Cervical Insufficiency: Risk Factors, Symptoms And Treatment

Cervical insufficiency is when the uterus is weakened. It can have serious consequences during pregnancy.

During pregnancy, the load on the cervix gets bigger and bigger all the time. The weight and pressure that the growing baby puts on the uterine wall increases, which can cause the cervix to open prematurely.

Causes of cervical insufficiency

The condition can occur naturally in some women. However, the weakening of the uterine wall is in most cases the result of some influencing factor. Some of the factors that can cause a woman to suffer from cervical insufficiency are the following:

• Surgery of the uterus before pregnancy

• Injury caused during a complicated birth
• A malformation of the uterus as a result of a congenital injury or malformation
• Trauma caused by a previous miscarriage or an induced childbirth
• Exposure to substances such as diethylstilbestrol, which is a synthetic estrogen hormone

Symptoms of cervical insufficiency

Despite the many different causes, cervical insufficiency affects only 1 in 100 pregnancies. On the other hand, it is a serious problem.

As the baby grows in the womb, he or she becomes larger and heavier. As a result, all this weight creates a pressure on the cervix. In response to this, the cervix begins to give way as childbirth approaches.

In other words, a weakened cervix can be a risk during pregnancy. A weakened uterus cannot satisfactorily withstand the increasing pressure.

Cervical insufficiency can lead to the following:

• It can cause the uterus to open long before the baby is ready to be born.
• It can lead to premature birth, in the second trimester and onwards.
• In some cases, this can lead to miscarriage. Cervical insufficiency is responsible for at least 25% of miscarriages that occur after the first trimester.

To treat the weakened uterus, a suture called a cerclage is placed around the cervix. However, the operation has risks. For example, it can result in premature degradation of the membrane or uterus. It can also lead to bleeding and rupture of the cervix or bladder.

Cerklage is, however, considered a safe procedure. Despite the seriousness of the complications that can occur, they are very unusual.

Specialists believe that cerclage is safe in general. Because surgery can save the lives of both mother and child, most women prefer to take any risks.

How is a weakened uterus diagnosed?

Your gynecologist may not detect cervical insufficiency during a routine examination; it can also only be detected during a pregnancy. It is usually only discovered after a miscarriage in the second or third trimester.

If the above risk factors apply to you, you can go for a more thorough examination early in pregnancy.

Transvaginal ultrasounds are effective in diagnosing women at risk for cervical insufficiency. The ultrasound image allows doctors to measure the length and opening of the cervix.

A vaginal examination can also lead to the discovery of a weakened cervix. If a doctor detects a fetal membrane in the cervix or vagina, this is an indication that the uterus is weakened.

Laboratory tests on amniotic fluid are also useful in diagnosis, as they can rule out a possible infection.

Once a doctor has discovered a cervical insufficiency, the next step is probably cerclage. The procedure must be done before week 24. The stitches are removed between weeks 36 and 38 in preparation for childbirth.

But cerclage is not an option if the woman has already expanded more than 4 cm or has ruptured membranes.

The outcome of pregnancy depends on several factors. The cervix must be able to carry all the weight and all the pressure that the fetus produces until delivery.

Having cervical insufficiency can be a complex problem. However, it is not very common, and there are several treatment methods available.

Regardless of the case, it is important to go for all routine examinations at the maternity ward during pregnancy. It can save both your and your child’s lives.