Incompetent cervix: Weakened cervix

During pregnancy, the baby grows and becomes heavier, presses on the cervix. This pressure can cause the cervix to dilate before the baby is ready to be born. This condition is called cervical incompetence or a weakened cervix, and it can lead to miscarriage or premature birth. However, cervical incompetence only occurs in about 1 in 100 pregnancies.

Carrying your developing baby to full term is the goal of any pregnancy. Most losses in the first trimester are due to chromosomal abnormalities. Discharge in the second trimester or later is often the result of cervical leakage.

What causes a leaky or weakened cervix?

Weakening of the cervix can be caused by one or more of the following conditions:

Previous surgery on the cervix
Damage during a difficult birth
Malformed cervix or uterus from a birth defect
Previous trauma to the cervix, such as a curettage from termination or a miscarriage
Diethylstilbestrol exposure

How do I know if I have the wrong collar?

Cervical insufficiency is not usually tested during pregnancy and is therefore usually diagnosed only after a miscarriage in the second or third trimester. Women can be screened before pregnancy or early in pregnancy with ultrasound if they have any factors that are potential causes of cervical leakage. Diagnosis can be made by a doctor through a pelvic exam or ultrasound. An ultrasound will be used to measure the dilation of the cervix or the length of the cervix.

How common is cervical incompetence?

Insolvency or weakening of the cervix occurs in about 1-2% of pregnancies. Almost 25% of miscarriages in the second trimester of pregnancy are due to cervical incompetence.

Prevention

You can't prevent cervical leakage, but experts offer the following tips to help ensure a healthy full-term pregnancy.

Seek regular prenatal care. Prenatal visits can help your doctor monitor your and your baby's health. Mention any sign or symptom that bothers you, even if it seems silly or unimportant.
Eat healthy food. During pregnancy, you will need more folic acid, calcium, iron, and other essential nutrients. Taking prenatal vitamins daily—ideally a few months before conception—can help fill nutritional gaps.
Gain weight wisely. Gaining the right weight can help your child's health. For women who were of normal weight before pregnancy, a weight gain of 11 to 16 kg is often recommended.
Avoid hazardous substances. If you smoke, quit. Alcohol and illegal drugs are also prohibited. Also, get your doctor's approval before taking any medications or supplements, even over-the-counter ones.

What treatment options are available?

Treatment for a leaky or weakened cervix is a procedure in which the cervix is sutured to strengthen a weak cervix. This procedure is called a cerclage and is usually performed between 14 and 16 weeks of pregnancy. These stitches will be removed between 36 and 38 weeks to avoid any problems during childbirth. Removing the cerclage does not lead to spontaneous birth of a child.

A woman is not eligible for a cerclage if:

-There is increased irritation of the cervix

-The cervix has dilated 4cm

-Membranes have ruptured

Possible complications of cervical banding include uterine rupture, maternal bleeding, bladder rupture, cervical rupture, preterm labor, and premature rupture of membranes. The likelihood of these risks is very minimal, and most doctors believe that cerclage is a life-saving procedure that justifies the possible risks associated with it.