As a fetal medicine specialist, I often meet expectant mothers navigating the delicate balance between excitement and concern. One of the conditions that deserves more awareness is cervical insufficiency, a silent yet significant contributor to second-trimester pregnancy losses and preterm births.
🧬 What Is Cervical Insufficiency?
Cervical insufficiency, also known as an incompetent cervix, occurs when the cervix begins to soften, shorten, or open too early in pregnancy—without pain or contractions. This premature dilation can lead to miscarriage or preterm delivery, particularly in the second trimester.
📌 Why Does It Happen?
The causes can be varied:
- Previous cervical surgeries (e.g., cone biopsy, LEEP)
- Trauma during previous deliveries
- Congenital abnormalities of the cervix or uterus
- Multiple gestations (twins or more)
- History of unexplained second-trimester losses
In some cases, there may be no clear underlying reason—it’s diagnosed only when complications occur.
🔍 How We Detect It
Early detection is key. As part of specialized fetal medicine care, we assess cervical length via transvaginal ultrasound, especially in women with known risk factors. A cervix measuring less than 25mm before 24 weeks may indicate a higher risk.
Routine surveillance helps us act before symptoms appear.
⚠️ Silent But Serious: What to Watch For
Cervical insufficiency may not cause pain, but subtle signs could include:
- Increased vaginal pressure
- Mild cramping
- Backache
- Vaginal discharge or spotting
That’s why proactive screening and fetal medicine evaluations are so crucial.
💡 Managing Cervical Insufficiency
In fetal medicine, our goal is always to preserve the pregnancy safely for as long as possible. Depending on the case, management may include:
- Cervical Cerclage: A surgical stitch placed to reinforce the cervix, ideally done between 12–14 weeks if indicated.
- Progesterone Support: Vaginal progesterone can help prevent preterm birth in high-risk pregnancies.
- Activity Modifications: Sometimes bed rest or reduced physical activity is advised.
🤰 The Outlook with Timely Care
The good news? With specialized monitoring and timely intervention, many women with cervical insufficiency go on to have healthy pregnancies and full-term deliveries.
As a fetal medicine specialist, I emphasize personalized care, constant monitoring, and evidence-based decisions—giving both mother and baby the best chance at a healthy outcome.
