Cervical Incompetence: What You Need to Know
Cervical incompetence, also known as cervical insufficiency, is a condition that affects some pregnant women. It occurs when the cervix, the lower part of the uterus that connects to the vagina, starts to open, shorten or weaken too early in pregnancy. This can lead to premature birth or miscarriage, especially in the second trimester.
The cervix normally stays closed and firm until the end of pregnancy, when it softens and dilates to allow the baby to pass through the birth canal. However, in some women, the cervix may have a congenital abnormality, a previous injury or surgery, or a genetic disorder that makes it weak and unable to support the weight of the growing baby. As a result, the cervix may start to open or shorten without any signs of labour, such as contractions or bleeding.
Cervical incompetence is not very common, affecting about 1 in 100 pregnancies. However, it can have serious consequences for the mother and the baby. Women who have had a previous premature birth or miscarriage in the second trimester, or who have had surgery on their cervix, are at higher risk of developing cervical incompetence. Other risk factors include having an irregularly shaped cervix or uterus, being Black, or expecting multiples.
Symptoms of Cervical Incompetence
Cervical incompetence may not cause any noticeable symptoms, so it can be hard to diagnose and treat. Some women may experience pelvic pressure, abdominal pain, spotting or changes in vaginal discharge. However, these symptoms may also occur in normal pregnancies or other conditions. Therefore, it is important to seek regular prenatal care and inform your doctor about your medical history and any concerns you may have.
Preventive Treatment
If you are diagnosed with cervical incompetence or are at high risk of developing it, your doctor may recommend a preventive treatment called cervical cerclage. This is a surgical procedure that involves placing strong stitches around the cervix to keep it closed and support the pregnancy. The stitches are usually removed before labour or delivery. Cervical cerclage is not suitable for everyone and may have some risks and complications, such as infection, bleeding or preterm labour.
Another option for preventing preterm birth due to cervical incompetence is using progesterone supplements. Progesterone is a hormone that helps maintain pregnancy and prevent contractions. It can be given as an injection, a vaginal gel or a suppository. Progesterone therapy may reduce the risk of preterm birth by about one-third in women with a short cervix.
In addition to these treatments, your doctor may also advise you to rest more, avoid heavy lifting and strenuous activities, drink plenty of fluids and eat a healthy diet. You may also need more frequent ultrasounds to monitor your cervix and your baby's growth and development.
Cervical incompetence can be a challenging condition to cope with, but with proper care and support, you can have a healthy and successful pregnancy. If you have any questions or concerns about cervical incompetence, talk to your doctor or midwife.
Sources
- Incompetent cervix - Symptoms and causes - Mayo Clinic https://www.mayoclinic.org/diseases-conditions/incompetent-cervix/symptoms-causes/syc-20373836
- Incompetent Cervix: Causes, Symptoms & Treatments - Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/17912-incompetent-cervix
- Cervical weakness - Wikipedia https://en.wikipedia.org/wiki/Cervical_weakness
- Cervical incompetence | Radiology Reference Article - Radiopaedia.org https://radiopaedia.org/articles/cervical-incompetence