Cervical Insufficiency and Cerclage

Cervical Insufficiency and Cerclage

It is possible to have cervical insufficiency during pregnancy. While it is a rare condition, it does pose serious risks.

What is the cervix?

The cervix is the lower end of the uterus. It forms a long, narrow canal that connects with the vagina. When a woman is not pregnant, her cervix remains slightly open to allow sperm to pass from the vagina into the uterus. Once a woman becomes pregnant, however, her cervix forms a mucus plug to protect fluids from passing in and out of the cervix. When the baby is ready to be delivered, the mucus plug will disintegrate and the cervix will soften, shorten, and dilate to prepare for labor.

What is cervical insufficiency?

Cervical insufficiency is when a woman’s cervix dilates, softens, and/or shortens prematurely during pregnancy, usually in the second or third trimester. Cervical insufficiency is typically caused by a weak cervix, which may be shorter or softer than average. Weakness in the cervix presents a problem when the growing baby puts pressure on the cervix. Typically, the cervix is strong enough to resist the pressure. In women with cervical insufficiency, however, this pressure can cause the cervix to dilate and shorten, as it would for labor. Cervical insufficiency is experienced by about 2% of women nationwide.

What are the effects of cervical insufficiency?

Cervical insufficiency is a serious condition that can lead to miscarriage or preterm labor. Cervical insufficiency may lead to preterm premature rupture of the membranes (PPROM) or early preterm or preterm delivery.  PPROM typically leads to delivery within 48 hours. Preterm delivery is defined as delivery before 37 weeks. Early preterm delivery is delivery before 32 weeks.

How will I know if I have cervical insufficiency?

Contractions don’t typically occur with premature dilation of the cervix, so it is hard to know if you have cervical insufficiency before the cervix has already began to shorten and dilate. If you have previously had multiple second-trimester miscarriages with no known causes, you may have an insufficient cervix. However, there is no definitive method to screen for this condition. If you have had miscarriages in the past or have a family history of it, your doctor will likely monitor the length of your cervix starting around week 16 to check for any signs of shortening.

Can cervical insufficiency be treated?

While there is no cure for cervical insufficiency, it can be treated. If you know you have the condition, your doctor will likely recommend a cervical cerclage. A cervical cerclage involves sewing the cervix closed during pregnancy. If done early enough in the pregnancy (around 3 months), it is a relatively effective treatment. If done later, however, the woman’s cervix may have already started to change and it can be less effective. Cervical cerclages can also cause complications, such as infections.

If you are concerned about cervical insufficiency, talk to your doctor about your options. Dr. Morice is a top-notch OB-GYN  and tubal reversal surgeon in Morgan City, Louisiana. Read more about Dr. Morice on our website, and contact us at (985) 702-BABY to make an appointment. To your health!


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