Incompetent Cervix

Causes and risk factors

Normally the cervix is open a bit to allow the entry of sperm and for the flow of blood during menstruation. During pregnancy the cervix becomes firm, long and is obliterated by a protective barrier called mucus plug until third trimester. It only in the late third trimester when the mother is about to go in labor the cervix becomes soft and slowly dilates so as to deliver the baby. However in cervical incompetency the cervix dilates before full term. As the baby grows the weight of the baby starts posing pressure on the cervix and the cervix may open up. Weakened cervix leads to cervical insufficiency. Previous history of surgery on cervix or trauma due to certain procedures like dilatation and curettage, injury to the cervical canal or certain congenital defects of the cervix (short cervix) contributes to the causation. Previous history of preterm labor or miscarriage increases the risk for incompetent cervix.

Clinical presentation

Cervical incompetence can lead to premature rupture of the membrane. It increases the preterm delivery of the baby i.e.: before 32 weeks of pregnancy. It can also lead to miscarriage. It is one of the main causes of miscarriages during second trimester. It does not cause any complaints to the patient.

Investigations

A regular antenatal check up and transvaginal ultrasound helps in confirming the diagnosis. A previous history of pregnancy aid in diagnosis.

Treatment  

Cerclage (procedures of sewing the cervix to keep it remain close) is the only choice of treatment. This procedure is usually performed between 14-16 weeks and the sutures are removed between 34-36 weeks. Bed rest and avoidance of physical exertion and exercises are certain care which needs to be taken.

Other modes of treatment:

Certain other modes of treatment can also be helpful in coping up the symptom. Taking into consideration the symptoms in holistic way, homoeopathy can offer a good aid for the relief of the symptoms

Facts and Figures:

About 25% of miscarriages occurring during second trimester are due to cervical incompetence.

The incidence is 1-2% of pregnancies.