An incompetent cervix is a cervix which is unable to perform its required function of retaining a pregnancy, frequently resulting in miscarriage or preterm birth in the second trimester.

Cervical incompetence may be the result of previous cervical trauma due to surgery or a difficult vaginal delivery, or it may be due to a genetic malformation of the cervix. These factors make it more likely for a recurrence of this problem in subsequent frequencies.

The primary symptom of an incompetent cervix in pregnancy is spotting or bleeding. Although the majority of miscarriages are due to an abnormality in the fetus, recurrent miscarriages, three or more in a row, may be due to an incompetent cervix. Fortunately, today, with the aid of ultrasound, signs/indications of an incompetent cervix can be determined and treated early-on. One such surgical treatment is called cerclage. In this procedure, one or two sutures encircling the cervical opening are taken. The purpose of the suture is to tighten the cervix to prevent it from dilating under the growing weight of the fetus. The suture is removed approximately one week before delivery.

Another treatment, a non-surgical approach, used alone or in conjunction with the cerclage, is the use of a pessary, which is precisely fitted to the individual patient. A number of different pessaries have been used during pregnancy. With the aid of ultrasound, risk factors for premature labor such as an incompetent cervix (shortening of the cervix) as well as, multiple gestation, previous history of premature labor, treatment can begin prior to the onset of symptoms. Your clinician may also recommend bedrest and the administration of a tocolytic agent to relax the muscles of the uterus, if there are no contraindications for its use