The cervix, also known as the cervix, may have a much wider opening than it should be in some cases. Such conditions are called cervical insufficiency or cervical insufficiency. In the later stages of pregnancy, if the cervix is not closed enough, it may begin to open before the labor pains begin. Thus, the risk of premature birth arises. In general, the risk of cervical insufficiency is higher in those who have previously undergone hysteroscopy for the removal of uterine fibroids or polyps, those who have given birth before, those who have had abortion, and those who have given birth with forceps or vacuum before, compared to others.
How Is Cervical Insufficiency Determined?
Cervical insufficiency can be diagnosed with a simple examination. Cervical opening should be around 8 mm at most in the controls performed outside the menstrual period. Uterine dilatation greater than 8 mm is considered cervical insufficiency. A definitive diagnosis can be made with tests performed with Hegar plugs. This test can be performed without causing any discomfort to the patient. In pregnant women, it is a little more difficult to make this diagnosis. Births due to cervical insufficiency, which are more difficult to detect than miscarriage or premature birth, are usually seen between the 18th and 22nd weeks of pregnancy. Premature birth, on the other hand, usually occurs after the 26th week of pregnancy.
How and When Is Cerclage Performed?
The ideal period for cerclage application is between the 12th and 14th weeks of pregnancy. This is called prophylactic cerclage. On the other hand, in some cases, cerclage may be required after delivery. In such cases, cerclage should be performed in future pregnancies. On the other hand, emergency cerclage is required for people who have previously delivered prematurely, or in cases where the length of the cervix is 2 cm or less in vaginal ultrasonography, or when funneling is observed in the amniotic sac. However, no cerclage application can be performed when the birth starts actively, when bleeding occurs in the uterus, when the water sac is opened, when inflammation occurs in the uterus or amniotic sac, in fetal anomalies and in cases where the fetus is not alive.