Disease: Incompetent cervix


    An incompetent cervix, also called a cervical insufficiency, occurs when weak cervical tissue causes or contributes to premature birth or the loss of an otherwise healthy pregnancy.

    Before pregnancy, your cervix — the lower part of the uterus that opens to the vagina — is normally closed and firm. As pregnancy progresses and you prepare to give birth, the cervix gradually softens, decreases in length (effaces) and opens (dilates). If you have an incompetent cervix, your cervix might begin to open too soon — causing you to give birth too early.

    An incompetent cervix can be difficult to diagnose and treat. If your cervix begins to open early, or you have a history of cervical insufficiency, your doctor might recommend preventive medication during pregnancy, frequent ultrasounds or a procedure that closes the cervix with strong sutures (cervical cerclage).

    Source: http://www.mayoclinic.com


    If you have an incompetent cervix, you may not have any signs or symptoms during early pregnancy. Some women have mild discomfort or spotting over the course of several days or weeks starting between 14 and 20 weeks of pregnancy.

    Be on the lookout for:

    • A sensation of pelvic pressure
    • A new backache
    • Mild abdominal cramps
    • A change in vaginal discharge
    • Light vaginal bleeding

    Source: http://www.mayoclinic.com


    An incompetent cervix can only be detected during pregnancy. Even then diagnosis can be difficult — particularly during a first pregnancy.

    Your doctor will ask about any symptoms you're having and your medical history. Be sure to let your doctor know if you've had a pregnancy loss during the second trimester or if you had a procedure on your cervix.

    Your doctor might diagnose an incompetent cervix if you have:

    • A history of painless cervical dilation and second trimester deliveries
    • Advanced cervical dilation and effacement before week 24 of pregnancy without painful contractions, vaginal bleeding, water breaking (ruptured membranes) or infection

    Tests and procedures to help diagnose an incompetent cervix during the second trimester include:

    • Transvaginal ultrasound. Your doctor may use transvaginal ultrasound to evaluate the length of your cervix and to check if membranes are protruding through the cervix. During this type of ultrasound, a slender transducer is placed in your vagina to send out sound waves that generate images on a monitor.
    • Pelvic exam. Your doctor will examine your cervix to see if the amniotic sac has begun to protrude through the opening (prolapsed fetal membranes). If the fetal membranes are in your cervical canal or vagina, this indicates cervical insufficiency. Your doctor will also check for contractions and, if necessary, monitor them.
    • Lab tests. If fetal membranes are visible and an ultrasound shows signs of inflammation but you don't have symptoms of an infection, your doctor might test a sample of amniotic fluid (amniocentesis) to diagnose or rule out an infection of the amniotic sac and fluid (chorioamnionitis).

    There aren't any tests that can be done before pregnancy to reliably predict an incompetent cervix. However, certain tests done before pregnancy, such as an MRI or an ultrasound, can help detect uterine abnormalities that might cause an incompetent cervix.

    Source: http://www.mayoclinic.com


    An incompetent cervix poses risks for your pregnancy — particularly during the second trimester — including:

    • Premature birth
    • Pregnancy loss

    Source: http://www.mayoclinic.com


    You can't prevent an incompetent cervix — but there's much you can do to promote a healthy, full-term pregnancy. For example:

    • Seek regular prenatal care. Prenatal visits can help your doctor monitor your health and your baby's health. Mention any signs or symptoms that concern you, even if they seem silly or unimportant.
    • Eat a healthy diet. During pregnancy, you'll need more folic acid, calcium, iron and other essential nutrients. A daily prenatal vitamin — ideally starting a few months before conception — can help fill any dietary gaps.
    • Gain weight wisely. Gaining the right amount of weight can support your baby's health. A weight gain of 25 to 35 pounds (about 11 to 16 kilograms) is often recommended for women who have a healthy weight before pregnancy.
    • Avoid risky substances. If you smoke, quit. Alcohol and illegal drugs are off-limits, too. In addition, get your doctor's OK before taking any medications or supplements — even those available over-the-counter.

    If you've had an incompetent cervix during one pregnacy, you're at risk of premature birth or pregnancy loss in later pregnancies. If you're considering getting pregnant again, talk with your doctor to understand the risks and what you can do to promote a healthy pregnancy.

    Source: http://www.mayoclinic.com

    Lifestyle and home remedies

    If you have an incompetent cervix, your doctor might recommend restricting sexual activity or limiting certain physical activities.

    Source: http://www.mayoclinic.com

    Coping and support

    It can be difficult to learn that you have an incompetent cervix. It may make you feel anxious about your pregnancy and afraid to think about the future. Ask your doctor for suggestions on safe ways to relax.

    If you give birth prematurely, you might also feel that you did something to cause the premature birth or that you could have done more to prevent it. If you're experiencing feelings of guilt, talk to your partner and loved ones, as well as your doctor. Try to focus your energy on caring for and getting to know your child.

    Source: http://www.mayoclinic.com

    Risk factors

    Many women don't have a known risk factor. Risk factors for cervical insufficiency include:

    • Cervical trauma. Some surgical procedures used to treat cervical abnormalities associated with an abnormal Pap smear can result in cervical insufficiency. Other surgical procedures such as a D&C could also be associated with cervical insufficiency. Rarely, a cervical tear during a previous labor and delivery could be associated with an incompetent cervix.
    • Race. Black women seem to have a higher risk of developing cervical insufficiency. It isn't clear why.
    • Congenital conditions. Uterine abnormalities and genetic disorders affecting a fibrous type of protein that makes up your body's connective tissues (collagen) might cause an incompetent cervix. Exposure to diethylstilbestrol (DES), a synthetic form of the hormone estrogen, before birth also has been linked to cervical insufficiency.

    Source: http://www.mayoclinic.com

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