Cervical Insufficiency: A Dreaded Phenomenon During Pregnancy

The cervix is the lower opening of the uterus which is usually tight and prevents anything from going into or out of the uterus. In a normal pregnancy, a woman’s cervix will naturally begin to dilate under the playing of hormones. It will happen when the labor begins and the mother starts to feel the contractions. Dilation of the cervix usually happens as a response to contractions. However, for a few women out there, this cervix can dilate prematurely, leading to early childbirth or the loss of a baby in some cases. It can be a devastating experience for parents who might be in their second or third trimester already.

As per some quoted women who had been diagnosed with cervix insufficiency, the experience can be traumatizing as in many cases, the baby is healthy to grow but due to some structural insufficiency of the cervix, the mother’s body might not be able to hold it for long. The condition usually happens during the second or third trimester of the pregnancy when the cervix starts to dilate prematurely owing to the growing weight of the baby.

Doctors and healthcare researchers are yet to find definite causes of the condition. As per experts, some women might be born with a congenital weakness of the cervix. Other risk factors could be previous pregnancy losses, collagen disorders and a history of surgeries.

Not easy to predict, might start with pain

Unfortunately, most women and their attending doctors will not see cervical insufficiency coming. The symptoms usually are vaginal pressure, spotting or bleeding, non-specific abdominal pain or lower back pain, or vaginal discharge. As per some quoted women, there are chances that this pain might be dismissed as something not serious. In some cases, a pelvic test might reveal if the cervix is soft and dilated prematurely.

In women considered at risk, doctors might begin monitoring for the condition through a transvaginal ultrasound, beginning around week 16 of pregnancy. If the doctor can see early signs of cervical shortening, they might continue to monitor or start away with the treatment straight away.

Sometimes, a woman might have a history of miscarriages or a genetic condition affecting collagen (protein necessary for healthy growth of tissues) or a history of surgical procedures in case of precancerous lesions on the cervix. These women lie at a high risk of suffering from cervical insufficiency.

What is the way out?

There might be three ways in which the condition can be treated. They include monitoring, progesterone supplement and a surgical procedure (cervical cerclage). As per Yale Medicine, cervical cerclage is a minor surgical procedure which can be an effective and safe treatment option that can help prolong the pregnancy to full term. During the procedure, the cervix is stitched to protect the baby. As seen in all surgeries, the procedure involves some risk of infection and bleeding. The procedure is avoided in women expecting twins, as it brings a higher risk of premature birth. Women detected with the condition in the later stages of pregnancy might also be prescribed strict bed rest till they reach the full term.

Some women find the terminology annoying

There are some women who find the terminology cervical insufficiency or incompetency (used earlier) problematic. For them, the term incompetency suggests a sort of social failure. They suggest that the terminology must suggest a health condition and must not sound like an inability of some kind.