Insufficient Cervix

Overview Of Insufficient Cervix

Insufficient cervix occurs when the cervix begins to soften too early in a pregnancy. This could cause miscarriage or premature birth. The cervix is the narrow lower end of the uterus that goes into the vagina.

In a normal pregnancy, the cervix stays firm, long, and closed until late in the 3rd trimester.

In the 3rd trimester, the cervix starts to soften, get shorter, and open up (dilate) as a woman’s body prepares for labor.

An insufficient cervix may begin to dilate too early in pregnancy. If this condition is present, the following problems are more likely to occur:

  • Miscarriage in the 2nd trimester
  • Labor begins too early, before 37 weeks
  • Bag of waters breaks before 37 weeks
  • A premature (early) delivery

Commonly Associated With

Incompetent cervix; Weak cervix; Pregnancy – cervical insufficiency; Premature labor –cervical insufficiency; Preterm labor – insufficient cervix

Causes Of Insufficient Cervix

No one knows for sure what causes this condition, but these things may increase a woman’s risk:

  • Being pregnant with more than 1 baby (twins, triplets)
  • Having an insufficient cervix in an earlier pregnancy
  • Having a torn cervix from an earlier birth
  • Having past miscarriages by the 4th month
  • Having past first or second semester abortions
  • Having a cervix that did not develop normally
  • Having a cone biopsy or loop electrosurgical excision procedure (LEEP) on the cervix in the past due to an abnormal Pap smear

Symptoms Of Insufficient Cervix

Often, you will not have any signs or symptoms unless you have a problem it might cause. That is how many women first find out about it.

Exams & Tests

If you have any of the risk factors for insufficient cervix:

An insufficient cervix may cause these symptoms in the 2nd trimester:

  • Abnormal spotting or bleeding
  • Increasing pressure or cramps in the lower abdomen and pelvis

Treatment Of Insufficient Cervix

If there is a threat of premature birth, your provider may suggest bed rest. However, this has not been proven to prevent loss of pregnancy and may result in complications for the mother.

Your provider may suggest you have a cerclage. This is a surgery to treat an insufficient cervix. During a cerclage:

  • Your cervix will be stitched closed with a strong thread that will remain in place during the whole pregnancy.
  • Your stitches will be removed near the end of the pregnancy, or sooner if labor begins early.Cerclages work well for many women.
  • Sometimes, medicines such as progesterone are prescribed instead of a cerclage. These help in some cases.
  • Talk with your provider about your situation and treatment options.