It's all about the cervix!

Premature Birth — Every Minute of Every Day

A baby is born too soon every minute of every day in the U.S. – that’s one of every 8 babies.  Babies born before 37 completed weeks of pregnancy haven’t had enough time to fully develop their bodies or their brains. Some premature babies suffer developmental delays or lifelong disabilities such as blindness, cerebral palsy, and respiratory disease.  And, prematurity is the leading cause of infant death.

Prematurity is a difficult puzzle to solve. To prevent it, we need to better understand what causes it, which pregnant women are more likely to deliver early, and what type of treatment can reduce their risk.  Thankfully, researchers are finally putting some of the pieces together.  Two critical pieces of the puzzle are the cervix, which is the lower part of the uterus, and progesterone, a naturally occurring hormone that helps prolong pregnancy. 

Premature Cervical Shortening

The cervix is like a doorway from the uterus to the vagina.  During pregnancy, your cervix naturally shortens (effaces) and opens (dilates) as delivery nears so that your baby can enter the birth canal.  Sometimes the cervix starts to shorten too soon, as early as the second trimester.  Although this only happens to about ten percent of pregnant women, they are six times more likely to have a premature birth.

To find out if you’re at high risk, it’s important to have your cervical length measured mid-pregnancy.  Most women have a normal, long cervix mid-pregnancy – so cervical length measurements are reassuring for them.  For the women who learn their cervix may be shortening prematurely, that knowledge is the key to getting specialized care.

If your cervix is shortening too soon, your doctor or midwife may want to do more testing.  And, progesterone treatment might be an option that can reduce your risk.  Be sure to ask your doctor or midwife about cervical length and other risk factors to make sure you get preventive treatment if you and your baby need it. 

Two Ways to Measure

Transvaginal Ultrasound

When people think of pregnancy and ultrasound, most think of the exam that uses a probe on the expectant mother’s abdomen to see digital images of the baby.  This abdominal ultrasound exam is a great way to check the baby’s health and growth, but it is not a reliable way to view and measure the cervix.

A different type of ultrasound exam, transvaginal ultrasound, does provide a reliable cervical length measurement.  This exam uses a probe inserted into the vagina to create digital images of the cervix and uterus. The measurement is made using those images. This procedure is usually done at an extra prenatal appointment – or you may be referred to an ultrasound center or a Maternal-Fetal Medicine specialist.  Transvaginal ultrasound can take 15-30 minutes. 

• SEE THE TECHNOLOGY

CerviLenz®

CerviLenz is a new, easy way for your doctor or midwife to measure cervical length at any prenatal visit. Using a speculum to see the cervix, this disposable device is inserted into the vagina and directly measures the outer wall of the cervix. Your cervical length can be measured reliably in just a few minutes with CerviLenz.

• SEE THE TECHNOLOGY

Learn More

Here are resources you can download and print about prematurity and what you can do to find out if you’re at risk so you can get specialized care if you need it.  Most importantly, be sure to talk to your doctor or midwife about cervical length and other risk factors such as a history of premature birth and twin pregnancies.  Knowledge is power!

• Your Cervix During Pregnancy
• Measure to be Sure
• The Pregnancy Foundation – High Risk Pregnancy FAQs
• March of Dimes – Signs and Symptoms of Preterm Labor
• March of Dimes – More about Other Risk Factors
• March of Dimes – About Progesterone
• Healthy Women – Premature Birth: Managing Risk Factors
• KeepEmCookin – Prevention and Treatment