Incompetent CervixAnn E. Butenas
The term "incompetent cervix" indicates a cervix is not strong enough to support a pregnancy. According to Dr. Stefan Semchyshyn in his book How to Prevent Miscarriage and Other Crisis of Pregnancy, when the uterus expands and the growing fetus presses down on the opening of the womb, "a weakened cervix will begin to efface as it would in preparation for labor." If this problem is not corrected in time, the cervix can fail and the baby will either be miscarried or born prematurely.
Dr. Semchyshyn notes that the trick is to discover this condition early on. Nonetheless, that is not always easy. Some women may exhibit clear symptoms, such as backache, cramping, spotting, a thick, mucous discharge or pressure in the pelvic region. Other women may not exhibit these symptoms at all.
An incompetent cervix can affect any woman, but those at increased risk for this condition may have had a prior miscarriage, second-trimester abortions, premature labor, a prior D and C, or they may have been exposed to DES while in their mother's womb.
Prior to pregnancy, a doctor may check for a weakened cervix with a special probe designed for this. Dr. Semchyshyn notes that if the probe glides in too easily, the cervix may be too loose to maintain a pregnancy. Ultrasound technology can also be used to diagnose an incompetent cervix.
If an incompetent cervix is noted, a doctor may recommend the patient undergo cervical cerclage, in which the cervix is sewn closed for the duration of any pregnancy. According to Sheila Kitzinger in her book The Complete Book of Pregnancy and Childbirth, this procedure is relatively simple. A suture is inserted under anesthesia, threaded through and around the cervix. At about the 36th week of pregnancy, the suture is removed. Since contractions typically start shortly after the removal of the suture, some doctors prefer to induce labor at this point. This is something that the patient will need to fully discuss with her doctor.
Further, notes Dr. Semchyshyn, some doctors may keep the cerclage in tact for the next pregnancy, while others believe it is best to redo the procedure each time.
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References for this article: Semchyshyn, Stefan, M.D., 1989. How to Prevent Miscarriage and Other Crisis of Pregnancy. New York: MacMillan Publishing Company. Kitzinger, Sheila, 1996. The Complete Book of Pregnancy and Childbirth. New York: Dorling Kindersley Limited.
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