What Is Cervical Insufficiency? How Is It Treated During Pregnancy?
Pregnancy is a period in which women experience both physical and emotional changes, requiring careful monitoring to ensure the well-being of both mother and baby.The proper functioning of the uterus and the cervix (the neck of the womb) is vital for maintaining a healthy pregnancy.Cervical insufficiency, also known as incompetent cervix, occurs when the cervix becomes too weak to support the growing baby and begins to open prematurely.If left untreated, it can increase the risk of preterm birth or miscarriage, making early diagnosis and close follow-up essential.
What Is Cervical Insufficiency?
During a healthy pregnancy, the cervix remains closed and firm, holding the baby securely inside the uterus.In some women, however, the cervix begins to shorten, thin, or dilate without contractions or pain, often during the second trimester (weeks 14–24).This condition is known as cervical insufficiency and can lead to premature rupture of membranes, preterm labor, or pregnancy loss if not managed properly.
Causes of Cervical Insufficiency
Cervical insufficiency can result from various factors, including:
Previous cervical trauma from childbirth or medical procedures
Recurrent miscarriages
Prior cervical surgeries (such as LEEP or cone biopsy)
Congenital weakness of the cervical tissue
Multiple pregnancies increasing pressure on the cervix
Each patient may have different underlying causes, which is why individualized assessment and monitoring are crucial.
Symptoms of Cervical Insufficiency
The condition often develops silently, with no noticeable symptoms. However, some women may experience:
Mild pelvic or lower back pain
A sensation of pelvic pressure
Increased vaginal discharge
Light spotting or bleeding
If these symptoms occur, it’s important to consult an obstetrician immediately.
How Is Cervical Insufficiency Treated During Pregnancy?
Treatment depends on the patient’s medical history, pregnancy progress, and the degree of cervical weakness. Common management options include:
1. Cervical Cerclage (Stitch Placement)
The most widely used treatment method. A stitch is placed around the cervix to keep it closed and prevent early opening.It is typically performed between weeks 12 and 16 of pregnancy and removed near term.
2. Vaginal Pessary
A silicone ring is inserted into the vagina to support the cervix and help distribute the baby’s weight more evenly.
3. Bed Rest and Monitoring
In mild cases, partial or full rest may be recommended along with regular ultrasounds to measure cervical length.
4. Medication
Progesterone supplementation and medications to prevent uterine contractions can help maintain pregnancy stability in select cases.
Why Is Early Diagnosis Important?
When not detected early, cervical insufficiency can lead to premature birth or pregnancy loss.Regular prenatal check-ups and ultrasound monitoring of cervical length enable early identification of risks and timely intervention — often preventing complications.
Safe Pregnancy Monitoring with Op. Dr. Yeliz Akçelik
Every pregnancy is unique, and so are the needs of each expectant mother.At her clinic in Kartal, Op. Dr. Yeliz Akçelik provides detailed and attentive prenatal care, offering personalized treatment plans for women with cervical insufficiency or other high-risk pregnancy conditions.Her approach ensures a safer, more confident, and well-managed pregnancy journey for every mother.
Frequently Asked Questions
1. When does cervical insufficiency usually occur?It most often appears between weeks 14 and 24 of pregnancy.
2. Can it recur in future pregnancies?Yes. Women who have had cervical insufficiency are at higher risk in subsequent pregnancies.
3. Is the cerclage procedure painful?No. It is performed under anesthesia, so there is no pain during the procedure.
4. Can women with cerclage have a normal delivery?Usually, the stitch is removed before labor, and delivery proceeds according to the doctor’s recommendation.
5. Can cervical insufficiency be detected by ultrasound?Yes. Measuring cervical length via ultrasound is an effective way to diagnose risk.
6. Is complete bed rest necessary?Not always. The doctor may recommend partial or full rest depending on the case.
7. Is pessary treatment safe?Yes. When correctly inserted and monitored, it is safe and effective.
8. Is progesterone therapy used for everyone?No. It is prescribed only when medically appropriate, based on individual evaluation.
9. Can women with cervical insufficiency have healthy deliveries?Yes. With proper treatment and close follow-up, most women go on to deliver healthy babies.
10. Who is at higher risk for cervical insufficiency?It is more common in women who have had previous cervical surgery, recurrent miscarriages, or multiple pregnancies.
