During pregnancy, your cervix is not open in the lower end. It thins and opens before childbirth. When it opens too early in a pregnancy, it is known as Incompetent Cervix (also known as cervical insufficiency). Complications linked to incompetent cervix can include premature birth and miscarriage.
What Is Incompetent Cervix?
Incompetent Cervix occurs when your cervix opens, gets weak or short too early in pregnancy. It’s also known as cervical insufficiency. It can cause problems including miscarriage (loss of the pregnancy) and premature birth (being born before 37 weeks of pregnancy).
If you’re at risk for an incompetent cervix or your cervix shows signs of opening too soon, your pregnancy care provider may recommend preventative treatment to avoid pregnancy complications.
What Are The Symptoms and Causes Of Incompetent Cervix?
Unlike other signs of premature labour like contractions or your water breaking, cervical insufficiency may not cause noticeable symptoms.
In some people, though, signs of the condition include:
- Pelvic pressure or pain in your belly.
- Spotting or changes in your vaginal discharge.
Because there are no symptoms of Incompetent Cervix, most pregnancy care providers rely on understanding your health history. This tells them if you may be at risk for cervix in incompetency.
What Causes Incompetent Cervix?
Healthcare experts have not identified an exact cause for incompetent cervix. However, they know certain factors can put you at risk. These risk factors include damage to your cervix, prior surgeries to your cervix or being born with an irregularly-shaped cervix or uterus.
What Is The Natural Physiology Of Cervix During A Normal Pregnancy?
In normal pregnancies, the mouth of the uterus/ cervix is not open. It is firm and measures 3-4cm in length. It is well seal by a mucus plug throughout the pregnancy so that infection from the vagina does not gets upwards and reach the baby. Hence, the integrity of cervix is of utmost importance for the safety and well-being of the baby.
What happens when you have Incompetent Cervix?
In a patient of Incompetent Cervix, the length of the cervix shortens before time that is in the 4th or 5th month. Patient generally presents with sudden abortion at 4-5 months of pregnancy with no other complaints. Water bag bursts suddenly and the mouth of uterus (cervix) opens up and baby comes down before time which eventually leads to abortion.
Why Does This Happen?
In some patients, the mouth of uterus/ cervix is really weak and, in that case, it is not able to hold the weight of the growing baby. This is mostly due to inherent structural problem of the cervix or strong medications taken in the past. It may also occur due to previous trauma to the cervix during previous delivery/ abortion or any other operative procedure of the uterus. In some patients with malformations of the uterus like bicornuate/ septate uterus. It is also common in some patients with multiple pregnancy like twins or triplets.
How Do We Diagnose Incompetent Cervix?
The specialists can suspect the Incompetent Cervix in patients with looking at the history of previous mid trimester abortions. Get the right diagnosis by serial ultrasounds in the specialists take the measurement of the length of cervix. It is more accurately measured by transvaginal ultrasound. Also, the measurement of cervical length is along with NTNB scan at 12 weeks of pregnancy and Level 2 USG which takes place around 20 weeks and subsequently or in between also if there is a need.
How Can We Treat Incompetent Cervix?
The main aim of treating Incompetent Cervix is to actually help you stay pregnant as long as possible without any complications. As it is hard to diagnose and knowing the risk factors of this condition are extremely important. Your doctor will also decide which treatment is ideally the best for you based on your condition and medical history.
Know about Cervical cerclage:
Pregnancy care professionals attempt to stop early labor by performing a treatment known as a cervical cerclage. Your cervix must be sewn shut. Cerclage operations usually take place between weeks 12 and 14 of pregnancy. In order to facilitate a vaginal delivery, your provider then removes the stitches at about 37 weeks of pregnancy.
Your doctor might suggest cerclage if:
- You’ve previously experienced a second-trimester miscarriage.
- In previous pregnancies, you underwent a cerclage.
- A cerclage is not possible for everyone. The operation won’t be carried out on you by your provider if.
- You are expecting twins, triplets, or more. Research indicates that carrying multiple foetus does not reduce the risk of preterm delivery.
- Your cervix has already widened by four centimeters.
- Your membranes have ruptured (your water has broken).
Progesterone supplements For Incompetent Cervix:
If you have risk factors for incompetent cervix, your provider may recommend taking progesterone supplements beginning in your second trimester.
Get Increased Regular monitoring with ultrasound:
If you have risk factors for cervical insufficiency, your pregnancy care provider may decide to monitor the length of your cervix using ultrasound up until about 24 weeks of pregnancy. If your provider notes changes to your cervix’s length, they may recommend a cerclage. Cervical cerclage can only happen until about the 24th week of pregnancy.
Conclusion: Treatment With Care For Incompetent Cervix:
An Incompetent Cervix or cervical insufficiency occurs when your cervix shortens, weakens or even opens too soon during the stages of pregnancy. This can also cause miscarriage or premature birth issues. It is hard to detect incompetent cervix unless there is a history of miscarriage or other risk factors in the pregnancy.
It becomes crucial when you discuss your complete medical history with your provider as well as any pregnancy symptoms you have. So, knowing this information in advance can really help your healthcare provider to determine if you are at any kind of risk for cervical insufficiency. Also, in most of the cases, this condition is treatable with a procedure called a cerclage.
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