Weak Cervix:11 Questions, Seeking Answers.

Daniel Chukwuemeka Okwum

1. What is cervical incompetence?

Cervical incompetence, also known as cervical insufficiency or a weak cervix is a medical condition where the cervix suddenly begins to open up during pregnancy, and is hence unable to bear its weight to term (maturity). This challenge has caused so much heart aches, scattered families, shattered dreams, doing havoc to women of child bearing ages. This makes this article of great importance in this generation where the rate of divorce due to inability to birth a child is on the increase.

Image showing incompetent cervix.

Source: Uncle Scan Ultrasound album. 

2. What portion of the uterus is called cervix?

The cervix is the gate into the uterus, starting from the end of the vagina to the beginning of the potential space called endometrium. 

3. What is the function of the cervix?

It permits the passage of fluids such as blood, sperm or any other fluids, and a baby, or anything else. It’s about 4-5cm in length and reduces slightly, say by about 0.5cm, at about second trimester. The ability of a cervix to keep pregnancy intact is a function of its staying power or strength.  Its strength determines how secured your pregnancy might be, especially at the second trimester and forward. 

4. What are the effects and causes of an Incompetent cervix?

A weak or incompetent cervix is the major cause of miscarriages at the second trimester or later. First trimester miscarriages are often due to chromosomal or hormonal issues. Possible causes of a weak cervix are medical or criminal abortion (D&C), previous operation at the cervix, abnormality of the cervix or uterus, etc.

5. Any Remedy for incompetent cervix?

If you have been told you have an Incompetent cervix, NEVER GIVE UP, all hope is not lost. The next thing your gynecologist would likely advice you do is a Cerclage.

6. How do I know I need a cerclage?

-          Previous miscarriage at second trimester and above

-          Multiple pregnancies or whenever the strength of the cervix is in doubt.

7. Cerclage?

Cerclage, in lay man terminology, is the sewing of the cervix with the aim if strengthening it artificially. This is done during first trimester. The gynecologist opens up your vagina using a device called the speculum and the sewing is done. The sewing of the cervix can also be done through the lower abdomen to access the cervix. This procedure secures your pregnancy with a possibility of only 10-20% failure. You will be required to do a scan of your baby’s well being which also evaluates the state of the cervix. Such request for ultrasound examination may be a little more frequent that usual, depending on your peculiarity. 

8. Does cerclage fail?

Let me emphasize here that such incidence of failure is very rare. However, in case your cerclage loosens as the pregnancy progresses, your gyna may decide to take you in again for probably a rescue cerclage, depending on the gestation age, estimated weight of your baby, and probably some other factors.        

9. I’m scared, isn't it so painful?

I agree with you, it is painful. However, to reduce pains, an anesthesia, spinal or epidural, will be administered to you to render certain parts of your body temporarily insensitive, especially from the belly region to the lower limbs.

10. Would I be put to sleep during the procedure?

No, you wouldn’t. You would be awake and alert but with less or no pains at all.

11. When will the cerclage be removed?

At about a month to the EDD (Expected Due Date/Expected Date of Delivery), you will be required to report to the hospital for the removal so that your cervix can allow your baby passage when labor sets in.

In summary, being diagnosed of cervical incompetence does not imply all hope is lost. As a pregnant woman, you should avail yourself for routine scans at least three times during your pregnancy so that possible threats can be handled as early as possible.