Incompetent Cervix

What is an Incompetent Cervix?

General description/overview

An incompetent cervix (cervical insufficiency, cervical incompetence) is characterized by a weak cervix that results in premature birth or loss of pregnancy. A healthy cervix remains firm and closed until the body begins preparation for birth.

When the cervix is incompetent, connective tissues may be inherently weak or the cervix may dilate too soon. When cervical incompetence causes preterm birth, the baby is delivered between the 16th and 22nd week, thus resulting in prematurity or miscarriage. Risk increases for those with three or more 2nd trimester miscarriages, but the rate of occurrence for a second preterm birth is less than 30%. Risk factors are heightened in those with a short uterus, those with medical or accidental cervical injuries and in women with connective tissue disorders.

What are the Symptoms of an Incompetent Cervix?

Some women experience no symptoms of an incompetent cervix. They only become aware of the problem after a preterm birth. Others have symptoms that last for days or weeks, thus allowing time for a treatment plan that could lower the risk of preterm birth. Those with symptoms may experience:

  • Pelvic pressure
  • Minor cramping
  • Backache
  • Light spotting or bleeding
  • Unusual vaginal discharge

An incompetent cervix cannot be diagnosed before pregnancy, but abnormalities of the uterus can be discovered through a physical exam and/or imaging. Tests can be performed in the second trimester to evaluate and monitor the pregnancy. They may include:

  • Routine exams
  • Transvaginal ultrasound imaging to look for abnormalities
  • Ultrasounds to monitor cervical length
  • Amniocentesis

How is an Incompetent Cervix Treated?

The treatment for an incompetent cervix depend on the level of risk for preterm delivery.

Treatment includes

  • Progesterone injections or suppositories
  • Stitching the cervix closed (cervical cerclage)
  • Restriction of sexual activity
  • Limited physical activity
  • Bed rest
  • Support or the cervix (pessary)
Resources
Last Reviewed:
September 21, 2016
Last Updated:
September 01, 2017