In some cases, the cervix, also known as the cervix, can have a much wider opening than it should. Such conditions are called cervical insufficiency or cervical insufficiency. If the cervix is not closed enough in the later stages of pregnancy, it may begin to dilate before labor pains begin. Thus, the risk of premature birth arises. The risk of cervical insufficiency is generally higher in those who have previously undergone hysteroscopy to remove myomas or polyps in the uterus, those who have given birth before, those who have had an abortion, and those who have previously given birth with forceps or vacuum.
How is Cervical Insufficiency Determined?
Cervical insufficiency can be diagnosed with a simple examination. In checks performed outside the menstrual period, the cervical dilatation should be around 8 mm at most. A uterine dilatation of more than 8 mm is considered as cervical insufficiency. Definitive diagnosis can be made with tests performed with the Hegar bougie. This test can be performed without causing any discomfort to the patient. It is a little more difficult to make this diagnosis in pregnant women. Births caused by cervical insufficiency, which are more difficult to detect than miscarriage or premature birth, generally occur between the 18th and 22nd weeks of pregnancy. On the other hand, premature birth usually occurs after the 26th week of pregnancy.
How and When is Cerclage Performed?
The ideal period for cerclage application is the 12th week of pregnancy. It is between . and 14 weeks. This is called prophylactic cerclage. On the other hand, in some cases, cerclage may be required after birth. In such cases, cerclage is required in future pregnancies. On the other hand, urgent cerclage is required for people who have previously given birth prematurely, or when 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 should be performed when labor begins actively, bleeding occurs within the uterus, the water sac is opened, inflammation occurs in the uterus or amniotic sac, fetal anomalies and in cases where the fetus is not alive. It cannot be done.
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