Cervical Insufficiency

Formerly Called Incompetent Cervix

Discovering a problem during your pregnancy can be a frightening experience, but we are here to help you through every step of the process. If you have been diagnosed with cervical insufficiency, formerly incompetent cervix, your cervix might begin to open too soon, leading to a miscarriage or premature delivery. This section will review risk factors, symptoms, and treatment options.

What Is Cervical Insufficiency?

Cervical insufficiency is diagnosed based on either prior pregnancy history or a combination of pregnancy history and ultrasound measurements of cervical length. Before pregnancy, a woman’s cervix (the lower part of the uterus) is closed and firm. During the latter part of pregnancy, the cervix will naturally begin to soften, decrease in length (efface) and open (dilate) as the body prepares for birth. If you have cervical insufficiency, the opening and shortening of the cervix begin too early, leading to a miscarriage or premature delivery.

What Are The Risk Factors?

Various factors may contribute to a woman’s risk for cervical insufficiency. They include:

• Recurrent second-trimester pregnancy losses/deliveries associated with no or minimal symptoms.
• Prior cervical trauma resulting from procedures like cervical biopsies, LEEP, or surgical manipulation of the cervix from a D&C or other uterine/endometrial abnormality.
• Race – Black women have a higher risk of developing cervical insufficiency, but it is unclear why.
• Congenital conditions like uterine anomalies or certain genetic disorders cause abnormalities with the body’s fibrous proteins and connective tissues.
• Exposure to DES (diethylstilbestrol) before birth has also been linked to cervical insufficiency.  DES was used many years ago.  It has since been banned in pregnancy by the FDA.

Cervical Insufficiency Symptoms

Many women don’t have symptoms and have cervical insufficiency during their routine prenatal care. Some women present with the following symptoms:

• Pelvic pressure
• Braxton-Hicks-like contractions
• Premenstrual-like cramping
• Backache
• Vaginal discharge
• Vaginal spotting or bleeding

Treatment

Women found to have cervical insufficiency or cervical shortening will be monitored closely during pregnancy for preterm labor symptoms. Patients may also be referred to a Maternal-Fetal Specialist to determine if they are a candidate for a cervical cerclage placement or progesterone administration. Some women are advised to follow pelvic rest, bed rest, or other preterm labor precautions.

Cervical cerclage, a minor surgical procedure, is an effective and safe treatment option that can help prolong the pregnancy, ideally to full term.  The procedure involves the placement of a strong suture (stitch) around the cervix to keep it closed. It is generally done during the third month (12-14 weeks) of pregnancy.

We Can Help

If you have suffered from previous miscarriages or been told you have an incompetent cervix, our OB/GYN providers have the experience and wisdom to diagnose and provide treatment options for cervical incompetence. Please contact us today for an evaluation by one of our skilled providers.