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Ask Dr. Norm S. Your Own Question
Dr. Norm S.
Dr. Norm S., Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 11114
Experience:  Over 30 years of experience in OB/GYN practice, including teaching students. Fellow of American Board of Obstetrics and Gynecology.
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I am 21 weeks pregnant and my cervix is 2.5 cm, I had an

Customer Question

Customer: Hi, I am 21 weeks pregnant and my cervix is 2.5 cm , I had an emergency cerclage last week. WHat can be the prognosis? How far do women usually go with this kind of measurements?
JA: Thanks. Can you give me any more details about your issue?
Customer: My cervix lenght was 1.4 cm and I was sent for a cerclage at 20 weeks. 5 days after, the lenght was 2.5 cm. My question is what are my risks during the pregnancy? How well does it hold with a cerclage?
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Customer: How long is the wait though? Also, I do not want my name to appear in public.
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Submitted: 1 year ago.
Category: OB GYN
Expert:  Dr. Norm S. replied 1 year ago.

Have you had previous pregnancies? If so, what were the outcomes?

Was the cerclage done because of symptoms, or because of the length of the cervix found on routine ultrasound?

Was your cervix dilated at all? Thank you.

Customer: replied 1 year ago.
I had 4 terminations before, and one pregnancy with 9 month delivery meaning, no preterm labor. The only symptom was the lenght of the cervix found on an ultrasound. Thank god, it was not dilated.
Expert:  Dr. Norm S. replied 1 year ago.

I would say that your prognosis is excellent. Most likely you will get near term and the cerclage will be taken out and you will subsequently go into normal labor.

We consider a cervix of less than 2.5cm around 18 weeks as increasing the risk of preterm delivery, but mostly in high risk women (such as women with a history of preterm delivery).

In low risk women such as yourself, only 25% of women with a short cervix deliver prematurely.

Once a cerclage is in place without complication, it will generally hold the cervix closed quite well.

So I think your prognosis is excellent at this point. Best wishes.

Customer: replied 1 year ago.
How am I low risk if I had to do an emergency cerclage?
Customer: replied 1 year ago.
p.s. I had a cerclage placed on a 20th week
Expert:  Dr. Norm S. replied 1 year ago.

You're low risk because you have not had a previous preterm delivery.

Your risk increased because of the short cervix, but the statistics I mentioned are from studies done on pregnant women comparing women with a short cervix who either had or did not have a previous preterm delivery.

Customer: replied 1 year ago.
I forgot to mention that I had a miscarriage at 16 weeks as well. Does it matter? Does it change a situation?
Expert:  Dr. Norm S. replied 1 year ago.

Do you know whether the miscarriage was due to an incompetent cervix? In other words, was there painless dilation of the cervix, or was it a miscarriage the began with bleeding and cramping?

Customer: replied 1 year ago.
My water broke back then. I was bleeding for about 3 weeks and then my water broke. Noone ever told me it could be because of the short cervix
Expert:  Dr. Norm S. replied 1 year ago.

When you were bleeding for 3 weeks, did anyone check your cervix?

Customer: replied 1 year ago.
No, they did not
Expert:  Dr. Norm S. replied 1 year ago.

It's hard to know.

If you did have an incompetent cervix, that would put you in the high risk group.

Often an incompetent cervix shows up when a woman has no contraction, her cervix dilates, and the water breaks. Usually then she is seen and found to have a dilated cervix. There is no usually bleeding beforehand.

If that was an incompetent cervix, then you are at high risk. I would not be quite as optimistic, but I would still say you now have a good chance to go to term with the cerclage in place.

Most women I've see with a cerclage do very well, as long as they aren't dilated at the time of placing the cerclage.

Customer: replied 1 year ago.
Hello Dr.
I had a miscarriage during my first trimester, so the issue with incomplete cervix never came up. How does it change things if it does? Thanks
Expert:  Dr. Norm S. replied 1 year ago.

A miscarriage in the first trimester is not uncommon, and is not related to incompetent cervix, so it doesn't change anything.

Customer: replied 1 year ago.
You first were more optimistic before I told u about my miscarriage. I just made sure it was 1st trimester. Now, the question is am I still at higher risk or not?
Expert:  Dr. Norm S. replied 1 year ago.

You said that you had a miscarriage at 16 weeks. That is not 1st trimester. I'm confused.

Customer: replied 1 year ago.
sorry, I made sure with my Doctor and it was at 10 weeks and 6 days.
Expert:  Dr. Norm S. replied 1 year ago.

So again I would say that such an early miscarriage does not increase your risk for incompetent cervix or preterm delivery. You are still low risk.

Customer: replied 1 year ago.
But I was measured 1.4 before my emergency cerclage. After it was 2.5 at 21 weeks. I also had 4 terminations , so my dr said that might be the cause of my incomplete cervix now. I am writing this just as a reminder, do you still think I am at low risk? Please, let me know. Thanks
Expert:  Dr. Norm S. replied 1 year ago.

The fact that your cervix went from 1.4 to 2.5cm after the cerclage is a good sign.

The 4 terminations might have something to do with the short cervix, but also may have nothing to do with it.

You don't have an incompetent cervix, which means that it's dilating. You have a short cervix.

I still think you are at low risk.

Customer: replied 1 year ago.
Hi, I had a check up at my doctors today, and my cervix went down to 2.2, I am getting worried since I am only 22 weeks. Can you tell me how can it possibly go? Thanks
Expert:  Dr. Norm S. replied 1 year ago.

If the cervix is measured several times, it will usually vary a few mm from one time to the next. It's not as exact a measurement as we'd like.

I would wait until the next measurement. It might be longer. If it's even shorter, that's not a good sign, but it's still much longer than 1.4cm.

It will take some time to see how it will go.

Customer: replied 1 year ago.
What does 1.4 mean? Thanks
Expert:  Dr. Norm S. replied 1 year ago.

Wasn't that the length of your cervix before the cerclage?

Customer: replied 1 year ago.
it was... I just want to know the outcomes of the measurements.
Expert:  Dr. Norm S. replied 1 year ago.

Time will tell. It's too soon to know the outcome.

Customer: replied 1 year ago.
Dr, I have a question. I needed to urinate non stop since last night. I am 23 weeks today. Is it okay? I feel non stop urge to go to the bathroom.
Expert:  Dr. Norm S. replied 1 year ago.

Frequent urination without painful urination suggests pressure on the bladder. That pressure is likely from the baby shifting lower. It doesn't necessarily mean that the cervix has changed, but I think your doctor probably would like to see you for an exam to be sure everything is OK. I would call your doctor now.

Customer: replied 1 year ago.
Can urinating so often be a sign of cervix change ? My dr did not call me back yet and I am really worried. Thanls
Expert:  Dr. Norm S. replied 1 year ago.

Usually if the cervix is dilating, it won't have any effect on frequency of urination.

However, there is a small chance that the cervix is dilating some and the membranes have bulged through, putting pressure on the bladder.

Just in case, I would lie down until you hear from your doctor. That takes pressure off the cervix and membranes.