Cervical incompetence

Cervical incompetence is a medical condition in pregnancy where the cervix of a pregnant woman dilates prematurely, leading to potential miscarriage or preterm birth. This condition is also known as insufficient cervix or weak cervix.

Definition

Cervical incompetence is characterized by the painless dilation of the cervix without contractions due to a structural or functional defect in the cervix. This condition typically occurs in the second trimester of pregnancy, but can occur anytime from 14 to 20 weeks of gestation.

Causes

The exact cause of cervical incompetence is unknown, but several factors have been associated with the condition. These include previous cervical surgery, damage during a difficult birth, congenital conditions, and exposure to the drug diethylstilbestrol (DES). Other risk factors include multiple gestation, polyhydramnios, and certain infections.

Diagnosis

Diagnosis of cervical incompetence is challenging as the condition is often asymptomatic until a premature birth or miscarriage occurs. However, certain diagnostic methods such as transvaginal ultrasound and hysterosalpingogram (HSG) can be used to assess the length and shape of the cervix.

Treatment

Treatment for cervical incompetence aims to prevent premature birth and includes both surgical and non-surgical options. The most common surgical treatment is a procedure known as cerclage, where a stitch is placed around the cervix to keep it closed. Non-surgical treatments include bed rest, pelvic rest, and the use of progesterone.

Prognosis

With appropriate treatment, most women with cervical incompetence can carry a pregnancy to term. However, the condition does increase the risk of premature birth and repeated miscarriages.

See also

• Preterm birth
• Miscarriage
• Cerclage
• Diethylstilbestrol