Incompetent Cervix Health Article

Definition

A cervix (the structure at the bottom of the uterus) that is incompetent is abnormally weak, and therefore it can gradually widen during pregnancy. Left untreated, this can result in repeated pregnancy losses or premature delivery.

Description

Incompetent cervix is the result of an anatomical abnormality. Normally, the cervix remains closed throughout pregnancy until labor begins. An incompetent cervix gradually opens due to the pressure from the developing fetus after about the 13th week of pregnancy. The cervix begins to thin out and widen without any contractions or labor. The membranes surrounding the fetus bulge down into the opening of the cervix until they break, resulting in the loss of the baby or a very premature delivery.

Causes and symptoms

Some factors that can contribute to the chance of a woman having an incompetent cervix include trauma to the cervix, physical abnormality of the cervix, or having been exposed to the drug diethylstilbestrol (DES) in the mother's womb. Some women have cervical incompetence for no obvious reason.

Diagnosis

Incompetent cervix is suspected when a woman has three consecutive spontaneous pregnancy losses during the second trimester (the fourth, fifth and sixth months of the pregnancy). The likelihood of this happening by random chance is less than 1%. Spontaneous losses due to incompetent cervix account for 20–25% of all second trimester losses. A spontaneous second trimester pregnancy loss is different from a miscarriage, which usually happens during the first three months of pregnancy.

The physician can check for abnormalities in the cervix by performing a manual examination or by an ultrasound test. The physician can also check to see if the cervix is prematurely widened (dilated). Because incompetent cervix is only one of several potential causes for this, the patient's past history of pregnancy losses must also be considered when making the diagnosis.