The University of Chicago Medicine offers hope to families struggling with an incompetent cervix diagnosis, also called cervical insufficiency. With treatment from our experts, it's possible for women with a history or high risk of recurrent pregnancy loss or preterm birth to carry and deliver healthy babies.
What is incompetent cervix?
Women with incompetent cervix experience preterm deliveries because their cervix is either too short or too weak to sustain a full-term pregnancy. A woman’s cervix should open at the beginning of labor after about nine months of pregnancy. Yet, in these women, pressure from the growing fetus in the uterus causes the cervix to open prematurely, leading to preterm delivery in the second trimester. The pregnancy loss typically occurs between the 16th and 24th weeks of pregnancy — most commonly between weeks 18 and 22.
Experts have not identified an exact cause or risk factors that lead to cervical weakness in women with incompetent cervix. Though it rarely occurs, incompetent cervix can develop after a woman has already carried one or more successful pregnancies.
Risk and Diagnosis
If you are at risk for cervical insufficiency, your doctor may conduct a pelvic exam or an ultrasound early in your pregnancy to evaluate your condition.
However, in most cases, incompetent cervix is not detected until after a second trimester pregnancy loss. Women who miscarry due to cervical insufficiency will likely miscarry future pregnancies if they do not seek treatment.
Incompetent Cervix Treatment: Cervical Cerclage Procedures
Placement of a cerclage is the standard treatment for cervical insufficiency. A cerclage is the placement of a band or suture for reinforcement to help prevent the amniotic sac from "funneling" down into the cervix prematurely. There are different types of cerclage procedures, including:
What’s the difference between a transabdominal cerclage and a transvaginal cerclage?
A band placed at the top of the cervix that supports the entire length of the cervix
- Placed before becoming pregnant (only during pregnancy in rare exceptions)
- Outpatient surgical procedure or one overnight hospital stay
- At least 95% to 98% success rate
- Must have a cesarean delivery (C-section)
- May be left in place for future pregnancies
Stitches placed high in the vaginal portion of the cervix
- Can only be performed during pregnancy, usually during the 12th week
- No surgical incision
- Outpatient procedure
- May require modified activity or in some cases bed rest
- Vaginal delivery possible
- About 75% live birth rate
- Increased risk for pre-term delivery
- May not be a candidate if the vaginal portion of your cervix is too short, or if you’ve experienced cervical tears during childbirth