Skip to main content

Health Encyclopedia

Search the Health Encyclopedia

Insufficient cervix

Alternative Names

Incompetent cervix; Weak cervix; Pregnancy - insufficient cervix; Premature labor - insufficient cervix; Preterm labor - insufficient cervix

What is an Insufficient Cervix?

The cervix is the narrow lower end of the uterus that goes into the vagina.

  • In a normal pregnancy, the cervix stays firm, long, and closed until late in the 3rd trimester.
  • In the 3rd trimester, the cervix starts to soften, get shorter, and open up (dilate) as a woman's body prepares for labor.

An insufficient cervix may begin to dilate too early in pregnancy. If there is an insufficient cervix, the following problems are more likely to occur:

What Causes it?

No one knows for sure what causes an insufficient cervix, but these things may increase a woman's risk:

  • Being pregnant with more than 1 baby (twins, triplets)
  • Having an insufficient cervix in an earlier pregnancy
  • Having a torn cervix from an earlier birth
  • Having past miscarriages by the 4th month
  • Having past late-term abortions
  • Having a cervix that did not develop normally
  • Having a cone biopsy or loop electrosurgical excision procedure (LEEP) on the cervix in the past due to an abnormal Pap smear

How do I Know I Have it?

Often, you will not have any signs or symptoms of an insufficient cervix unless you have a problem it might cause. That is how many women first find out about it.

If you have any of the risk factors for insufficient cervix:

  • Your health care provider may do an ultrasound to look at your cervix when you are planning a pregnancy, or early in your pregnancy.
  • You may have physical exams and ultrasounds more often during your pregnancy.

An insufficient cervix may cause these symptoms in the 2nd trimester:

  • Abnormal spotting or bleeding
  • Increasing pressure or cramps in the lower abdomen and pelvis

How is it Treated?

If you have an insufficient cervix, your provider will likely suggest bed rest. During bed rest, you will be advised not to have sex. Your provider may suggest you have a cerclage. This is a surgery to treat an insufficient cervix. During a cerclage:

  • Your cervix will be stitched closed with a strong thread for the whole pregnancy.
  • You will be given medicine to prevent a miscarriage that could occur from the surgery.
  • Your stitches will be removed near the end of the pregnancy, or sooner if labor begins early.

Cerclages work well for many women.

Sometimes, medicines such as progesterone are prescribed instead of a cerclage. These help in some cases.

Talk with your provider about your situation and treatment options.

References

Berghella V, Iams JD. Cervical insufficiency. In: Creasy RK, Resnik R, Iams JD, Lockwood CJ, Moore TR, Greene MF, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 41.

Ludmir J, Owen J, Berghella V. Cervical insufficiency. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 28.

Review Date:11/11/2016
Reviewed By:Irina Burd, MD, PhD, Associate Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

adam.com

The Agency for Health Care Administration (Agency) and this website do not claim the information on, or referred to by, this site is error free. This site may include links to websites of other government agencies or private groups. Our Agency and this website do not control such sites and are not responsible for their content. Reference to or links to any other group, product, service, or information does not mean our Agency or this website approves of that group, product, service, or information.

Additionally, while health information provided through this website may be a valuable resource for the public, it is not designed to offer medical advice. Talk with your doctor about medical care questions you may have.

We Appreciate Your Feedback!
1. Did you find this information useful?
         Yes
         No
2. Would you recommend this website to family and friends?
         Yes
         No