What is Cervical Incompetence?

Cervical incompetence can cause the complete abortion of an otherwise healthy pregnancy. This rare but serious medical condition is also called cervical insufficiency or incompetent cervix. It is characterized by an early softening of the cervix which can cause women to give birth before they reach full term.  Read on to find out more about the causes, symptoms, risks, and treatments for cervical insufficiency.

1. What are the Causes of Cervical Incompetence?

As you can see in the diagram, your cervix acts as a sort of “door” between the uterus and your vagina. When you’re not pregnant it is hard and does not open. But in the final weeks of pregnancy, it begins to soften and dilate in preparation for delivery. An incompetent cervix begins this process in the first or second trimester. There are a number of possible causes for this condition which include:

• Congenital (hereditary) conditions: You may have a condition passed down through your family which increases your chances of miscarriage or preterm labor.
• Damage or trauma to the cervix: Very occasionally, tears and trauma to the cervix are caused by a previous delivery or abortion.
• Environmental damage to the cervix: The research is not solid on this yet but there are some studies that have linked exposure to synthetic hormones or radiation to cervical incompetence. 

If you have a history of miscarriage or you know that your mother or sisters had a history of miscarriage or other congenital condition during pregnancy, you should make an appointment before you conceive and discuss the condition with a specialist.

2. What are the Cervical Incompetence Symptoms?

Unfortunately, you cannot feel your cervix softening and, if it happens in early pregnancy, there are sometimes no symptoms before you miscarry. However, there are symptoms to look out for in the second trimester. These include:

• Light spotting or bleeding
• Severe lower back pain
• Persistent abdominal cramps
• A difference in vaginal discharge
• A feeling of pressure in the pelvis

Any of these symptoms on their own are not necessarily are cause for concern and could just be normal pregnancy symptoms. But if you have a combination of the symptoms or any bleeding or severe pain, you should not wait to seek medical help. It is a good idea to keep a journal of your symptoms throughout pregnancy so that you can track any changes you may not otherwise notice. It is also important to find pregnancy professionals you trust early on and have regular checkups throughout your pregnancy.

3. How does Cervical Incompetence Diagnosis Work?

It can be very difficult to diagnose this condition before it causes a miscarriage or preterm delivery. Unfortunately, it is generally only diagnosed after a woman has had multiple miscarriages and cannot be diagnosed before you become pregnant. If you have a history of miscarriage, are experiencing possible signs of an incompetent cervix, or have a congenital condition that can affect cervical competency, there are a number of diagnostic tests your specialist can use. These include:

• Pelvic Examination
• Ultrasounds
• Laboratory Tests

If your obstetrician or gynecologist believes you are at risk of cervical incompetence, they will monitor your pregnancy carefully and carry out diagnostic tests as needed.

4. What are the Risks of Cervical Incompetence during Pregnancy?

Before 20 weeks of pregnancy, the major risk of an incompetent cervix is a miscarriage. After 20 weeks the risk is of preterm labor. If a diagnosis has been made, it may be possible to prevent miscarriage and preterm labor using a range of treatments.

5. What is the Treatment for Cervical Incompetence?

If you have been diagnosed with an incompetent cervix, you should still be able to carry a healthy pregnancy to full term. You will just need to have more comprehensive prenatal care from a specialist OBS/GYN. The treatments your specialist may use include:

• A prescription of daily hormone medication to prevent the cervix from softening.
• A surgical procedure (cervical cerclage) which keeps the cervix closed with sutures.
• Regular ultrasounds to monitor the length of the cervix and bed rest.

Stress and anxiety can make symptoms and complications worse. Living in fear of a miscarriage or preterm birth will not help you or your baby. Try and stay relaxed, listen to the advice of your specialist, and ask for help when you need it. There are some things which are outside our control.

Do you have another question about the risks, signs, or treatment of cervical incompetence?

Remember, there’s no such thing as a silly question! If you’ve read the article and are still wondering about an aspect of cervical incompetence, it’s likely that other women are wondering the same thing. Either post your question in the comments section below or send a private message through our contact us page.

More Advice and Articles about Pregnancy Symptoms and Complications:

Choosing prenatal care to suit you and your family:

The professional care you choose can make a huge difference to your health and safety during pregnancy. Click here to find out more about the options available to you.

Unusual pregnancy symptoms: 

Every woman’s pregnancy is different and there are literally hundreds of symptoms you might experience. We all know about morning sickness and back pain. But what are some of the less common pregnancy symptoms? And which are safe and which could be the sign of a more serious complication? Find out more here.

Coping with cramps and pains during pregnancy:

Cramps and pains are a normal part of being pregnant. And, as long as they are not severe or persistent, they pose no risk to you or your baby. Click here to find out about the causes of pregnancy cramps, strategies you can use to ease them naturally, and what to do if your cramps become severe.