Incompetent cervix definitely hits close to home with me. Please take all of this information in. Use it, protect your baby.
Cervical incompetence, or IC, is the cause of 20-25% of all second trimester losses. IC is a cervix that is too weak to stay closed during a pregnancy. It can result in preterm birth and possibly losing the baby. In some cases, cervical incompetence can be diagnosed in the early part of the second trimester, sometimes as late as the early part of the third trimester. Pressure from the fetus’ development around the 13th week of pregnancy can begin the onset of incompetent cervix. Usually premature opening of the cervix happens without labor or contractions. The membranes that surround the fetus begin to bulge downward into the opening of the cervix until they break.
As in my own situation, incompetent cervix can go undetected. Cervical dilation can take place and advance suddenly. You can have incompetent cervix for no obvious reason at all. This is important to keep in mind if you are thinking about traveling while pregnant.
How is it Diagnosed?
Your doctor is able to manually check your cervix as well as use of an ultrasound. Ultrasonography is great for diagnosis and is used when the opening of the cervix has advanced greater than 2.5 cm, or in other words, if the length has shortened to less than 20 mm.
What are the Symptoms?
– Pelvic heaviness, discomfort, more discharge than normal
– Weakened cervix from previous childbirth
– Late pregnancy termination or surgery
Who is at risk?
– *My personal note: ALL PREGNANT WOMEN ARE AT RISK! GET TREATED BY YOUR DOCTOR AS SUCH!*
– Women who have had previous surgery on cervix
– Damage caused during a difficult birth
– A malformed uterus or cervix from a birth defect
– D&C (Dilation and curettage), or previous trauma to the cervix from a termination or miscarriage.
– DES (Diethylstilbestrol) exposure
How is it treated?
I cannot stress enough how important it is to be sure that your cervix is routinely being measured as you get closer to your 13 week mark and after. There is a procedure called cervical cerclage that can be performed if incompetent cervix is diagnosed early enough. A cerclage is a stitch or suture that ties the cervix closed. This is done under general anesthesia, epidural, or under a spinal. Your doctor may recommend for this procedure to be done between weeks 14 and 16 as this is the most effective time. Towards the end of your pregnancy, it is removed. Usually, there is no need for anesthesia when cerclage is removed.
There are however risks with a cerclage such as premature rupture of the amniotic membranes, amniotic sac infection (risk increases as pregnancy progresses), and preterm labor.
Your doctor will monitor you for preterm labor after a cerclage is placed. Contact your doctor if any signs of contractions are experienced.
If you are already more than 4 cm dilated, or amniotic membranes are torn and water has broken, a cervical cerclage cannot be performed.
What is the prognosis?
Cerclage has a success rate of 80-90%. Most go on to deliver healthy babies. This rate is higher for cerclage procedures performed early on in pregnancy. So– knowing this, please have your doctor watch you.
“A pregnancy has a HIGH chance of developing an incompetent cervix without precautionary treatment to prevent cervical widening.”