Cervical Incompetence

Repeat pregnancy loss may be caused by cervical incompetence

Miscarriages are common, but that fact is hardly comforting to someone experiencing a pregnancy loss. One common cause of repeated pregnancy loss is cervical incompetence. In a typical pregnancy, the cervix stays closed tight until it is time to give birth. Then it begins to soften, shorten and dilate (open) to prepare for birth. If you suffer from cervical incompetence, your cervix may go through these changes—softening, shortening and dilating—well before it is time to give birth. When this happens, the cervix is not strong enough to hold the growing fetus and the pregnancy is lost. Most women who experience miscarriage due to cervical incompetence lose the pregnancy around 20 weeks.

It’s not your fault

It’s important to remember that cervical incompetence is not caused by external factors. Even if you do everything possible to have a healthy pregnancy, you cannot control whether or not you experience cervical incompetence. A pregnancy loss due to cervical incompetence is not your fault. It can also be hard to diagnose cervical incompetence. Your doctor may suspect cervical incompetence if you have a history of miscarriages that occur during the second trimester (13–26 weeks). In addition, some women experience symptoms that the cervix is changing too early, such as:

• Cramping
• Lower backache
• Pelvic pressure
• Spotting (bleeding) during the second trimester

Most women do not have any symptoms. Talk to your doctor if you experience any symptoms of cervical incompetence.

Carrying your pregnancy to term

Having cervical incompetence does not mean you must continue to suffer from miscarriage. Main Line Health offers multiple ways to help women suffering from cervical incompetence carry pregnancy to term, including:

• Bed Rest: Reducing your activity level toward the end of pregnancy may help limit your risk of the cervix opening too soon.
• Cervical Cerclage: Physically stitching the cervix closed during the beginning of the second trimester (around 14 weeks) can help ensure that your cervix remains closed until it is time to deliver.
• Hormone Therapy: Injections of progesterone to supplement your body’s own progesterone levels may help delay cervical changes.

If you are at risk for cervical incompetence, your doctor will monitor your pregnancy using vaginal ultrasound and pelvic exam. Then, if your cervix begins to show any signs of change—including softening, shortening or opening—your doctor can take steps to treat cervical incompetence. With treatment, you can expect to experience a successful, full-term pregnancy.

To schedule an appointment with a specialist at Main Line Health, call 1.866.CALL.MLH (1.866.225.5654) or use our secure online appointment request form.