Incompetent Cervix

Treating a weak cervix to avoid preterm birth

In some pregnant women, the cervix starts to thin out and widen before the baby is ready to be born. This condition is known by several names, including weak cervix and cervical incompetence. It can occur as early as the second trimester of pregnancy, and may result in either a miscarriage or a preterm birth.

An incompetent cervix is a fairly rare condition, occurring in only about 1.5 percent of women in the United States. However, if it happens to you, it is very important that you seek immediate treatment to give your baby the best chance of being born at full term, without any complications or birth defects.

Risk Factors for Cervical Incompetence

Incompetent cervix is difficult to diagnose, and unfortunately in many cases it is not detected in a first pregnancy before it is too late. In subsequent pregnancies, however, your medical team will know to be on the alert. You are at elevated risk for an incompetent cervix if you meet one or more of these conditions:

  • Your uterus has structural abnormalities or anomalies.
  • You have had a cervical biopsy or other surgery to the cervix.
  • Your cervix was damaged in a previous birth.
  • You have had more than one pregnancy terminated.
  • You experienced cervical incompetence during an earlier pregnancy.
  • You have had a second-trimester miscarriage with no known cause.
  • You have a history of preterm birth not caused by preterm labor or placental abruption.
  • You have a history of preterm premature rupturing of cervical membranes (PPROM).

Treatment of a Weak Cervix

If you have cervical incompetence, you will likely be recommended for a surgical procedure known as cervical cerclage. Essentially, your cervix will be sewn shut to reinforce its strength so that your baby can safely remain in your womb until you reach a full term of 37 to 38 weeks.

The best time to perform a cerclage operation is when you are between 12 and 14 weeks pregnant. If your weak cervix wasn't detected in time, you can have the procedure performed later in pregnancy, but this make it all but certain that you will need to have cerclages performed during subsequent pregnancies as well.

Recovery from a cerclage procedure generally takes about a week. You will need to refrain from vaginal intercourse for about a week leading up to your operation, and you may be told to abstain from sex for the rest of your pregnancy. Your doctor will provide you with additional recovery and pain management options depending on the circumstances of your particular case. Some doctors recommend bed rest, to keep the weight of the baby from putting undue pressure on your cervix.

If you have a cerclage procedure, your doctor will go in and remove the stitches holding your cervix shut around the 37th week of pregnancy. If you begin experiencing labor contractions or if your water breaks, be sure to inform your caregivers that you have had a cervical cerclage so they can take appropriate action to ensure the safe delivery of your baby.