What is Cervical Insufficiency? How to Treat?

Pregnancy loss that occurs when the cervix is opened painlessly after the second trimester of pregnancy, that is, the 14th week, is called cervical insufficiency. This situation usually occurs when the cervix is not strong enough to carry the pregnancy. In this article, we talked about cervical insufficiency for you. You can continue reading our article to get detailed information on the subject.

What is Cervical Insufficiency?

Cervical insufficiency, also known as cervical insufficiency, occurs in approximately 1% of pregnancies. Diagnosis is usually made after the first pregnancy loss.

What Causes Cervical Insufficiency?

The exact cause of cervical insufficiency is unknown. However, damage to the cervix for any reason may cause cervical insufficiency problems. For example; The cervix may be damaged due to a previous surgical operation or a traumatic birth. In some women, there may be a structural problem or weakness in the cervical tissues due to a congenital problem.

What are the symptoms of cervical insufficiency?

Cervical insufficiency can have various symptoms. We can list some of these symptoms as follows:

• Feeling of pain or discomfort,

• Feeling of downward pressure in the groin area,

• Experiencing lower back pain or cramps in the lower back,

• Feeling the baby down

However, it should be noted that; All of these symptoms can also be seen in normal pregnancies. Therefore, it can be distinguished from cervical insufficiency with a doctor’s evaluation. These symptoms can sometimes start days or weeks before the opening occurs.

The usual story is that miscarriage or birth occurs as soon as you feel pregnant pains and go to the hospital.

Who are the Risk Group for Cervical Insufficiency?

We can list the situations that may pose a risk for cervical insufficiency as follows:

• If the expectant mother’s cervix was injured in previous births,

• If procedures such as conization or deep LEEP have been performed on the cervix,

• If there has been an unreasonable miscarriage between 4 and 6 months,

• If you have had one or more premature births,

• If there was cervical insufficiency in previous pregnancies,

• If there are genetic uterine and cervical anomalies (such as double uterus, half uterus),

• Some diseases occurring in the cervix (cancerous onset, chronic infection, etc.),

• If you have had frequent abortions.

What should be the length of the cervix during pregnancy?

Vaginal ultrasonography examination performed between the 16th and 24th weeks of pregnancy is reassuring if the cervical length is 30 mm or more. If the expectant mother’s cervix length is below 25 mm, it is considered a high-risk pregnancy.

How is Cervical Insufficiency Treated?

It is very important to make a correct diagnosis in cervical insufficiency. The continuation of the pregnancy can be ensured with the treatment method applied in a timely manner after correct diagnosis. There are various treatment methods for cervical insufficiency.

Drug treatment is the priority for expectant mothers who are having their first pregnancy or who have not had a premature birth before. If no successful results can be obtained with drug treatment, cervical stitching method is used.

Cervical stitch treatment method; It can be applied for different reasons and at different weeks of pregnancy. Generally speaking, cervical stitching, which is performed in the 12th to 14th weeks of pregnancy, can also be performed urgently in later weeks if the cervix opens prematurely.

How to Perform Cervical Stitching?

Cervical treatment method; It is performed under operating room conditions and preferably under general anesthesia. This treatment takes approximately 30 minutes and a special 5 mm wide suture material that is not absorbed by the body is used. The stitch goes all around the opened cervix and is compressed in a similar way to the opening of the bag. In this way, the cervix is prevented from opening before birth. The success rate of cervical stitching is; It varies between 60 and 70 percent depending on the week of pregnancy when the stitches are placed, the current status of the pregnancy and the structure of the cervix.

The important point is that pregnant women with cervical insufficiency are risky pregnant women and their follow-up and treatment should be carried out by a risky pregnancy specialist, that is, a perinatologist.