Cervical insufficiency, also known as incompetent cervix, refers to a condition where the cervix begins to dilate (widen) and efface (thin) prematurely during pregnancy, usually without pain or contractions. This can lead to a
preterm birth or loss of an otherwise healthy pregnancy.
The exact cause of cervical insufficiency is often unknown. However, several factors may contribute to weakening of the cervix, including previous
cervical surgeries (like a cone biopsy), trauma during a previous delivery, congenital cervical anomalies, or exposure to
diethylstilbestrol (DES) in utero.
Diagnosis can be challenging as cervical insufficiency often presents without symptoms. It is typically diagnosed through a combination of patient history, physical examination, and
ultrasound. An ultrasound may reveal a shortened cervix or funneling (where the internal part of the cervix opens while the external part remains closed).
Symptoms are generally subtle and may include mild discomfort, a sensation of pelvic pressure, or changes in vaginal discharge. Some women may experience
spotting or light bleeding. Often, cervical insufficiency is not detected until significant cervical changes have already occurred.
Treatment options depend on the individual case but may include
cerclage, a surgical procedure where a stitch is placed around the cervix to keep it closed. Bed rest, avoidance of heavy physical activity, and progesterone supplementation may also be recommended to reduce the risk of preterm labor.
A cerclage is a surgical procedure in which a strong suture is placed around the cervix to prevent it from opening prematurely. This procedure is usually performed between 12 and 14 weeks of pregnancy and can be removed around the 37th week of pregnancy or earlier if
preterm labor ensues.
While generally safe, a cervical cerclage does carry some risks such as infection, bleeding, or rupture of the membranes. There is also a risk of preterm labor induced by the procedure. It is crucial to weigh these risks against the benefits in consultation with your healthcare provider.
Prevention is challenging due to the often unknown etiology of cervical insufficiency. However, women with known risk factors may benefit from early cervical screening and monitoring. Progesterone supplementation and lifestyle modifications might also help in preventing premature cervical changes.
Progesterone is a hormone that helps maintain the uterine lining and prevent contractions. In women with a history of cervical insufficiency, progesterone supplementation might help in reducing the risk of preterm birth. It is typically administered either as a vaginal suppository or an intramuscular injection.
If you have a history of cervical insufficiency or experience any symptoms mentioned above, contact your healthcare provider immediately. Early diagnosis and intervention can significantly improve pregnancy outcomes.
For more information and support, consult your gynecologist or a specialist in maternal-fetal medicine.
