Cervical Incompetence
What is cervical incompetence?
This is a condition where the cervix (neck of the womb) is softer and weaker than normal. As the pregnancy advances, the womb compresses on the cervix and in those women with cervical incompetence, the cervix will start to dilate, thin out and shorten without contraction in the second or third trimester causing delivery of the baby before it is ready. Cervical incompetence occurs in about 1 – 2% of pregnancies and it the cause of up to 25% of second trimester miscarriages.
How do I know whether I have cervical incompetence?
Cervical incompetence is not usually screened in pregnancy. Therefore, it may only be diagnosed after the miscarriage or preterm labour occurs. However, it may be suspected if you have several mid-trimester miscarriages or preterm labour from no known cause and especially if it was painless.
Who are at risk of having cervical incompetence?
- Women who were born with an abnormal uterus or cervix
- Women whose mother took DES (diethylstilbestrol) during pregnancy.
- Previous surgery on the cervix (e.g cone biopsy)
- Previous trauma to the cervix during childbirth
What is the treatment for cervical incompetence?
Those women who are suspected to have cervical incompetence will be counseled to have an elective surgical procedure called cervical cerclage at 14 -16 weeks of pregnancy. In this procedure, stitches will be placed in the cervix to prevent it from prematurely dilation. The procedure is normally done through the vagina and the stitches will be removed at about 36 – 38 weeks of pregnancy. Complications from the procedure include fever, increased hospital admission, laceration to the cervix and bleeding. However, the risk is minimal in majority of the cases.
Which women will not be eligible for cervical cerclage?
There are several condition where it would not be possible to do the cervical cerclage such as:
- The cervix has dilated to more than 4cm
- The membranes have ruptured
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