Incompetent Cervix

The term ‘incompetent’ feels a bit abrasive when describing a part of your body that has such an integral part to play in conception, pregnancy and labour and for those women who receive such a diagnosis might be left feeling extreme anxiety over their ability to carry their unborn child to term.

The term incompetent cervix refers to the weakness of the cervical tissue which can cause or contribute to a premature birth or the loss of an otherwise healthy pregnancy.

The cervix marks the entrance to the womb and is located in the lower part of the uterus at the top of the vagina. Once pregnancy has occurred the cervix closes and remains closed and firm until the end of pregnancy when it begins to gradually soften and decrease in length and then finally begins to open signally the start of labour. An incompetent cervix might begin to open too soon causing you to give birth prematurely. Cervical incompetence is rare and is considered to only affect 1% of pregnancies.

Diagnosis of an incompetent cervix can be difficult as many women won’t be aware they have this condition until pregnant and many of the warning symptoms are similar to regular pregnancy symptoms if you suspect you may have an incompetent cervix symptoms such as the below usually present themselves at 14-16 weeks:

  • A sensation of pelvic pressure
  • Abdominal cramps and aches
  • A change in vaginal discharge
  • Light bleeding
  • New backache

 

The reasons for an incompetent cervix include:

  • You may have undergone treatment for cervical cancer or precancerous cells
  • You may have experienced previous obstetric cervical trauma, such as cervical tearing during labour or an abortion.
  • You may have undergone a full or partially dilated emergency c-section in a previous pregnancy and had damage to the top of your cervix during the delivery of your baby.
  • You may have been born with a connective tissue disorder such as hypermobility or ehlers danlos syndrome, which effects the collagen within the tissues of the cervix causing it to be weak.
  • You may have a uterine abnormality. Uterine abnormalities have not been shown to affect the structure of the cervix but they are linked to preterm birth.
  • You may have been born with a naturally weak or short cervix and this may be genetic.

 

Treatment options include:

  • Regular transvaginal scans
  • Vaginal swabs for markers of preterm birth
  • Continual monitoring
  • Antibiotic treatment to try and reduce the risk of infection as the cervix performs as a protective barrier between bacteria within the vagina and baby
  • A pessary is inserted into the vagina which secretes progesterone to prevent contractions of the uterus.
  • A stitch/cerclage may be made to prevent the cervix from opening, this is performed in those with a high risk of premature birth

 

Support groups are a vital support system for those pregnant with an incompetent cervix

Incompetent Cervix UK – a Facebook group for anyone and everyone in the UK and Ireland who would like advice, info or support on any aspect of cervical insufficiency.
UK TAC Support Group – a Facebook group specifically for women who have a transabdominal cerclage or are thinking of having one placed in the UK or in Ireland. It has been award nominated for the support it provides to its members.

 

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