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Incompetent Cervix: Symptoms, Diagnosis, and Treatment

By Dr. Jesús Alberto Félix Atondo

Many women still believe you cannot carry a baby to full term if you have an incompetent cervix. Advances in diagnosing and treating incompetent cervix have led many women to safe, successful pregnancies. At the Fertility Center, we specialize in the incompetent cervix: its symptoms, diagnosis, and treatment.


What is an Incompetent Cervix?

Your uterus is connected to your vagina via the cervix. It is normal in pregnancy for the cervix to soften and dilate as you get ready to give birth. When the tissue of the cervix becomes weak, you risk losing a pregnancy early or giving birth prematurely. This is known as incompetent cervix or cervical insufficiency.

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Once you have had an incompetent cervix, you are at risk with all other pregnancies. Understanding the condition will help you seek the treatment you need to carry a pregnancy to full term.


Symptoms of Incompetent Cervix

An incompetent cervix can only be diagnosed during pregnancy unless you have a congenital cervical condition or had trauma to your cervix before getting pregnant. Most incompetent cervix symptoms appear about 24 weeks into your pregnancy. Because the symptoms are usually mild, many women do not recognize them. If you have one or more of these incompetent cervix symptoms, you should contact your doctor as a precaution.
New pain in your back – Back pain during pregnancy isn’t abnormal, but if you have never had a backache before and now you do, call your obstetrician.
Pressure in your pelvic region – The feeling of pressure or bloating that does not go away should be brought to your obstetrician’s attention.
Vaginal bleeding that is light – While some women have light bleeding during pregnancy, light vaginal bleeding accompanied by one or more of these symptoms may not be normal.
Mild stomach cramping – Abdominal cramping is uncomfortable. Whether it is mild or severe, you should contact your obstetrician immediately.
A vaginal discharge that changes – Some women have mild vaginal discharge during pregnancy. If the discharge changes, especially around the 24th week, you should see your doctor.

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Diagnosing an Incompetent Cervix

Diagnosing an incompetent cervix only happens during pregnancy. It is essential in your initial intake to share with your obstetrician your complete medical history. They will need to know if you have had any procedures involving your cervix, if you have lost a pregnancy in the second trimester, or if you delivered a baby before the 42nd week.
There is no specific test for cervical insufficiency, but your doctor can do an MRI or ultrasound to determine a congenital issue with your cervix.
Diagnosing an incompetent cervix starts with a pelvic exam. Your doctor will check to see if the wall of the amniotic sac surrounding the fetus has prolapsed (fallen into your cervical canal or vagina.) This is known as prolapsed fetal membranes. When this happens, your cervix is beginning to open. As a precaution, your obstetrician will track any contractions you may be having.
If the fetal membranes have prolapsed, the amniotic fluid in the sac is at risk for infection. Your doctor will do an amniocentesis. During the amniocentesis, a needle will be inserted through the abdomen into the uterus to retrieve a sample of the amniotic fluid. Once the fluid is removed, it can be tested for infection.
The doctor will also do a transvaginal ultrasound to get a good image of your cervix. The use of a transducer, which resembles a wand or thick round stick, is inserted into your vagina. It bounces sound off your cervix, creating a picture on the monitor, allowing the doctor to see how long your cervix is and if there is any prolapsed tissue.


Treatment Options for Incompetent Cervix

Incompetent cervix treatments range from non-invasive to invasive. Your specialist will determine what options are best for you. Together, you will create a treatment plan that will work best for you.

  • Continuing Ultrasounds are done at two-week intervals once you reach your 16th week and continue through week 24. These are done to monitor the length of your cervix if you are at high risk for an incompetent cervix or if your previous pregnancies ended in premature birth.
  • Progesterone supplements are used when you have never had a premature birth but your cervix is short. Progesterone comes in both gel form and suppositories. Both are applied to the vagina daily to reduce the risk of an early birth.
  • Cervical cerclage is the most invasive treatment option. Because it is used in single births, it is not a treatment option for all women. The criteria for this option are being 24 weeks pregnant, an ultrasound showing your cervix is dilating (opening) early, or a previous premature birth. In cervical cerclage, your obstetrician will sew your cervix tight, similar to pulling purse strings closed. This ensures the cervix stays closed until the ninth month of pregnancy, when your baby is full term and ready to be delivered!
    If you had an incompetent cervix in past pregnancies, cervical cerclage may be done prophylactically by the 14th week of pregnancy to ensure you carry the baby to full term.

Our fertility specialist Mexico at The Fertility Center specialize in incompetent cervix. We provide the latest in diagnosing and treating cervical insufficiency and other pregnancy issues—the same high-quality incompetent cervix treatment offered in the US at a fraction of the cost.
We offer a shuttle service from the San Diego International Airport to our clinic—a bilingual concierge service to assist you with scheduling and completing all paperwork, accommodations, and dining. Contact us to schedule your consultation or call us if you live in Mexico at 664 231 1020 or from the US at 858 867 4090. Ask about our best services such as uterus transplant and IVF in Mexico.

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Dr. Jesús Alberto Félix Atondo

Gynecology, Obstetrics and Biology of Human Reproduction Surgeon at the Autonomous University of Guadalajara, specialist Biologist of Human Reproduction by the Mexican Institute of Infertility.

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