An incompetent cervix, also called an insufficient cervix, is a condition that 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 connects to the vagina — is normally closed and rigid. 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, as a result, treat. If your cervix begins to open early, your health care provider might recommend preventive medication during pregnancy, frequent ultrasounds or a procedure that closes the cervix with strong sutures (cervical cerclage).
If you have an incompetent cervix, you might not experience any signs or symptoms as your cervix begins to open during early pregnancy. Mild discomfort over the course of several days or weeks is possible, however, starting at week 15 to week 20 of pregnancy. Be on the lookout for:
Various factors can increase your risk of an incompetent cervix. For example:
Limited research also suggests that black women might be at increased risk of cervical insufficiency. Further studies are needed to determine the underlying causes.
If you have an unusually short cervix, you're at increased risk of premature birth. However, many women who have a naturally short cervix deliver at term.
An incompetent cervix poses risks for your pregnancy — particularly during the second trimester — including:
If your baby is born prematurely, he or she might have health concerns — including low birth weight, breathing difficulties and underdeveloped organs. Children who are born prematurely also have a higher risk of learning disabilities and behavioral problems. The risks are greatest for babies born before 32 weeks of pregnancy.
Preparing for your appointment
If you're pregnant and have any risk factors for an incompetent cervix or you experience any symptoms during your second trimester that indicate you might have an incompetent cervix, consult your health care provider right away. Depending on the circumstances, you might need immediate medical care.
Here's some information to help you get ready for your appointment, as well as what to expect from your health care provider.
What you can do
Below are some basic questions to ask your health care provider about an incompetent cervix. If any additional questions occur to you during your visit, don't hesitate to ask.
What to expect from your health care provider
Tests and diagnosis
An incompetent cervix can be detected only during pregnancy, and even then diagnosis can be difficult — particularly during a first pregnancy. To help diagnose an incompetent cervix, your health care provider will document any symptoms you're experiencing. Also, your health care provider will ask about your medical history. Be sure to tell your health care provider if you've experienced second trimester pregnancy losses or you had a cervical tear during a previous labor and delivery.
Your health care provider might determine you have an incompetent cervix if you have:
Tests and procedures to help diagnose an incompetent cervix during the second trimester include:
Remember, there are no tests that can be done before pregnancy to reliably predict an incompetent cervix. However, certain tests done before pregnancy can help detect uterine abnormalities that might cause an incompetent cervix. For example, your health care provider might suggest an ultrasound or magnetic resonance imaging (MRI) — a procedure that uses a magnetic field and radio waves to create detailed images of the organs and tissues within your body. In some cases, hysterosalpingography — a procedure that uses X-rays to examine the inside of the uterus, fallopian tubes and surrounding area — is recommended.
Treatments and drugs
Treatments for or approaches to managing an incompetent cervix might include:
Your health care provider might also recommend the use of a device that fits inside the vagina and is designed to hold the uterus in place (pessary). A pessary can be used to help lessen pressure on the cervix. However, further research is needed to determine if a pessary is an effective treatment for cervical insufficiency.
Lifestyle and home remedies
If you have an incompetent cervix, your health care provider might recommend restricting sexual activity or limiting certain physical activities. Bed rest might be prescribed in some cases, although it isn't a proven remedy for preventing premature birth.
Coping and support
If you have an incompetent cervix, you might feel anxious about your pregnancy. You might be afraid to think about the future, and prenatal visits might make you particularly nervous — for fear that you'll hear bad news.
Unfortunately, anxiety can affect your health and your baby's health. Consult your health care provider about healthy ways to stay calm. Some studies suggest that certain techniques, such as imagining pleasant objects or experiences or listening to music, can reduce anxiety during pregnancy.
If you give birth prematurely, it won't affect your physical recovery from childbirth. Depending on when you give birth, however, your baby might need intensive medical care. You might be worried about the possible long-term effects for your baby. As the parent of a premature newborn, 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 health care provider. Try to focus your energy on caring for and getting to know your child.
You can't prevent an incompetent cervix — but there's much you can do to promote a healthy, full-term pregnancy. For example:
If you have an incompetent cervix, you're at risk of premature birth or pregnancy loss in subsequent pregnancies. If you're considering getting pregnant again, work with your health care provider to understand the risks and what you can do to promote a healthy pregnancy.
Last Updated: 2012-03-23
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