Incompetent cervix

An incompetent cervix, also called a cervical insufficiency, 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 opens to the vagina — is normally closed and firm. 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 treat. If your cervix begins to open early, or you have a history of cervical insufficiency, your doctor might recommend preventive medication during pregnancy, frequent ultrasounds or a procedure that closes the cervix with strong sutures (cervical cerclage).

Symptoms

If you have an incompetent cervix, you may not have any signs or symptoms during early pregnancy. Some women have mild discomfort or spotting over the course of several days or weeks starting between 14 and 20 weeks of pregnancy.
Be on the lookout for:
  • A sensation of pelvic pressure
  • A new backache
  • Mild abdominal cramps
  • A change in vaginal discharge
  • Light vaginal bleeding

Risk factors

Many women don't have a known risk factor. Risk factors for cervical insufficiency include:
  • Cervical trauma. Some surgical procedures used to treat cervical abnormalities associated with an abnormal Pap smear can result in cervical insufficiency. Other surgical procedures such as a D&C could also be associated with cervical insufficiency. Rarely, a cervical tear during a previous labor and delivery could be associated with an incompetent cervix.
  • Race. Black women seem to have a higher risk of developing cervical insufficiency. It isn't clear why.
  • Congenital conditions. Uterine abnormalities and genetic disorders affecting a fibrous type of protein that makes up your body's connective tissues (collagen) might cause an incompetent cervix. Exposure to diethylstilbestrol (DES), a synthetic form of the hormone estrogen, before birth also has been linked to cervical insufficiency.

Complications

An incompetent cervix poses risks for your pregnancy — particularly during the second trimester — including:
  • Premature birth
  • Pregnancy loss

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