Incompetent Cervix

An incompetent cervix means that a woman’s cervix is effacing and dilating prematurely (meaning before a baby is full term). During a normal pregnancy, the cervix remains long, firm, and closed until late in the third trimester as it begins to prepare for birth. For women with an incompetent cervix, the cervix will efface (soften) and dilate (open) too early. Cervical incompetency can result in second-trimester miscarriages, premature rupture of the membranes, and/or preterm labor.

In the past, it has been very hard to determine whether a woman had an incompetent cervix. Unfortunately, it was often not discovered until a woman had multiple second-trimester miscarriages or early preterm births. Today, a woman who is considered high risk for an incompetent cervix will have regular transvaginal ultrasounds beginning around mid-pregnancy. This transvaginal ultrasound will measure the length of the cervix and check for any signs of effacement. If any changes are found during these ultrasounds, a woman will be at a much higher risk for preterm labor or late miscarriage.

When a woman is diagnosed with an incompetent cervix, she will almost certainly be put on immediate and full bed rest. If the diagnosis is made prior to being 24 weeks pregnant, a doctor may recommend a cerclage. A cerclage is a procedure in which a band of strong thread is placed around the cervix to reinforce it and help hold it closed. There are some differences of opinion about whether a cerclage should be used, so you will want to talk in detail with your doctor if you have been diagnosed with an incompetent cervix.

Your doctor (often a team of doctors) will closely monitor your entire pregnancy and will give you the best care available in order to bring you and your baby through a successful pregnancy.

Posted on behalf of Carlos Alarcon, M.D., Marietta OB-GYN Affiliates, P.A.

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