Cervical insufficiency

Cervical insufficiency (also known as premature cervical dilation or incompetent cervix) is a medical condition during pregnancy where the cervix begins to shorten and open too early before the pregnancy has reached term, leading to either a late miscarriage or preterm birth.

Definition

Cervical insufficiency is characterized by a painless change in the cervix that can occur in the second trimester of pregnancy. This change can lead to the cervix shortening and opening (dilating) too early, which may result in the loss of an otherwise healthy pregnancy.

Causes

The exact cause of cervical insufficiency is not known. However, it is believed to be related to a combination of genetic, hormonal, and environmental factors. Some potential causes include previous trauma to the cervix, such as a difficult birth, dilation and curettage (D&C), or cone biopsy, and certain congenital conditions such as Ehlers-Danlos syndrome.

Diagnosis

Diagnosis of cervical insufficiency is often difficult as the condition is usually asymptomatic until a premature birth or miscarriage occurs. However, it can sometimes be diagnosed through a routine ultrasound during pregnancy, which can show a shortening of the cervix.

Treatment

Treatment for cervical insufficiency depends on the specific circumstances of the patient and the stage of the pregnancy. Options may include a procedure known as a cerclage, where a stitch is placed around the cervix to keep it closed, or the use of progesterone supplements.

Prognosis

With appropriate treatment and monitoring, many women with cervical insufficiency are able to carry their pregnancies to term. However, the condition does increase the risk of preterm birth and potential complications for the baby.

See also

• Preterm birth
• Miscarriage
• High-risk pregnancy