Incompetent Cervix

Definition - What does Incompetent Cervix mean?

Incompetent cervix is a condition in which the cervix fails to support the weight of a growing fetus. As a result, it opens prematurely, causing miscarriage or premature delivery. Cervical incompetency is thought to be the cause of up to 25% of miscarriages occurring in the second and third trimesters.

FertilitySmarts explains Incompetent Cervix

In a healthy pregnancy, the cervix remains tightly closed until the process of labor begins. If the cervix is weakened due to natural causes or past trauma, it may be unable to support the weight of the growing fetus. Causes of cervical insufficiency can include:

  • Previous surgery or injury to the cervix.
  • Damage resulting from a difficult birth.
  • Congenital abnormalities of the cervix.
  • Exposure to the chemical Diethylstilbestrol, or DES. DES was a medication given to women to prevent miscarriage in the 1970s. It was removed from the market after it was discovered to cause congenital issues, including incompetent cervix, in some people whose mothers took the medication while they were pregnant with them.

There is currently no way to screen for cervical insufficiency prior to pregnancy. In some cases, miscarriage due to cervical insufficiency may occur with no warning. In others, mild symptoms may occur during the second trimester of pregnancy as the fetus grows. These include:

  • A sensation of pressure within the pelvis
  • Prementrual-like cramping
  • Backache
  • Increased vaginal discharge
  • Vaginal discharge that changes from clear, white, or yellow to tan or pink.
  • Spotting

Incompetent cervix may be suspected in women who have had past miscarriages in the second or third trimesters. If an incompetent cervix is believed to be a risk, transvaginal ultrasounds may be done throughout pregnancy to determine if the cervix is opening improperly.

Cervical insufficiency may be treated using a procedure called cerclage, where doctors sew the cervix shut to prevent it from opening improperly during the second trimester. The sutures are removed in late pregnancy, when it is safe for delivery to occur.

In cases where the cervix has already dilated to a width of more than 4 centimeters or membranes have already ruptured, cerclage cannot be performed. Doctors may also choose not to perform cerclage if they find problems such as cervical irritation.

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