Cervical Incompetence

The cervix may weaken due to obstetric, gynecological or congenital issues. This general happens due to one or few of the following reasons:

• Previous surgery on the cervix
• Damage caused due to a difficult birth
• Cervix or uterus malformed due to a birth defect
• Previous trauma to the cervix, such as Dilatation or Curettage
• DES (Diethylstilbestrol) exposure

An incomptent cervix can be tested and diagnosed in one of the following ways:

• Transvaginal Ultrasound: The length of the cervix is evaluated to identify if the membranes are protruding through the cervix. During the procedure, a slender transducer is placed in your vagina to send out sound waves that generate images on a monitor. If the length of the cervix is less than 2.8mm, the woman has incomplete cervix.
• Pelvic Exam: The cervix is examined to check if the amniotic sac has begun to protrude through the opening. If the fetal membranes are in the cervical canal or vagina, it is a case of Cervical Insufficiency. Only a speculum examination is done and not per vaginal exam.
• Lab Tests: If an ultrasound of the fetal membranes show signs of inflammation but no symptoms of infection, your doctor might test a sample of amniotic fluid to diagnose or rule out an infection of the amniotic sac and fluid.

If you have a history of premature birth, weekly Progesterone Supplementation during the second and third trimesters may prove to be a good approach.

If the history shows early premature birth, careful monitoring of the length of your cervix may be recommended every two weeks from week 16 to week 24 of the pregnancy. Should the cervix open or become shorter than a certain length, a cervical cerclage may be recommended.

In a Cervical Cerclage, the cervix is stitched closed with strong sutures, only to be removed during the last month of pregnancy or during labour.