Incompetent Cervix: Loss of a Pregnancy in the Second Trimester

Incompetent Cervix

An incompetent cervix is also called cervical insufficiency. Normally, your cervix remains tight and hard right up until the time you are ready to deliver your baby. In some women, the cervix starts to soften and open during the second trimester. This can cause loss of the pregnancy. Incompetent cervix is not common as it occurs in less than one percent of pregnancies.

What Causes Incompetent Cervix?

In many cases, there is no known cause. Some women are born with an abnormally short cervix which can lead to incompetence. Some women are also born with a condition that makes connective tissue weak. This could be another cause. Your cervix could also be damaged or weakened by certain procedures. These include having a dilation and curettage (D&C), a cone biopsy, or an abortion.

How Would You Know if Your Cervix Is Incompetent

In many cases, the only way to know is when you lose a pregnancy in the second trimester. Once you have a history of early pregnancy loss, your doctor can be on the alert for an incompetent cervix and have a better chance of diagnosing it. If you have lost one pregnancy because of incompetent cervix, there is about a 30 percent chance it will happen during another pregnancy. It may be diagnosed if:

  • Your doctor examines your cervix during the second trimester and finds it to be bulging and opening
  • An imaging study (ultrasound of the cervix) shows the cervix to be too short.

In some cases, this condition can be diagnosed even if you do not have a prior history. This can happen if your doctor finds your cervix bulging or opening on a routine exam or if you have symptoms of incompetent cervix, which causes your doctor to do the exam.

In most cases, incompetent cervix is painless and gives no warning signs. But in some cases, there may be warning signs. These include the following:

If you have lost one pregnancy because of incompetent cervix, there is about a 30 percent chance it will happen during another pregnancy.

Can Anything Be Done

Sometimes when the only sign of this condition is early pregnancy loss, nothing can be done. But if you have a history of the condition or if your doctor finds warning signs before pregnancy loss, treatment can help.

The most common treatment is called cervical cerclage. During this treatment, which can be done through your vagina, stitches are placed into the cervix to strengthen it and keep it closed. The stitches can be removed when you are full term. In some cases, the stitches are left in place, and the baby is delivered by C-section.

Can Cervical Incompetence Be Prevented?

The answer is no. But loss of your pregnancy can be prevented if your doctor diagnoses incompetence before you lose the pregnancy. This is what you can do to lower your risk:

  • Let your doctor know about any risk factors you have for incompetent cervix, especially any history of pregnancy loss in the second trimester.
  • Keep all your prenatal visits. This is important.
  • Always let your doctor know if you have any of the symptoms or signs of cervical incompetence, even if they seem minimal.
Christopher Iliades
Dr. Chris Iliades is a medical doctor with 20 years of experience in clinical medicine and clinical research. Chris has been a full time medical writer and journalist since 2004. His byline appears in over 1,000 articles online including EverydayHealth, The Clinical Advisor, and Healthgrades. He has also written for print media including Cruising World Magazine, MD News, and The Johns Hopkins Children's Center Magazine. Chris lives with his wife and close to his three children and four grandchildren in the Boston area.

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