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Normally, the cervix should be at least 30 mm in length. Cervical weakness is variably defined. However, a common definition is a cervical length of less than 25 mm at or before 24 weeks of gestational age. The risk of preterm birth is inversely proportional to cervical length: [7] Less than 25 mm; 18% risk of preterm birth
Rankins says cervical insufficiency happens when there's painless dilation, or opening, of the cervix, typically in the second trimester of pregnancy, or during weeks 13 through 28.
A cervical pregnancy is an ectopic pregnancy that has implanted in the uterine endocervix. [2] Such a pregnancy typically aborts within the first trimester, however, if it is implanted closer to the uterine cavity – a so-called cervico-isthmic pregnancy – it may continue longer. [3]
Prior to effacement, the cervix is like a long bottleneck, usually about four centimeters in length. Throughout pregnancy, the cervix is tightly closed and protected by a plug of mucus. Effacement is accompanied by cervical dilation. When the cervix effaces, the mucus plug is loosened and passes out of the vagina.
Cervical pessary is a medical device used to treat an incompetent (or insufficient) cervix (cervix starts to shorten and open too early). Early in the pregnancy a round silicone pessary is placed at the opening to the cervix to close it, and then it's removed later in the pregnancy when the risk of a preterm birth has passed.
There is a small amount of evidence that rutosides (a herbal remedy) may relieve symptoms of varicose veins in late pregnancy but it is not yet known if rutosides are safe to take in pregnancy. [25] Risk factors include obesity, lengthy standing or sitting, constrictive clothing and constipation and bearing down with bowel movements.
A McDonald cerclage, described in 1957, is the most common, and is essentially a pursestring stitch used to cinch the cervix shut; the cervix stitching involves a band of suture at the upper part of the cervix while the lower part has already started to efface. [2] This cerclage is usually placed between 16 weeks and 18 weeks of pregnancy.
The chance of survival at 22 weeks is about 6%, while at 23 weeks it is 26%, 24 weeks 55% and 25 weeks about 72% as of 2016. [189] With extensive treatment up to 30% of those who survive birth at 22 weeks survive longer term as of 2019. [190] The chances of survival without long-term difficulties is less. [24]