During pregnancy, the cervix or cervix is usually sealed with a mucous plug. However, sometimes the entrance to the uterus begins to dilate before the pregnancy has reached full term , which can usually happen in the third or fourth month.
This problem is known as incompetent cervix or cervical insufficiency , which occurs when the cervix opens prematurely under the pressure of the enlarging uterus and fetus.
Any opening of the cervix can cause the amniotic sac to drop down into the vaginal canal and rupture, leading to miscarriage. It is estimated that between 1% and 2% of pregnancies suffer from an incompetent cervix, and this is believed to be the cause of 20 to 25% of miscarriages during the second trimester.
Another of its consequences can be the very premature birth of the baby , with serious dangers for its health, even for its survival.
Causes of cervical insufficiency
In any case, an incompetent cervix can be due to several reasons :
- A weakening of the cervix of genetic cause.
- A hyperextension or severe lacerations to the cervix during one or more previous deliveries.
- Surgery or laser therapy on the cervix.
- Uterine or cervical malformation.
- Previous trauma to the cervix.
- In multiple pregnancies (two or more babies) there is a higher risk of incompetent cervix.
- Short length of the cervix.
Symptoms of incompetent cervix
Regarding the symptoms, it is common not to feel any signs of incompetent cervix , since the cervix slowly thins and expands on its own, without vaginal bleeding or labor contractions.
However, some of these symptoms could occur, although none by itself is an unequivocal sign of this problem and may be due to other reasons. Therefore, if we feel several of the points that we list below, we will have to go to the specialist to evaluate our case and make the correct diagnosis:
- Back pain.
- Discomfort or pressure in the lower abdomen.
- Spilling or dripping of warm fluid from the vagina.
- Blood spots or abnormal bleeding.
- Vaginal discharge with the appearance of mucus.
- Pain when urinating.
- Sensation of having something bulging in the vagina.
What is done in case of incompetent cervix?
If diagnosed early, the doctor will take whatever steps he or she deems appropriate to prevent miscarriage or premature delivery.
- He will probably order rest during pregnancy, and prohibit sexual relations.
- Surgery is usually performed to tie and close the cervix (cerclage or cervical suture), which is not without risk.
- Sometimes a plastic or rubber patch or device is placed in the vagina to elevate and support the cervix and keep it closed, which would be removed about a week before the due date.
- It can also be treated with medications that stop or prevent labor contractions before the fetus is mature.
Despite all these measures, it is possible that the abortion will eventually occur. In fact, incompetent cervix is often only diagnosed when a woman has a second-trimester miscarriage after experiencing progressive cervical thinning and dilation without detectable vaginal discharge or uterine contractions.
It can also be diagnosed when an ultrasound or vaginal exam shows shortening or premature opening of the cervix.
In Babies and more | Preterm birth: what are the most frequent causes
