Weak or Incompetent Cervix
A Reason Why Pregnancies Fail
As the baby grows and gains weight, the pressure put on the cervix may cause it to open before the baby is ready to be born.
Women can be checked for a weak cervix before or early in pregnancy by an ultrasound or pelvic exam by a doctor. The ultrasound will measure the cervical opening and/or the cervix length.
This is not routinely checked during pregnancy and is usually not diagnosed until after a second or third trimester miscarriage or delivery has occurred.
If a woman is not pregnant, the cervix is slightly open for menstrual blood to flow out and sperm to enter. Once a woman becomes pregnant, secretions fill this opening and form a mucous plug. The cervix should then be closed until the third trimester when labor begins. If a woman has a weak cervix, the amniotic membranes weigh down on the cervix opening until it breaks causing a miscarriage or premature delivery.
The American Pregnancy Association states incompetent cervix happens in one of two pregnancies and almost 25 percent of second trimester miscarriages.
Causes
There are many factors that could cause a weak cervix. They include:
- previous surgery on the cervix
- damage during a difficult birth
- malformed cervix or uterus
- previous trauma to the cervix such as a dilation and curettage from a previous miscarriage or termination
- diethylstilbestrol (DES) exposure
Symptoms
The Physician’s Desktop Reference (PDR) states there are usually no signs or symptoms of an incompetent cervix. The cervix just slowly opens without vaginal bleeding or labor contractions. However, a woman can have some of these symptoms:
- backache
- lower abdomen pressure/discomfort
- gush of warm liquid from vagina
- mucous-like vaginal discharge
- passing urine with pain
- lump in the vagina
Treatment
There is a procedure that can help the pregnancy go full-term. Between the fourteenth and sixteenth week of pregnancy, a cerclage will be performed. This procedure sews the cervix closed to reinforce the weak cervix. The stitches will be removed between weeks 36 and 38 to prevent any complications when going into labor. Taking out the stitches will not result in a spontaneous delivery.
A woman should not have a cerclage if there is increased irritation of the cervix, membranes have ruptured or the cervix has dilated to four centimeters.
The PDR also says bed rest may be required for the last four to six months of pregnancy. A woman may also need a pessary, a plastic or rubber device placed in the vagina to elevate and support the cervix, and tocolytics, medicines to stop or prevent labor contractions.
Complications
Cerclage is a life-saving procedure that is worth the possible risks involved, agree most health care providers. The likelihood of the risks below is very small. These risks are:
- uterine rupture
- maternal hemorrhage
- bladder rupture
- cervical laceration
- preterm labor
- premature membrane rupture
Fetus in Womb
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