Home / Guides / Trying to conceive

Cervical insufficiency in the second trimester: signs, screening, and treatment options

NNova editorial team · 6 min read

Cervical insufficiency means the cervix shortens or begins to open earlier than expected in pregnancy. Treatment depends on gestational age, cervical length, pregnancy history, and risk, and may include progesterone, a cervical stitch (cerclage), or close monitoring.

What cervical insufficiency is

Cervical insufficiency is a condition in which the cervix shortens or begins to open earlier than expected. It often has no symptoms, so doctors may check cervical length with an ultrasound during pregnancy.

Cervical insufficiency does not mean labor will start right away. The plan depends on gestational age, cervical length, previous preterm birth, and exam findings.

How doctors usually choose a plan

  • transvaginal ultrasound to measure cervical length
  • review of previous preterm birth or second-trimester pregnancy loss
  • vaginal progesterone when the cervix is short and there is a history of preterm birth
  • cerclage, a stitch placed in the cervix, in selected situations
  • close monitoring with follow-up exams and ultrasounds

A pessary, a device placed in the vagina to support the cervix, is being studied, but it is not a standard treatment in most US practices. Ask your OB-GYN or midwife whether it is an option for you.

When to get care right away

  • regular cramping or tightening
  • pelvic pressure that does not go away
  • bloody discharge
  • leaking fluid or a sudden gush of fluid
  • new or severe back or pelvic pain
If you notice any of these signs, call your OB-GYN or midwife right away. If you cannot reach them, go to the nearest labor and delivery unit or emergency department. Do not wait for symptoms to get worse, especially if you have a known risk of cervical insufficiency.

Learn more

Follow your pregnancy in Nova

Week-by-week growth, a symptom log and a report for your doctor.

Get it on the App Store

General information only; it does not replace advice from your doctor or midwife.