Women’s Health: The Incompetent Cervix
This is one of the numerous fears of the pregnant woman. During pregnancy, as the baby grows and gets heavier, it presses against the cervix. This may cause the cervix, which is the muscle which encloses the uterus, to open up before the baby is ready to be born. This condition is called an incompetent or weakened cervix, and will result in a miscarriage between the 13th and 20th weeks of pregnancy. Although this condition is rare (about 1 in a 100 pregnancies), it still accounts for about 25% of all second semester miscarriages.
The cervix is composed of circular muscular fibers that keep it tightly closed throughout the pregnancy. However, damage to the cervical muscles may result in incompetent cervix. Damage can result from:
- Previous surgery on the cervix
- A previous difficult birth
- Malformations due to a birth defect
- Previous trauma such as dilation and curettage from a termination or miscarriage
Diagnosis of an incompetent cervix is rare as it is not routinely checked for during pregnancy. However, ultrasounds and pelvic exams can unearth the problem. Some signs and symptoms of the condition are given below:
- Lots of discharge (incompetent cervix is suspected when there are three discharges in the second semester).
- Pelvic heaviness
- Discomfort
The treatment for a weakened cervix is cerclage, a procedure that sews the cervix closed. Cerclage is performed in weeks 14-16 and the sutures are removed by week 36 to prevent any problems during labor. Complications can arise as a result of cerclage, including uterine rupture, maternal hemorrhage, cervical laceration…etc.
