A healthy cervix stays long and tightly closed until labor begins. But with cervical insufficiency, your cervix dilates too soon.
Cervical insufficiency may cause miscarriage in the second or third trimester, or premature delivery, if left untreated.
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Doctors define cervical insufficiency as a cervix that's weak and can open or dilate before your baby is due. This condition also may be referred to as cervical incompetence.
The cervix is a tunnel-like opening at the bottom of your uterus. It connects the uterus and vagina, allowing fluids to leave and enter the uterus.
When you’re pregnant, a healthy cervix stays long and tightly closed until labor begins. When you're ready to give birth, your cervix thins out, shortens, and dilates (opens) so your baby can pass through.
With cervical insufficiency, the cervix dilates too early. It can cause miscarriage in your second or third trimester or premature delivery.
As your unborn baby grows, their weight presses against your cervix. That also can cause an insufficient cervix to open even without contractions.
Premature dilation from cervical insufficiency happens in about 1 out of every 100 pregnancies.
Cervical insufficiency describes a cervix that's either one or both of these:
Doctors don't know exactly why some people have cervical insufficiency, and women their first pregnancies don't know they have this problem.
Unless you have risk factors, your doctors won't routinely check for cervical insufficiency during prenatal visits.
If you had a previous pregnancy loss due to cervical insufficiency, there's up to a 30% chance it may happen again.
Other risk factors of cervical insufficiency include:
Left untreated, cervical insufficiency increases your risk of pregnancy loss or early labor.
You can't prevent cervical insufficiency because there's nothing you can do to strengthen your cervix. But you can manage the risks it creates.
It's crucial to get routine prenatal care so your doctor can watch for any changes in your cervix. If needed, they'll refer you to a team of high-risk pregnancy specialists.
Many women who have cervical insufficiency don't have any symptoms.
Common cervical insufficiency symptoms include:
If you have any heavy bleeding or cramping, call your ob-gyn and then go to the emergency department.
To diagnose cervical insufficiency, your doctor can do:
If you have cervical insufficiency, your doctor will watch your cervix carefully with ultrasounds or pelvic exams.
If they decide you need treatment, they'll either do surgery or prescribe medicine. Both can help prevent your cervix from dilating too early, so you can carry your baby to term.
The hormone progesterone not only helps your uterus grow during your pregnancy, but it can also prevents contractions from starting.
If you're carrying only one baby, taking progesterone supplements can reduce your risk of having a miscarriage or premature labor. Your doctor might prescribe progesterone until you're 36 weeks pregnant.
It comes in the form of:
With a cervical cerclage, your doctor goes in through your vagina and stitches your cervix closed. Cerclage helps strengthen your cervix, so it's less likely to shorten and dilate.
This procedure is done as outpatient surgery. You'll get medication so you won't feel any pain during the surgery.
Your doctor can do a cervical cerclage early in your second trimester. They'll remove the stitches when you're about 36 weeks pregnant, or when it's safe to have your baby.
You can't have this treatment if:
Maternal fetal medicine at UPMC offers care for high-risk pregnancies from national and global experts. Our skilled team knows how to diagnose and treat cervical insufficiency. And we're trained in evidence-based obstetrical care for women with complex pregnancies.
Last reviewed by a UPMC medical professional on 2024-09-05.
