Patients with an incompetent cervix are at high risk of miscarriage or premature birth. Find out everything there is to know about cervical insufficiency, including the possible treatment methods and the risk factors related to pregnancy. Below, you will find expert-approved facts and insight on cervical insufficiency and what you can do about it. Learn about this condition, including the diagnosis and tests, treatment methods and management, and whether there is a way to prevent it. Before anything else, you will want to consult with the best professionals in your area. If you are located in Florida or seeking the best experts available, reach out to the number one clinic for women in Hialeah, FL.
With that in mind, here are the facts you must know about having an incompetent cervix.
What Does Having an Incompetent Cervix Mean?
When a patient is pregnant, the cervix closes at the lower end. Before giving birth, it becomes thin and open. However, when the cervix opens prematurely in pregnancy, it is referred to as cervical insufficiency or an incompetent cervix. Women dealing with an open cervix during pregnancy are at high risk of having a miscarriage (losing the pregnancy) or giving birth before term (giving berth before the 37 weeks of pregnancy). Patients at risk of cervix insufficiency or those who display signs of a prematurely open cervix will be suggested preventative treatment to ward off complications in pregnancy. If you have any questions or doubts about your health and your unborn child’s health, consult with a professional such as Dr. Ivan Carreras, MD, for expert guidance.
Approximately one in 100 pregnant women will have an incompetent cervix.
Some women naturally have shorter cervixes. What is a short cervix? If the cervix is only shorter than 25 centimeters in length between the 18 and the 24th week of gestation, it is short. Your healthcare professional will measure the cervix’s length with the help of an ultrasound scan.
Why Can Cervical Insufficiency Be Problematic During Pregnancy?
The cervix is located at the uterus’ lower end, and it opens to the vagina. Before giving birth, the cervix is firm and closed. As the patient approaches the due date, the cervix slowly softens, effaces or shortens, and dilates or opens. This happens so that the baby is born via the vagina.
If you have an open cervix during pregnancy, and the baby is too young, it can be born prematurely or before the organs have time to develop fully.
Who Can Be at Risk of Having an Incompetent Cervix?
As mentioned, a low cervix in early pregnancy can put the patient at risk of premature birth
and even pregnancy loss. But who is at risk of having an incompetent cervix? Patients who have the following need additional medical attention:
- If the patient injured the uterus or the cervix during a previous childbirth or pregnancy.
- If the patient has an irregularly shaped uterus or cervix.
- If the patient has a genetic disorder such as Ehlers-Danlos syndrome (this disorder causes cervical weakness).
- If the patient had cervical surgery.
Also, some findings point to the fact that women who are Black are at higher risk of having a low cervix in early pregnancy. This is also true for women who are expecting multiple births (such as twins or triplets).
What are Some Signs of Cervical Insufficiency?
While premature labor is accompanied by water breaking or contractions, an open cervix is typically unnoticeable. However, some patients may display some signs of this condition, including:
- Unusual vaginal discharge and spotting.
- Pain in the stomach or pelvic pressure.
Since there are usually no symptoms that point to having an open cervix, most healthcare professionals will try to understand the patient’s health history first. By doing this, the expert will gain deeper insight into your health and determine if you are at risk of having an open cervix.
What is the Cause of an Open Cervix?
Experts haven’t yet identified the exact reason why a low cervix in early pregnancy occurs. However, there are a few factors that can certainly put you at risk. For instance, some of the well-known risk factors of an insufficient cervix include having had prior cervical surgeries and damage to the cervix.
An open cervix can occur at any time during pregnancy. Nevertheless, it typically happens between the 14th and the 27th week of pregnancy or the second trimester.
How are an Open Cervix and Miscarriage Related?
Pregnancy loss before reaching the 20th week is defined as a miscarriage. It is helpful to imagine the cervix as the door between the uterus and the vagina. Namely, the door must stay closed until the due date, or when the baby is supposed to be born. If the door opens prematurely, the fetus can be born before all of the bones, organs, and other structures are completely developed. Nearly 25 percent of all miscarriages in the second trimester happen due to an open cervix. Additionally, a low cervix in early pregnancy can also lead to stillbirth.
Fortunately, there is a way to treat an open cervix, and the success rate is high. When a patient receives proper treatment, it is possible to go full-term, even with an open cervix. The main goal of treating an open cervix is to avoid premature childbirth and to allow the fetus to develop completely.
How to Diagnose and Treat an Open Cervix During Pregnancy
Firstly, the healthcare provider in charge of your pregnancy will ask you a few questions related to your pregnancy symptoms and your overall health history. Make sure to be honest, and open when discussing your health with the doctor. Let them know if you have had a miscarriage in the past or cervical surgery. The expert may suggest monitoring the cervix based on the different risk factors.
An open cervix is diagnosed by a transvaginal ultrasound and a pelvic exam. The imaging test will help the expert measure the opening and the length of the cervix.
Here are three outstanding ways to treat and manage an insufficient cervix. Make sure to discuss your possibilities with your healthcare provider, as the specific treatment method will be unique to you.
The first procedure is the cervical cerclage, which includes sewing the cervix shut. You may be a suitable candidate for a cervical cerclage if you:
- Have had a previous miscarriage in the 2nd trimester of pregnancy.
- Have had a previous cerclage.
Patients who are at high risk of premature birth may need to take progesterone supplements. Supplementation happens at the start of the second trimester. Also, patients who are at risk will need to be monitored more closely. The healthcare provider may want to monitor the cervix’s length with an ultrasound up until you reach the 24th week of pregnancy.
How to Have a Healthy Pregnancy?
Unfortunately, there is no way to prevent an insufficient cervix. However, there are a few important steps that you can take to ensure that your pregnancy goes smoothly. Make sure to:
- Gain a healthy weight during your pregnancy.
- Take a high-quality prenatal vitamin.
- Attend all of the prenatal appointments.
- Avoid recreational drugs and alcohol.
- Quit smoking.
- Eat a nutrient-dense diet.
- Hydrate properly.
- Manage stress levels.
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