If a woman is pregnant, there are going to be a lot of things on her mind. She’ll be consumed by thoughts about the baby, the pregnancy itself and all the changes occurring within her body. These changes can have an effect out of all proportion to an average person’s frame of reference which would include natural growth, weight gain and aches and pains coupled with mental burdens as well. The worst possible outcome that could occur in a pregnancy is a stillbirth or miscarriage. This happens when an unborn child dies inside the womb for various reasons including chromosomal abnormalities, health problems inherited from either parent or just bad luck to name but a few. Making plans for what you want your family to be like may distract from grief following the loss of your baby if you were planning on welcoming one into the world soon.
What Is Cervical Insufficiency?
The cervix is a narrow point at the bottom of the uterus, which is where a woman’s reproductive system can be found. It dilates and opens during pregnancy to allow babies to pass through it and out of the body of a healthy pregnant woman.
The cervix is the lower portion of the uterus that connects to the vagina. Though it seems somewhat fragile or weak by nature, it actually becomes much softer and more pliable during pregnancy and may later act as a pathway for a full-term baby to pass through when time comes. That being said, however, sometimes having too much going on inside of your uterus can cause premature dilation or effacement of the cervix which might result in miscarriage.
When a pregnant woman receives this diagnosis, she is often rather alarmed and confused as to why women with normal due dates tend to deliver early. Breaching of the water bag before the full term does occur more often in pregnant women than it does for newborns. Preterm delivery – which happens before the 37th week of pregnancy is usual in many cases among pregnant women thus increasing their risk of delivering early by 2 weeks or more.
Normally, the cervix of a woman in labour will dilate up to 10cm measured from its closed position at the beginning of labour. Women with cervical insufficiency tend to have a higher rate of getting dilated to 10cm or greater without any feeling of contractions and even before they have experienced the onset of labour. This makes it very likely that their baby will end up being born prematurely or will suffer a miscarriage.
Most gynecologists don’t detect cervical insufficiency until a patient has already suffered from a miscarriage on or after the fourth month of pregnancy. It was also proven that 25% of all miscarriages which occur after the 14th week are due to incompetent cervix.
Pregnancy is not a disease. However, there may be some mild symptoms that can manifest during the pregnancy time period. Some of the symptoms that you may experience include vaginal discharge, abdominal pressure, and breast tenderness to name a few. Moreover, pre-menstrual like cramping can also occur which might feel uncomfortable.
As a healthy woman, you should expect to experience vaginal discharge at some point during your menstrual cycle. Discharge that appears whitish or clear in colour tends to be heavier in amount than when it is thin and pink or tan in colour. If you experience mild contractions for several days also known to women as Braxton-Hicks contractions then this is common too. Sometimes pregnant women will experience spotting which can last approximately 10 days between their cycles. All of these symptoms are normal and typically present themselves around the time before menstruation occurs.
If left untreated, cervical insufficiency might lead to premature birth.
What Causes Cervical Insufficiency?
Although cervical insufficiency is not fully understood, scientists have come to realize that heredity, certain medical procedures and activities relating to vaginal childbirth can be factors.
Unusually long or unusually short cervixes are believed to be the main cause of weak cervixes. According to some studies, when an abnormally long cervical length causes a woman to give birth prematurely during her pregnancy, this is known as cervical insufficiency.
Who Are At Risk for Cervical Insufficiency?
Women are likely to suffer from cervical insufficiency if they have experienced the following:
Those who have done a LEEP surgery on their cervix
Engaged in cone biopsy
Those who have had a miscarriage in the past (second trimester)
Those who have had a preterm delivery in the past which was not caused by placental abruption or preterm labour
Those who have an abnormally short cervix
Those had been diagnosed with cervical insufficiency in your previous pregnancy
Women whose mothers took the drug diethylstilbestrol or DES during her pregnancy can suffer reproductive tract problems, infertility and other health issues.
What Can Be Done to Deal with Cervical Insufficiency
Some go to the doctors only when they have a mild presentation of infection or pain. However, in most cases, even though there are symptoms, the infections are mild and not immediately apparent. When that’s the case, what can follow is an asymptomatic phase where by things seem alright and women may even forget about their recent bouts of infections. It’s only during that phase that your doctor will perform an ultrasound scan to check if you are suffering from incompetent cervix.
If your doctor notices that you have a short cervix, there are two ways to deal with the issue: cerclage surgery and progesterone injections. Both options require minor adjustments to one’s lifestyle but which is best really depends on the individual.
According to research, cervical cerclage can even cause preterm delivery and rupture of the membranes, irritation of the uterine which causes contractions, and uterine infection. Despite this fact, many women have had this surgical intervention over the years and it is been discovered that there are more benefits to holding off on giving birth than actually have its costs. Research has shown that 75-90% of baby girls who underwent this procedure eventually lived through it.
Pelvic rest is recommended to all women who are about to give birth. This includes abstaining from sexual intercourse, douching and tampons. Reduced physical activities and bed rest is recommended for pregnant women who are more likely to have cervical insufficiency.
Management of Cervical Insufficiency after Several Pregnancies
If you have suffered from cervical insufficiency in your previous pregnancy, you should be very cautious about it happening again in your next pregnancy. We know it can be difficult, but the one thing you can do to reduce the chances of this condition affecting you again is by making an effort to get regular exercise and trying a few at-home tips that may help your cervix stay strong.
Before trying to conceive, get advice from a gynecologist. A good doctor may ask you to avoid sexual intercourse and strenuous physical activity as they might have an impact on your pregnancy.
If your doctor checks before time and finds that the lining of your cervix is dilating even before your due date, you may require bed rest and may be assigned to undergo a cervical cerclage.