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Writer's pictureCecilia Granger

Cervical Incompetence

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INCOMPETENT CERVIX

( when your cervix is not strong enough to hold your baby in during pregnancy)

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🛑 We say your cervix is incompetent when it is weak and can cause you to have your baby prematurely or lead to the loss of a healthy pregnancy.

🛑 Before pregnancy, your cervix is normally closed, firm and long . As pregnancy progresses and you near your due date , your cervix gradually softens, decreases in length and opens .

🛑 If you have an incompetent cervix, your cervix might begin to open too soon and cause 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 had your cervix open too early before during previous pregnancies , you might need preventive medication during pregnancy ( usually to put in your vagina) , frequent ultrasounds or a procedure that closes the cervix with strong stitches (cervical cerclage ). This decision is made by your doctor.

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Symptoms of cervical incompetence

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🛑 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. Dont take bleeding during pregnancy for granted

❗See your obgyn if you happen to notice any of these symptoms :

🛑 If you begin to feel pressure in your pelvis

🛑 Begin to have a new backache

🛑 begin to have Mild abdominal cramps

🛑 Notice a change in vaginal discharge

🛑 Notice light vaginal bleeding

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What puts you at risk of having an incompetent cervix

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🛑 Many women don't have a known risk factor. However a few things that put you at risk are :

🛑 Cervical trauma.

Some Cervical procedures eg Cervical conization done when you have abnormal pap smear results puts you at a higher risk . Having had a D&C could pose some risk as well.

🛑 Race.

Black women seem to have a higher risk of developing cervical insufficiency . It isn't clear why.

🛑 Conditions from birth

Some Abnormalities of the womb and genetic disorders come with risk of cervical incompetence.

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Complications of incompetent cervix

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🛑 An incompetent cervix poses risks for your pregnancy, particularly during the second trimester . This is why you don't skip your second trimester ultrasound screening or ignore the above symptoms during this period.

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Some complications including:

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🛑Premature birth

🛑Pregnancy loss

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Can this be prevented ?

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An incompetent cervix cannot be prevented, but your pregnancy can be managed in order for you to a healthy, full-term pregnancy.

♦️ Tips ♦️

🛑Seek regular antenatal care. This helps your doctor monitor your health and your baby's health. If you have any problems or symptoms that make you worry, let your doctor know about it, even if they seem silly or unimportant.

🛑 Eat a healthy diet. During pregnancy, you'll need more folic acid, calcium, iron and other essential nutrients. A daily prenatal vitamin, ideally starting a few months before conception ( at least 3 months), can help fill any dietary gaps.

🛑 Gain weight wisely.

Gaining the right amount of weight can support your baby's health. A weight gain of about 11 to 16 kilograms is often recommended for women who have a healthy weight before pregnancy.

🛑 Avoid risky substances.

If you smoke, quit. Alcohol and illegal drugs are off-limits, too.

🛑 Get your doctor's OK before taking any medications or supplements , even those available over-the-counter.

🛑 If you've had an incompetent cervix during one pregnacy, you're at risk of premature birth or pregnancy loss in later pregnancies. Let your doctor know this if he or she doesn't. Its very important

🛑 If you're considering getting pregnant again, talk with your doctor to understand the risks and what you can do to promote a healthy pregnancy.

🛑 An incompetent cervix can only be detected during pregnancy. Even then diagnosis can be difficult, particularly during a first pregnancy.

🛑 Let your doctor know if you've had a pregnancy loss during the second trimester or if you had a procedure on your cervix and your full Medical history. Don't hide any information from your doctor or lie about anything.

🛑 You will be told you have an incompetent cervix if :

🛑 You have had your cervix open without pain and have had some of your babies born in the second trimester.

🛑 Your cervix really shortens and opens before week 24 of pregnancy without painful contractions, vaginal bleeding, water breaking or infection

🛑 A transvaginal ultrasound is necessary to check the length of your cervix. This length shouldn't be less than 2.5cm.

🛑 A pelvic exam also helps to determine if your cervix is shorted, opening , or if there's a chance of your water breaking because the sac the baby is found in can be felt through your opened cervix.

🛑 A vaginal swab is taken to make sure there's no risk of your baby getting infected with your open cervix.

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How is this treated or managed

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🛑 Progesterone supplementation:

If you have a history of premature birth, your doctor might put you on progesterone during your second and third trimester to help sustain pregnancy .

🛑 Repeated ultrasounds.

If you have a history of early premature birth, or you have a history that may increase your risk of cervical insufficiency, you will need the length of your cervix to be monitored via ultrasound every two weeks from week 16 to week 24 of pregnancy. If your cervix begins to open or becomes shorter than a 2.5cm , cervical cerlage might be necessary ( cervix is stitched close) to prevent premature birth. The sutures will be removed during the last month of pregnancy or during labor.

🛑 If you have a history of premature births that are likely due to cervical insufficiency, it is recommended you have a cervical cerclage before your cervix begins to open (prophylactic cerclage). This procedure is usually done before week 14 of pregnancy. Not every obgyn finds this a necessary procedure.

❗Cervical cerclage isn't appropriate for everyone at risk of premature birth. The procedure isn't recommended for women carrying twins or more. Talk to your doctor about the risks and benefits of this procedure.

❗Get yourself a very good doctor throughout your pregnancy if this describes you or if you are a first time mother. It will do you lots of good. Join my Babyclub if you'd want me to walk you safely through your pregnancy journey.

Visit us at www.novacarefamilyobgyngrenada.com or call +14734187517


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