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Incompetent Cervix

WHAT YOU SHOULD KNOW:

Incompetent Cervix (Inpatient Care) Care Guide

  • An incompetent cervix is also called cervical insufficiency. The cervix is the bottom part of your uterus (womb). Normally, the cervix remains closed during pregnancy until your baby is ready to be born. A normal pregnancy lasts for about nine months. An incompetent cervix may begin to open at 4 to 6 months of pregnancy. The cervix begins to thin out and widen without pain or labor contractions. The amniotic sac, also called the bag of water, may bulge down into the opening of the cervix until it breaks. This may cause your baby to be born prematurely (early). There is no one cause of an incompetent cervix. An abnormal uterus or cervix or an injury to your cervix may put you at higher risk of having this condition. There are usually no signs and symptoms of an incompetent cervix. In some cases, you may have a backache, mucous discharge, or warm liquid coming from your vagina.

  • A pelvic exam and ultrasound may be used to diagnose an incompetent cervix. To treat this condition, a pessary may be placed inside your vagina to support your cervix. A pessary is a rubber or plastic device. You may need surgery to tie the cervix closed until it is closer to the time of your delivery, when the tie will be removed. Finding and treating an incompetent cervix as early in the pregnancy as possible may help you have a normal pregnancy.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

Treatment for an incompetent cervix may cause unpleasant side effects. Medicines may cause a rash, nausea (upset stomach), vomiting (throwing up), headache, weakness, or shortness of breath. The use of a pessary may cause infection, discomfort, or it may just fall out. You could also get an infection or bleed too much if the cervix is closed with surgery. After surgery, your cervix might tear open if the tie is not removed before you go into labor. Your bag of water may also break, causing you to go into premature (early) labor. If your incompetent cervix is not treated, you may have a greater chance of losing your baby. Ask your caregiver if you are worried or have questions about your condition, care, or medicines.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Activity:

You may need to rest in bed while lying on your left side most of the time. Your caregiver will tell you when it is OK to get out of bed. Call your caregiver before getting up for the first time. If you feel weak or dizzy, sit or lie down right away and call your caregiver.

External fetal heart monitoring:

Caregivers may use this to monitor your baby's heartbeat, and the contractions of your uterus. A small metal disc (monitor) with gel on it is placed on your abdomen. A belt will be fastened around your waist to hold the monitor in place. The monitor may need to be moved as your baby moves inside you. It may also be put on and taken off, or left in place. The monitor is attached to a machine with a TV-type screen, or a printer. The screen or the paper print out shows a tracing of your uterus contracting, and the baby's heartbeat.

Medicines:

You may be given the following medicines:

  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

  • Tocolytics: These medicines stop or prevent labor contractions.

Tests:

  • Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.

  • Pelvic exam: This is also called an internal or vaginal exam. During a pelvic exam, feel free to ask for a woman to be present if one is not. Your caregiver gently puts a warmed speculum into your vagina. A speculum is a tool that opens your vagina. This lets your caregiver see your cervix (bottom part of your uterus). With gloved hands, your caregiver will check the size and shape of your uterus and ovaries.

  • Ultrasound: Sound waves are used to show pictures of the inside of your abdomen. A small handle with lotion on it is gently moved about on your abdomen (stomach). The handle may also be placed in your vagina. Pictures of your uterus, ovaries, or cervix are seen on a TV-like screen. Sound waves are used to show pictures of the inside of your abdomen.

  • Urine test: A urine sample is collected and sent to a lab for tests.

Treatment options:

You may have the following treatments for an incompetent cervix. Ask your caregiver for more information if you need the following treatments:

  • Pessary: You may have this plastic or rubber device placed inside your vagina to elevate and support the cervix.

  • Surgery: You may have surgery called a cervical cerclage to tie the cervix closed. This surgery may be done before you get pregnant or during your pregnancy.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of the Blausen Databases or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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