What You Don't Know Yet About Incompetent Cervix And Miscarriage

What You Don't Know Yet About Incompetent Cervix And Miscarriage

It is usually difficult to immediately identify incompetent cervix symptoms, making it a dangerous pregnancy complication

Just six months after Meiling Wong found out she was pregnant, she suffered a miscarriage. This was the second time she’d lost her unborn child. At five months exactly, Wong expelled the baby without any pain. She only felt her water bag burst and the baby slipping out. The 28-year-old Wong displayed what practitioners call incompetent cervix symptoms.

Also known as cervical insufficiency, an incompetent cervix can lead to premature loss of pregnancy. Fortunately, it is treatable and Wong has a fairly good chance of becoming a mother this time.

Let’s understand more about this condition, including incompetent cervix symptoms. 

What Is An Incompetent Cervix?
incompetent cervix symptoms

When you have an incompetent cervix, it is unable to hold the baby’s weight and begins to soften and lengthens much before full-term. | Image courtesy: Shutterstock

An incompetent cervix, also known as cervical insufficiency, is a condition where the muscle fibres of the cervical tissues are weak leading to loss of pregnancy or premature birth. It is one of the common causes of recurrent miscarriages. But how does it happen?

Before your pregnancy, your cervix–which is the lower part of your uterus that opens up to the vagina–is firm and closed. This ensures that your baby grows safely inside your uterus. But when you conceive, in preparation of the delivery, the cervix softens and opens up, lengthens (effaces) and also opens (dilates).

However, when you have an incompetent cervix, it is unable to hold the baby’s weight and begins to soften and lengthens much before full-term. The woman may feel slight pain in the lower abdomen and have excessive mucous-like discharge, and without proper treatment, suffers a miscarriage or premature birth.

This usually happens anywhere between the fourth and the seventh month of pregnancy. Specifically, anywhere between 12 weeks and 20 weeks, or extremely prematurely when the pregnancy is between 20 week and 28 weeks. Occasionally, it can occur in the third trimester between its first few weeks and 32 weeks.

Causes Of Incompetent Cervix

Although the exact reason for incompetent cervix is still unknown, it is generally attributed to cervical weakness. This weakness may be inherent, which means the woman was born with it.

This usually may not occur due to external injury or trauma to the vaginal area, even though there haven’t been any studies to prove otherwise. Still, there are some health aspects that are often associated with incompetent cervix.

  • Exposure to DES (diethylstilbestrol) to unborn child: This drug was administered to women between 1930s and 1970s to prevent miscarriages. But it is no longer in use. Studies have found an association of exposure of this drug to miscarriages among young women.   
  • Serious trauma to the cervix: A woman can develop an incompetent cervix if she’s gone through an extensive cone biopsy, especially after an abnormal pap smear test. Or, has had her cervix operated more than five times.  
  • Surgical procedures. According to some studies, other surgical procedures including dilation and curettage (D&C) may also be associated with incompetent cervix.

For somebody who is born with a cervical weakness, it may begin to show its true form from the very first pregnancy. And it’s crucial to note here that once it happens during the first pregnancy, it’s likely to happen again in subsequent pregnancies as well.

Now the next big question is how to identify if you have an incompetent cervix.

Incompetent Cervix Symptoms: What And How To Weigh In
incompetent cervix  symptoms

Report to your doctor if you spot a change in vaginal discharge whether in the colour or smell. | Image courtesy: Pixabay

One of the crucial points to note here is that you cannot predict incompetent cervix symptoms or cervical weakness. Once a woman has had a miscarriage and the baby has slipped out with or without the water bag breaking, she is likely to go through this again.

So that of course, is one the first incompetent cervix symptoms.

You should also note if you feel mild discomfort or spotting between 14 and 20 weeks of your pregnancy. In addition to these two, you should also watch out for the following signs that are indicative of incompetent cervix symptoms.

  • Constant sensation of pressure in the pelvic area
  • Sudden development of a new backache
  • Mild cramps
  • Change in vaginal discharge whether in the colour or smell
  • Light vaginal bleeding between second and third trimester

These incompetent cervix symptoms may not seem significant at first. But its best to get a check up is a must if you spot any of them. If your doctor spots the condition, you will likely have to undergo a surgery. 

Treatment of Incompetent Cervix 

An emergency procedure called cerclage is usually the one that you’ll be advised if you’re diagnosed with an incompetent cervix. In this procedure, the doctor will sew back your weakened cervix into its closed position. This prevents the baby from slipping out. 

This procedure is usually performed between the 14 and 16 weeks of pregnancy. The sutures are typically removed anytime between 36 and 38 weeks of pregnancy. This prevents any complications as your body readies for delivery. 

The only issue is that the procedure might put you at risk of maternal hemorrhage, uterine rupture, cervical laceration, and bladder rupture, in addition to premature labour. Although the likelihood of these conditions is not high, your doctor may still advise the procedure, because it can be life-saving. 

The only reason that you not be a suitable ‘candidate’ for cerclage is because of the following:

  • You are already dilated 4cms
  • Your membranes have erupted
  • Irritation in your cervix increases by the day   

With that being said, even though there is no other prevention for an incompetent cervix than surgery, there are a few things you can do to keep your pregnancy healthy and safe.

Preventive Measures For Those With Incompetent Cervix
incompetent cervix  symptoms

Make sure to go for regular prenatal checks, as it is crucial to access your as well as your unborn child’s health. | Image courtesy: Pixabay

The fact is that you cannot stop or prevent incompetent cervix. If it’s something you are born with, only a thorough check-up will reveal its existence.

However, if you have been diagnosed with an incompetent cervix and have even spotted a few incompetent cervix symptoms, here are a few measures you can take to prevent a miscarriage.

  • Regular prenatal care. Going for regular prenatal checks with ultrasounds is crucial to access your and your unborn child’s health. You must share all and/or any symptoms or concerns, whether minor or not, with your doctor. 
  • Eat a healthy diet. Make sure to be and stay on a healthy diet routine during and pre-pregnancy. If you’re preparing for pregnancy, you’ll need folic acid. And during pregnancy you’ll require essential nutrients such as vitamins, calcium, and iron. Ask your doctor to recommend supplements if need be and check in with them about your dietary concerns. 
  • Don’t eat for two. Gaining weight wisely is key to being fit and losing weight postpartum. Typically, anything between 10 to 12 kilos of weight gain is considered normal and healthy. You only need about 300 calories more than your normal diet. Anything more can put you at risk of developing gestational diabetes or high blood pressure.  
  • Maintain a healthy lifestyle. Steer clear of smoking or consuming alcohol during your pregnancy. Both of these can cause birth defects in your baby including putting you at risk of premature birth, and your baby at risk of low birth weight, among other medical conditions. 

The crucial thing to remember is that previously diagnosed incompetent cervix can put you at a risk of miscarriage. So if you’re considering conceiving again, its best to speak with your doctor to get a proper treatment. 

Sources: Mayo Clinic, UN Health, Springer, WebMD, American Pregnancy

Also read: What is vanishing twin syndrome: causes, symptoms, and diagnosis

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Written by

Deepshikha Punj

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