If your cervix begins to open or becomes shorter than a certain length, your doctor might recommend cervical cerclage.Ĭervical cerclage. If you have a history of early premature birth, or you have a history that may increase your risk of cervical insufficiency, your doctor might begin carefully monitoring the length of your cervix by giving you ultrasounds every two weeks from week 16 through week 24 of pregnancy.

However, further research is needed to determine the best use of progesterone in cervical insufficiency. If you have a history of premature birth, your doctor might suggest weekly shots of a form of the hormone progesterone called hydroxyprogesterone caproate (Makena) during your second and third trimester. Treatments for or approaches to managing an incompetent cervix might include: Typically, the stitches are removed during the last month of pregnancy. In a cervical cerclage, strong stiches (sutures) are used to close the cervix during pregnancy to help prevent premature birth. However, certain tests done before pregnancy, such as an MRI or an ultrasound, can help detect uterine abnormalities that might cause an incompetent cervix. There aren't any tests that can be done before pregnancy to reliably predict an incompetent cervix. If fetal membranes are visible and an ultrasound shows signs of inflammation but you don't have symptoms of an infection, your doctor might test a sample of amniotic fluid (amniocentesis) to diagnose or rule out an infection of the amniotic sac and fluid (chorioamnionitis). Your doctor will also check for contractions and, if necessary, monitor them. If the fetal membranes are in your cervical canal or vagina, this indicates cervical insufficiency. Your doctor will examine your cervix to see if the amniotic sac has begun to protrude through the opening (prolapsed fetal membranes). During this type of ultrasound, a slender transducer is placed in your vagina to send out sound waves that generate images on a monitor. Your doctor may use transvaginal ultrasound to evaluate the length of your cervix and to check if membranes are protruding through the cervix. Tests and procedures to help diagnose an incompetent cervix during the second trimester include: Advanced cervical dilation and effacement before week 24 of pregnancy without painful contractions, vaginal bleeding, water breaking (ruptured membranes) or infection.A history of painless cervical dilation and second trimester deliveries.Your doctor might diagnose an incompetent cervix if you have:

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