Cervical incompetence also called cervical insufficiency or cervical weakness is a condition in which the cervix is unable to keep a pregnancy in the uterus due to an inherent weakness in the structure. The cervix has the job of keeping the uterus closed until the time of birth. Sometimes it is weak and opens prematurely and this can be a cause of a second trimester miscarriage. Traditionally cervical incompetence has been diagnosed after a woman has suffered through two second trimester losses in which the cervix opened without any symptoms. More recently with ultrasound evaluation and assessment of risk factors, cervical incompetence can be diagnosed earlier and prior to a loss. The treatment for a short cervix can be anything from the use of vaginal progesterone on a daily basis, or the placement of a cervical cerclage or in some cases a pessary may be used if it is too late for a cerclage.
Some risk factors include:
- IVF pregnancy
- Prior second trimester loss
- A history of multiple miscarriages
- Any surgical procedure affecting the cervix or uterus
- Birth defect of the uterus
Treatments:
- Progesterone therapy
- Cervical cerclage – a procedure in which the cervix is surgially closed
- Pessary – a device that is placed vaginally to support and close the cervix