Incompetent Cervix

GENERAL INFORMATION:

What is an incompetent cervix? 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. At this time, the cervix may begin to thin and widen without any pain or contractions. The amniotic sac, also called the bag of water, bulges down into the opening of the cervix until it breaks. This may cause a miscarriage or premature (early) delivery of your baby.

What causes an incompetent cervix? The exact cause of an incompetent cervix is not known. Some women have an incompetent cervix for no obvious reason. The following may cause an incompetent cervix:

• An abnormal cervix or uterus.
  
  
• Certain medicines, such as diethylstilbestrol (DES). Your mother may have taken DES when you were inside her womb.
  
  
• Changes in hormones during pregnancy.
  
  
• Damage to the cervix, such as during surgery or after a difficult delivery of a baby.

What are the signs and symptoms of an incompetent cervix? There are usually no signs and symptoms of an incompetent cervix. The cervix just slowly thins and opens without vaginal bleeding or labor contractions. You may have one or more of the following:

• Backache.
  
  
• Discomfort or pressure in the lower abdomen (stomach).
  
  
• Gush of warm liquid from your vagina.
  
  
• Mucous-like vaginal discharge.
  
  
• Pain when passing urine.
  
  
• Sensation or feeling of a lump in the vagina.

How is an incompetent cervix diagnosed? You may need the following tests:

• 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 and can measure the thickness of your cervical tissue. Pictures of your uterus, ovaries, or cervix are seen on a TV-like screen.

How is an incompetent cervix treated? You may need to rest in bed during the last 4 to 6 months of your pregnancy. You may also need one or more of the following:

• Pessary: This is a plastic or rubber device that may be placed in your vagina to elevate and support the cervix.
  
  
• Surgery: You may have surgery called cervical cerclage to tie the cervix closed. This surgery may be done before you get pregnant or during your pregnancy.
  
  
• Tocolytics: These medicines stop or prevent labor contractions.

Where can I find support and more information? Having an incompetent cervix may be life-changing for you and your family. Accepting that you have an incompetent cervix may be hard. You may feel sad, frightened, or angry. Talk about your feelings with your caregiver or someone close to you. Contact the following for more information:

• American Academy of Family Physicians
  PO Box 11210
  Shawnee Mission, KS 66207-1210
  Phone: 1-913-906-6000
  Web Address: http://www.aafp.org
  

• The American College of Obstetricians and Gynecologists
  409 12th Street, SW
  Washington, DC 20090
  Phone: 1-202-638-5577
  Web Address: http://www.acog.org
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

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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