Causes and treatment of cervical incompetence
Cervical incompetence is a difficult problem to diagnose, especially for first-time mothers. Therefore, it is important to get regular check-ups and notify your doctor if you experience even small symptoms.
Do you know what causes cervical incompetence? Cervical incompetence is also called cervical incompetence. This condition usually refers to the opening of the cervix too early during pregnancy without labor or uterine contractions. This eventually leads to premature delivery or miscarriage.
Normally, the cervix expands only when labor begins in response to contractions. However, with cervical incompetence, this cervical dilatation occurs in the second trimester of pregnancy without labor or contractions.
This problem can only be detected if the woman is pregnant.
Common Symptoms of Cervical Incompetence
In early pregnancy, cervical incompetence does not cause any symptoms.
Only some women experience minor bleeding during the 14th to 20th weeks of pregnancy. And the bleeding can go on for days or weeks.
Additionally, some women experience discomfort during the second trimester of pregnancy:
- changes in vaginal discharge
- pressure in the pelvis
- unfamiliar back pain
- mild abdominal cramps
Causes of cervical incompetence
There is no scientifically established cause of cervical insufficiency. However, experts have identified several causes that increase your chances of experiencing this problem. The most important ones are:
- Multiple Pregnancy : Cervical incompetence occurs more frequently in women who are pregnant with more than one fetus at the same time.
- If you have had a cervical rupture in a previous childbirth
- Conesectomy (LEEP) history : Conesectomy is performed to prevent uterine cancer and refers to a procedure in which the uterine shoulder is cut into a cone for biopsy and lesion removal.
- Congenital connective tissue disorders : These include several congenital abnormalities of the uterus, such as Ehlers-Danlos syndrome.
- Congenital uterine defect : This refers to an abnormality of the uterus that is present congenitally.
- cervical injury or trauma
- Exposure to Diethylstilbestrol : Diethylstilbestrol is a hormonal drug. If the mother takes this drug while pregnant, there is an increased risk of cervical incompetence.
Women who have had a miscarriage before the fourth month of pregnancy are especially more likely to experience this problem.
Diagnosis of cervical incompetence
Diagnosis of cervical incompetence is difficult. This is especially true if you are pregnant for the first time. So, if in doubt, your doctor may order some tests.
Common diagnostic tests include:
- Vaginal ultrasound : This test is used to measure the length of the cervix and checks to see if the membrane is protruding through the cervix. If the cervix is less than 25 mm, cervical incompetence is certain.
- Pelvic Examination : A pelvic examination is a visual and manual examination to ensure that the amniotic and fetal membranes are in place.
- Laboratory analysis : Your doctor will do this test if you suspect an infection. Then, a sample of amniotic fluid is taken for confirmation and then analyzed under a microscope.
Possible Treatments for Cervical Incompetence
Once cervical incompetence is diagnosed, it should be treated to avoid more serious problems. The goal of all these treatments is to delay labor as much as possible. Some treatments include:
progesterone supplementation
According to a study conducted by several medical centers and universities in the Netherlands, progesterone supplementation may reduce the risk of preterm labor and miscarriage when mothers have a short cervix. In this case, the mother can supplement with progesterone in the form of injections or vaginal suppositories.
uterine neck round bundle
A cervix neck circular tying is a surgical procedure in which the cervix is tied with a tying thread. This round bundle is removed between 36 and 38 weeks when it is safe to give birth. Usually, 37 weeks is considered full term. Occasionally, doctors will remove the round bundle during delivery.
arabin pessary
This is a procedure in which a doctor wraps the cervix with a specially designed ring and then closes it. In this case, surgery is not required. This procedure is known to be very effective, especially when the mother’s cervix is ”V” shaped. However, studies supporting this are still lacking.
bed rest
Bed rest has proven to be an effective way to delay labor. This bed rest may be partial or total. In some cases, the mother only wakes up to eat and can only go to the bathroom. This can be very daunting for a mother, but it is a simple and proven method.
Risk factors and complications
Cervical trauma is one of the major risk factors for cervical incompetence.
The most obvious risk factor, in this case, is cervical trauma. You are more likely to develop cervical incompetence if you have had any kind of injury to this area or have had surgery in that area.
As already discussed above, other risk factors include congenital problems, connective tissue disease, and exposure to diethylstilbestrol. However, many women who experience this problem may not have any known risk factors.
Experts have found that black American women are slightly more likely to experience this problem. Of course, the most serious types of complications are premature births or miscarriages.
The need for regular prenatal screening
There is no way to know if a woman has cervical incompetence unless she is pregnant. Therefore, early diagnosis and treatment of this problem are difficult.
Therefore, it is of utmost importance to have regular prenatal check-ups. And at this point, you should tell your doctor about all your symptoms, no matter how light they appear.
It is also important to ask your doctor if you have any questions. Doing so can reduce the risk of complications.
