Potential Complications:
Weakened Cervix

hat is a weakened cervix?
 

Let’s back up for a moment and review: 

As you might already know, the cervix is found where the uterus meets the top of the vagina. During pregnancy, the cervix needs to remain closed in order to keep your baby safe, as well as to keep any harmful materials out. It is the cervix that will dilate when you are ready to deliver, widening the opening for your baby to exit your womb.

If your cervix is weakened – or “incompetent” (yes, it’s a poorly chosen term), there is a risk of miscarriage or premature delivery.

How common is it?
According to the Mayo Clinic, this condition affects 1-2% of pregnant women. However, their statistics claim that the condition is responsible for as many as 20-25% of second trimester miscarriages.

Am I at risk?
The cervix can be weakened by one or more of the following:

• Congenital defect of the cervix or uterus
• Previous trauma to the cervix, i.e., from a D&C or difficult birth
• Prior surgery on the cervix
• Exposure to DES (diethylstilbestrol)
• Uterine abnormalities

How can I find out if my cervix is weakened?
Most practitioners won’t routinely check for a weakened cervix; therefore, if you have any reason (see above factors) to suspect you might have this condition, inform your practitioner. A diagnosis can be made via pelvic exam or through an ultrasound.

What can I do if I have a weakened/incompetent cervix?
The most common treatment for this condition is "cervical cerclage," in which the cervix is closed with sutures. This can be done at 14-16 weeks, either vaginally or through the abdomen. The sutures are then removed at 36-38 weeks to allow for a complication-free labor and delivery. If your doctor recommends this procedure, you should make sure you are informed about any potential complications.

References: American Pregnancy Association, Mayo Clinic