk of surgical complications.

• #1 Cervical Insufficiency: Causes, Symptoms and Treatment for Incompetent Cervix

  https://www.sakraworldhospital.com/blogs/cervical-insufficiency/436

  Cervical insufficiency is a serious condition that requires close medical attention to prevent pregnancy complications. If you have a history of preterm labor or experience cervix open symptoms, consult your doctor for evaluation and possible treatment. Regular prenatal check-ups can help ensure a healthy pregnancy and reduce the risks associated with an incompetent cervix.

• #2 Incompetent Cervix: Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17912-incompetent-cervix

  If youre at risk for an incompetent cervix or your cervix shows signs of opening too soon, your pregnancy care provider may recommend preventative treatment to avoid pregnancy complications. […] The goal of treating incompetent cervix is to help you stay pregnant as long as possible. […] A procedure called a cervical cerclage is one way pregnancy care providers try to prevent premature labor. It involves sewing your cervix shut. […] Your provider may recommend cerclage if: […] If you have risk factors for incompetent cervix, your provider may recommend taking progesterone supplements beginning in your second trimester. […] If you have risk factors for cervical insufficiency, your pregnancy care provider may decide to monitor the length of your cervix using ultrasound up until about 24 weeks of pregnancy. […] Incompetent cervix can cause complications, including miscarriage and premature birth. […] Cerclage treatment for incompetent cervix is successful in nearly 90% of cases. […] In most cases, this condition is treatable with a procedure called a cerclage.

• #2 Management of Incompetent Cervix | Maternal Fetal Associates of the Mid-Atlantic

  https://mfama.com/project/management-of-incompetent-cervix/

  Management of Incompetent Cervix […] What is the Treatment for Cervical Incompetence? […] – Vaginal Progesterone in mild cases. […] – Cervical cerclage a procedure in which the cervix is surgically closed. A cerclage can be placed early in pregnancy on an elective basis or it may need to be placed later in pregnancy on a more urgent/emergent basis (Rescue cerclage). A Cerclage is removed 3-4 weeks prior to the expected date of delivery to allow for vaginal delivery or can be removed at the time of a scheduled cesarean section. […] – Pessary a device that is placed vaginally to support and close the cervix. This can be done as an outpatient procedure.

• #2 Cervical Cerclage: Purpose, Procedure, Risks & Results

  https://my.clevelandclinic.org/health/treatments/17970-cervical-cerclage

  Cervical cerclage is a way of keeping your cervix closed during pregnancy to prevent premature birth due to incompetent (weakened) cervix. If your cervix has weakened, your healthcare provider will likely recommend a cervical cerclage. This is to keep the fetus safe inside of your uterus until its time for you to give birth. […] During this procedure, your healthcare provider will place one or several sutures (stitches) in the opening of your cervix to keep it safely closed during your pregnancy. […] There are several reasons why your healthcare provider may recommend cervical cerclage during your pregnancy. Some reasons for cervical cerclage include: Incompetent (weakened) cervix. This can happen due to past surgeries such as LEEP procedures or other surgeries on cervical tissue. […] If your healthcare provider thinks you may benefit from a cervical cerclage procedure, theyll perform it at about 12 to 14 weeks into your pregnancy, before your cervix thins out.

• #2 Incompetent cervix | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/incompetent-cervix?content_id=CON-20373818

  Cervical cerclage. During this procedure, the cervix is stitched tightly closed. The stitches are taken out during the last month of pregnancy or just before delivery. You may need a cervical cerclage if you are less than 24 weeks pregnant, you have a history of early births and an ultrasound shows that your cervix is starting to open. […] Sometimes, cervical cerclage is done as a preventive measure before the cervix starts to open. This is known as a prophylactic cervical cerclage. You might have this type of cervical cerclage if you’ve had an incompetent cervix with past pregnancies. This procedure often is done before 14 weeks of pregnancy. […] Cervical cerclage isn’t the right choice for everyone at risk of premature birth. For instance, the procedure isn’t recommended if you’re pregnant with twins or more. Be sure to talk to your doctor about the risks and benefits cervical cerclage may have for you.

• #2 Treating an Incompetent Cervix | Preventing Miscarriage| The CP Lawyer

  https://www.thecplawyer.com/birth-injury/preventing-miscarriage/

  In many cases a simple ultrasound can reveal signs of an incompetent cervix before complications arise. […] The most common treatment for an incompetent cervix is known as a cerclage, which involves suturing the cervix to prevent it from continuing to prematurely dilate. […] Cerclages performed during the third trimester may also be appropriate on an emergency basis to facilitate a full term pregnancy. […] Unfortunately, not every woman is able to have a cerclage. Specifically, if her water has already broken, a cerclage will not successfully slow the progression of labor. […] Moreover, a cerclage is also ineffective at preventing pre-term labor if a woman’s cervix is dilated more than four centimeters, or if the cervix is extremely irritated. […] Under these circumstances, a doctor will likely prescribe bed rest in the Trendelenburg position, where a woman lies on an inverted slope with her feet elevated above her head.

• #2 Cervical Insufficiency Treatment & Management: Cervical Cerclage, Progesterone Supplementation, Cervical Pessary

  https://emedicine.medscape.com/article/1979914-treatment

  Surgical treatment of cervical insufficiency has long consisted of cervical cerclage, which is the placement of a stitch in an attempt to improve the tensile strength of the cervix. A cerclage can be placed from a transvaginal or transabdominal approach, with the primary objective of reinforcing the cervix at the level of the internal os and, thus, increasing the functional length of the cervix. […] According to a 2014 practice bulletin from the American College of Obstetricians and Gynecologists (ACOG), possible indications for cervical cerclage in women with singleton gestations include the following: History of second trimester pregnancy loss with painless cervical dilatation or prior cerclage placement for cervical insufficiency („history-indicated cerclage”). Painless cervical dilatation in the second trimester („emergency” or „rescue cerclage”). History of spontaneous preterm birth (prior to 34 weeks gestation) and a short cervical length (eg, 25 mm) prior to 24 weeks gestation („ultrasound-indicated cerclage”).

• #2 Incompetent Cervix: What Causes It, and How It’s Treated

  https://www.webmd.com/women/what-is-incompetent-cervix

  Treatments for an Incompetent Cervix […] There are several treatment options your doctor might consider if you have an incompetent cervix. These may include: […] Cerclage. This is a stitch in your cervix to help hold it closed. It’s usually done between 12 and 14 weeks of pregnancy. The stitch will be removed around 27 weeks of pregnancy. If you’re pregnant with twins or multiples your doctor won’t do a cerclage because it hasn’t been shown to help in those cases. […] Progesterone treatment. Progesterone is a hormone. If you have a history of giving birth too early, your doctor may give you shots of progesterone every week during your second and third trimester. […] Bed rest. If your doctor discovers you have an incompetent cervix later in your pregnancy, they may put you on bed rest for the rest of your pregnancy. This means you need to stay in bed and not do your normal activities.

• #2 Incompetent Cervix (Cervical Insufficiency) – UChicago Medicine

  https://www.uchicagomedicine.org/conditions-services/pregnancy-childbirth/high-risk-pregnancy-maternal-fetal-medicine/conditions/incompetent-cervix-cervical-insufficiency

  The University of Chicago Medicine offers hope to families struggling with an incompetent cervix diagnosis, also called cervical insufficiency. With treatment from our experts, it’s possible for women with a history or high risk of recurrent pregnancy loss or preterm birth to carry and deliver healthy babies. […] Placement of a cerclage is the standard treatment for cervical insufficiency. A cerclage is the placement of a band or suture for reinforcement to help prevent the amniotic sac from „funneling” down into the cervix prematurely. There are different types of cerclage procedures, including: […] Transabdominal cervical cerclage (TAC procedure) […] Transvaginal cervical cerclage.

• #2 Understanding treatments for incompetent cervix | My Vanderbilt Health

  https://my.vanderbilthealth.com/understanding-treatments-for-incompetent-cervix/

  An incompetent cervix, also known as cervical insufficiency, means the cervix dilates too early, resulting in premature birth or pregnancy loss. […] If youve experienced cervical insufficiency in the past, there are treatment options. […] Sometimes the pregnancy can be completed with the help of a technique called rescue cerclage. […] In this case, your doctor might recommend an abdominal cerclage in preparation for carrying a baby. […] This procedure uses a 5-millimeter cloth band rather than a suture. […] The abdominal cerclage doesn’t affect any function of reproduction or the reproductive tract at all. […] Weve actually had very good success, Anderson added regarding the procedure.

• #2 Cervical Cerclage: Purpose, Procedure, Risks & Results

  https://my.clevelandclinic.org/health/treatments/17970-cervical-cerclage

  But if you have a weakened cervix, a cervical cerclage procedure is the best way to prevent preterm labor (labor that begins before 37 weeks). The advantages are clear. […] Your healthcare provider will only recommend a cerclage procedure if the benefits outweigh the risks. But, as with almost any medical procedure, there are some risks to be aware of with a cervical cerclage procedure. […] Your healthcare provider will want you to take it easy for a week to 10 days after your cerclage procedure to allow time for your cervical stitches to heal properly. […] Your healthcare provider will want you to abstain from sexual activity for a week before your cervical cerclage procedure and probably for a week to 10 days after your procedure to allow your cervical stitches time to heal. […] Your cerclage will stay in place until your pregnancy reaches full term or about the 37th week of pregnancy. […] While it might be scary to consider cerclage treatment, this procedure is successful in nearly 90% of cases.

• #2 Incompetent Cervix | American Pregnancy Association

  https://americanpregnancy.org/getting-pregnant/incompetent-cervix/

  Incompetent cervix is a condition that may lead to a miscarriage or premature delivery. […] The treatment for an incompetent or weakened cervix is a procedure that sews the cervix closed to reinforce the weak cervix. This procedure is called a cerclage and is usually performed between week 14-16 of pregnancy. […] Possible complications of cervical cerclage include uterine rupture, maternal hemorrhage, bladder rupture, cervical laceration, preterm labor and premature rupture of the membranes.

• #2 Short cervix: Diagnosis and treatment

  https://www.medicalnewstoday.com/articles/short-cervix

  Having a short cervix can complicate labor and delivery. If a doctor recognizes someone has a short cervix early on, it can make treatment easier and more effective. […] Receiving treatment can prevent complications associated with having a short cervix. […] There are generally two treatment options for a short cervix. […] For some women, a doctor may recommend a cerclage. This is a stitch in the cervix that reinforces it, reducing the risk of pregnancy loss or preterm labor. […] A 2017 review of 15 studies concluded that while cerclage reduces the risk of preterm birth in women at high risk it is still unclear whether other options may be more effective, particularly vaginal progesterone. […] Vaginal progesterone can be administered with suppositories or injections. A doctor may, for example, recommend suppositories for a woman who has a short cervix but no history of preterm delivery. According to a 2013 study, vaginal progesterone reduces the risk of delivering before 33 weeks by 44%.

• #2 Short cervix: Diagnosis and treatment

  https://www.medicalnewstoday.com/articles/short-cervix

  Treatment for a short cervix is most effective if it begins before 24 weeks of pregnancy. […] Pregnant women who receive this treatment often have uncomplicated pregnancies and delivery. […] Even when a woman goes into premature labor, progesterone or cerclage may still delay labor by several weeks, giving the fetus more time to develop. This decreases the risk of complications.

• #2 Cervical incompetence – Miracle Babies

  https://www.miraclebabies.org.au/content/cervical-incompetence/gm41js

  The diagnosis and management of cervical incompetence is usually managed by an obstetrician. However, the maternity and Labor and Delivery nurse should educate the patient that the non-surgical approaches of managing cervical incompetence like limiting activity, bed rest, and pelvic rest have not proven effective and their use is discouraged. […] Another nonsurgical treatment to be considered in patients at risk of cervical insufficiency is the vaginal pessary. The evidence is limited for a potential benefit of pessary placement in select high-risk patients. The decision to treat rests solely with the obstetrician. […] Your Obstetrician will decide on the best treatment for your condition, some options include: A transvaginal cervical suture placed through surgery between 12- and 14-weeks pregnancy, A transvaginal emergency cervical suture placed during pregnancy which has higher risks, Vaginal pessary, Transabdominal cervical suture placed prior to pregnancy through laparoscopic surgery.

• #2 Reddit – The heart of the internet

  https://www.reddit.com/r/ShortCervixSupport/comments/1fty53x/managing_short_cervix/

  Based on a conversation with my regular OBGYN and research and stories I’ve read online, I am also trying: […] [OBGYN recommendation] Taking it easier. I’m still lifting and carrying my nearly 30 lb 10 month old and doing some cooking, but I’m sitting as much as possible and my husband is taking care of all additional heavy-lifting and housework. […] [OBGYN recommendation] Pelvic rest (no sex or orgasms) […] [OBGYN recommendation] Not eating/drinking anything that is purported to „ripen the cervix” (raspberry leaf tea, dates, etc.) […] [Personal choice, but cleared it with MFM] In addition to my regular supplements (I take a prenatal vitamin, fish oil, probiotic, magnesium and choline) I added an ALA (alpha lipoic acid) supplement. I read a couple studies that showed it helped stabilize short cervix and reduce risk of preterm labor. […] [Personal choice] In addition to my oral magnesium supplement, I started spraying magnesium oil on my belly morning and night. My understanding is that magnesium has a tocolytic effect, so similar logic to the electrolytes here.

• #2 Cervical Incompetence | Cervical Shortening in Pregnancy | Alana Healthcare

  https://www.alanahealthcare.com.au/services/obstetrics/cervical-incompetence/

  If you are diagnosed with a short cervix, the choice of treatment needs to be tailored to a variety of factors and your Alana doctor will direct you as to the most appropriate treatment for your particular circumstances. […] Research has shown that if the cervix measures less than 10 mm in length then neither cerclage nor progesterone may be effective in preventing delivery. […] It has long been held that complete bed rest to take the pressure off the cervix may help to reduce the risks associated with early delivery in women with a short cervix.

• #2 Incompetent Cervix: Symptoms, Causes and TreatmentCircleBumpCheckedFilledMedicalBookmarkBookmarkTickBookmarkAddCheckBoxCheckBoxFilled

  https://www.thebump.com/a/incompetent-cervix

  Additionally, your doctor may also recommend that you limit or abstain from sex and other physical activities, notes Mayo Clinic. […] Unfortunately, you can’t really prevent cervical insufficiency. […] That said, if you have a history of pregnancy loss or premature birth due to cervical insufficiency, make sure your doctor knows; they may put you on pelvic rest and recommend a cervical cerclage or other treatment to lower the risk of complications. […] Whether you call it an incompetent cervix or cervical insufficiency, remember that it’s not your fault. Take comfort knowing that many people with cervical insufficiency can go on to have full-term, healthy pregnancies.

• #3 Incompetent cervix – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/incompetent-cervix/symptoms-causes/syc-20373836

  An incompetent cervix can be a hard problem to diagnose and treat. If your cervix begins to open early, or if you’ve had cervical insufficiency in the past, you might benefit from treatment. This might include having a procedure done to close the cervix with strong sutures, called a cervical cerclage. You also may take medicine to help the incompetent cervix and have ultrasound exams to check how things are going. […] If you’ve had an incompetent cervix during one pregnancy, you’re at risk of premature birth or pregnancy loss in later pregnancies. If you’re considering getting pregnant again, talk with your doctor to understand the risks and what you can do to promote a healthy pregnancy.

• #3 Cervical Insufficiency > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/cervical-insufficiency

  Treatment includes monitoring, progesterone supplement, and surgery (cervical cerclage) […] Cervical cerclage, a minor surgical procedure, is an effective and safe treatment option that can help prolong the pregnancy, ideally to full term. […] If the physician and patient are in agreement, her cervical insufficiency can be treated with a simple surgical procedure called cervical cerclage, which can help prolong the pregnancy. […] Dr. Kohari notes that cervical cerclage is most often used for women with a history of at least one early loss in the absence of labor. […] According to Dr. Kohari, cervical cerclage stitches the cervix closed, helping to keep the baby safely in the womb. […] Cervical cerclage is an outpatient procedure, done in the hospital under regional anesthesia. […] For complicated cases, including those in which the cervical cerclage hasn’t worked in the past, another technique called transabdominal cerclage is an option.

• #3 Cervical Cerclage | ACOG

  https://www.acog.org/womens-health/faqs/cervical-cerclage

  A cervical cerclage is a treatment that involves temporarily sewing the cervix closed with stitches. This may help the cervix hold a pregnancy in the uterus. A cerclage is done in the second trimester of pregnancy to prevent preterm birth. […] Sometimes the cervix isnt strong enough to stay closed as the pregnancy grows. This weakness is called cervical insufficiency (formerly called an incompetent cervix). Cervical weakness may cause a quick delivery and preterm birth. The goal of a cerclage is to prevent cervical weakness from causing preterm birth. […] There are two types of cerclage: Transvaginal cerclage. Ob-gyns most often do a cerclage by reaching through the vagina to place stitches in the cervix. Transabdominal cerclage. This is when a cut is made in the abdomen (belly) to reach the cervix and place stitches.

• #3 Cervical Insufficiency & Incompetence Treatment — A/Prof Alex Ades

  https://www.advancedgynaecologymelbourne.com.au/cervical-insuficiency

  At present indications for a Transabdominal Cerclage include: Previous failed Transvaginal Cerclage, Previous surgery to remove part of the cervix like cone biopsies, Shortened cervix on examination. […] The procedure is similar to the Transabdominal Cerclage, but is done through laparoscopy (keyhole surgery). The benefits are that the operation is less invasive, with only three small (less than 1 cm) incisions. Most women go home the same day or the following morning.

• #3 Incompetent cervix: Causes, Symptoms, & Treatment | MyloFamily

  https://www.mylofamily.com/article/incompetent-cervix-causes-symptoms-treatment-214305?internal_source=organic_article&internal_medium=218129&srsltid=AfmBOop48wiZClZ0nZAhTkjca2MSxvK0G4kW51CriK0pPgrLY9Jxyap-

  If you have a premature birth because your cervix isn’t strong enough, your doctor may suggest getting a cervical cerclage before your cervix opens. Most doctors recommend scheduling this procedure before the 14th week of pregnancy. […] Another option that your doctor may suggest is using a vaginal gadget to keep the uterus in place (pessary). Using a pessary has been shown to reduce stress on the cervix. […] Incompetent cervix treatment is possible, and the patient can fully recover. To give the developing fetus the best chance at health, treatment for this disease focuses on putting off labor as long as feasible. […] The success rate of cerclage treatment for incompetent cervix is close to 90%.

• #3 What is Incompetent Cervix?

  https://www.hamptonking.com/blog/what-is-incompetent-cervix/

  One study found that the effect of elective operation at 14 to 18 weeks of pregnancy was more ideal than waiting longer. Women with a history of cervical insufficiency might need to undergo this procedure around 14 weeks or possibly even before. […] Sometimes doctors might order an emergency cerclage in the third trimester to prevent preterm birth. […] Doctors might recommend a cerclage for a woman who has had incompetent cervix or preterm deliveries in the past. Its not recommended for women who have an infection, placental abruption, or preterm premature rupture of membranes (PPROM). […] Cerclage is a safe, uncomplicated procedure. Women often go home a few hours after having it done. But it doesnt come without a few risks. Potential complications include: Infection, Cervical lacerations, Bladder or uterine rupture, Preterm labor, Premature membrane rupture, Maternal bleeding. […] After a cerclage, doctors have the obligation to monitor women for signs of complications. If there are no signs of complications, the woman can leave the hospital. Most doctors recommend staying inactive for a few days so that the suture site can heal.

• #3 Treating an Incompetent Cervix | Preventing Miscarriage| The CP Lawyer

  https://www.thecplawyer.com/birth-injury/preventing-miscarriage/

  For women who are diagnosed with an incompetent cervix, it is important they see their doctor regularly to monitor the integrity of the cervix as her pregnancy progresses. […] It is also recommended that she refrain from any strenuous activity that can put undue pressure on her uterus and cervix. […] If a woman was previously diagnosed with an incompetent cervix or if she exhibits other risk factors associated with the condition, it is important that she informs her doctor so immediate and preventative measures can be taken.

• #3 Incompetent Cervix: symptoms – The fertility center mexico

  https://thefertilitycentermexico.com/en/blog/incompetent-cervix-symptoms-diagnosis-and-treatment/

  Cervical cerclage is the most invasive treatment option. Because it is used in single births, it is not a treatment option for all women. The criteria for this option are being 24 weeks pregnant, an ultrasound showing your cervix is dilating (opening) early, or a previous premature birth. In cervical cerclage, your obstetrician will sew your cervix tight, similar to pulling purse strings closed. This ensures the cervix stays closed until the ninth month of pregnancy, when your baby is full term and ready to be delivered! If you had an incompetent cervix in past pregnancies, cervical cerclage may be done prophylactically by the 14th week of pregnancy to ensure you carry the baby to full term. […] Our fertility specialist Mexico at The Fertility Center specialize in incompetent cervix. We provide the latest in diagnosing and treating cervical insufficiency and other pregnancy issues—the same high-quality incompetent cervix treatment offered in the US at a fraction of the cost.

• #3 The shortened cervix in pregnancy: Investigation and current management recommendations for primary caregivers

  https://www1.racgp.org.au/ajgp/2019/march/the-shortened-cervix-in-pregnancy

  If CL is 20 mm, vaginal progesterone pessaries should be started, as multiple randomised control trials have shown a significant risk reduction of PTB and improved neonatal outcomes. […] For women deemed to be high risk, cervical cerclage should be considered if there is cervical dilatation pre-viability or if the cervix continues to shorten during surveillance. […] Progesterone is generally the preferred treatment because of the lower risk of surgical complications.

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