Pressure on the cervix increases during pregnancy as the baby grows. This pressure may force the cervix to begin opening prematurely before the baby is ready for childbirth. This condition is known as incompetent cervix, which can be very dangerous. The weakened cervix may not be able to sustain a full-term pregnancy, and can therefore lead to miscarriage or premature delivery.
An incompetent or weakened cervix is fairly uncommon. This condition affects about 1% to 2% of pregnancies. Almost 25% of babies lost in the second trimester are the result of an incompetent cervix. Most women are not aware that they have an incompetent cervix until after a pregnancy loss has occurred.
Symptoms of an Incompetent Cervix
Routine prenatal appointments do not necessarily involve checking for this condition. There are signs or symptoms that can identify if this condition is present. These include:
- Vaginal bleeding or spotting
- Pelvic pressure
- Abdominal or pelvic cramping
- Watery vaginal discharge
Risk Factors
Women with certain pre-existing factors may have a higher risk of suffering from an incompetent cervix. These factors include:
- History of unexplained preterm labor
- Injured cervix from a previous birth
- Short Cervix
- Malformed cervix from a birth defect
- Family member who has suffered second trimester pregnancy loss
- Previous cervical cancer cone biopsy conducted on the cervix
- Cervical trauma or surgery
- Diethylstilbestrol (DES) taken during pregnancy
Sometimes a pregnancy ends in a loss due to a spontaneous incompetent cervix with no reason for the condition. Future pregnancies have a higher chance developing an incompetent cervix. Precautionary treatment will be necessary in subsequent pregnancies to prevent cervical dilation.
Treatment
If an incompetent cervix is diagnosed, treatment can prevent premature birth. Treatment can take the form of medication or surgery. Medication can be administered to relax the uterus and prevent premature labor and delivery, but surgery usually yields the most successful results.
The surgery conducted to treat an incompetent cervix is called cervical cerclage. This operation involves sewing the cervix shut to prevent it from widening any more than it already has, thus reducing the chance of pregnancy loss. When the pregnancy is full-term, the stitches are removed so delivery can take place.
Cervical cerclage is generally recommended between weeks 14 and 16 of a pregnancy. Plenty of rest and light activity will most likely be recommended for the duration of the pregnancy. Sexual intercourse should be avoided until the end of pregnancy.
The success rate for cervical cerclage is about 80% to 90%. Although certain complications can arise from such a surgery, the risks are rare. The benefits of undergoing a cervical cerclage far outweigh the risks.
For more pregnancy-related information, please visit: www.complete-pregnancy-guide.com.
References:
1. Curtis, Glade B., MD, OBGYN, Your Pregnancy Week by Week, 1997
2. Eisenberg et al, What to Expect When You’re Expecting, 1991
3 American Pregnancy Association
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