What is an Incompetent Cervix?
An
incompetent cervix, also known as cervical insufficiency, refers to a condition in which the cervix begins to dilate and efface prematurely during pregnancy, often without contractions or pain. This can lead to preterm birth or the loss of an otherwise healthy pregnancy.
Previous cervical surgery, such as a
LEEP procedure or cone biopsy.
Congenital cervical anomalies, which might be genetic or due to exposure to certain substances like
DES (diethylstilbestrol).
Trauma to the cervix from previous difficult deliveries or multiple dilation and curettage (D&C) procedures.
Structural abnormalities such as a
bicornuate uterus.
A sensation of pelvic pressure.
Backache.
Mild abdominal cramps.
Change in vaginal discharge.
Light vaginal bleeding.
In many cases, an incompetent cervix is asymptomatic and is discovered only after a preterm birth or miscarriage.
Medical history review, particularly focusing on previous pregnancies and cervical procedures.
Transvaginal ultrasound to measure cervical length and identify any signs of funneling or dilation.
Physical examination to assess cervical changes.
In some cases, a doctor may perform a
pelvic exam to check for early dilation.
Cervical cerclage, a surgical procedure where a stitch is placed around the cervix to keep it closed.
Progesterone supplementation, which can help in reducing the risk of preterm birth.
Bed rest or reduced physical activity to decrease pressure on the cervix.
Pessary, a device placed in the vagina to help support the cervix.
Second-trimester miscarriage.
Preterm birth, which can lead to complications for the newborn such as respiratory distress syndrome, infections, and long-term developmental issues.
Risks related to cerclage may include infection, bleeding, or preterm premature rupture of membranes (PPROM).
Regular prenatal care and early screening for women with a history of cervical insufficiency.
Avoiding unnecessary cervical procedures that could weaken the cervix.
Discussing the possibility of
prophylactic cerclage with a healthcare provider if there is a history of second-trimester losses or preterm births.
Living with an Incompetent Cervix
Women diagnosed with an incompetent cervix can often have successful pregnancies with proper management. Open communication with a healthcare provider, following prescribed treatments, and attending all prenatal appointments are crucial for the best outcomes.
