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A Cervix Issue

Managing Incompetent Cervix

By Cecelia A. Cancellaro

Carol Alvarado, 37, of Browns Valley, Calif., is the very happy mother of two healthy children -- but she endured a great deal of difficulty to reach this point. While pregnant with her first child, at the age of 29, Carol was diagnosed with incompetent cervix.

Incompetent cervix is a condition in which a pregnant woman's cervix is softer and weaker than normal, and as a result, might open prematurely during pregnancy. In some cases an ultrasound image can lead to the diagnosis of incompetent cervix, but most often, the condition is not discovered until a woman has lost a pregnancy, usually in her second or third trimester. "It is estimated that incompetent cervix is responsible for 25 percent of all second trimester miscarriages," says Dr. Traci Kurtzer, an obstetrician-gynecologist with ENH Medical Group in Deerfield, Ill.

"The diagnosis is a challenging one. A history of multiple second trimester deliveries or progressively earlier deliveries in successive pregnancies might be an indicator. A physician might also be more observant for signs of incompetent cervix in patients who have had cervical trauma or surgery, who have had exposure to the drug DES in utero, or who have other congenital defects in the uterus or cervix."

During the 22nd week of a pregnancy that was going very well, Alvarado knew something was terribly wrong when she found pink mucous on her toilet tissue one morning. She'd done enough reading during her pregnancy to recognize that the discharge may have been a sign that her mucuous plug had dislodged. "I drove myself to the hospital and, much to my surprise, the doctor determined that I was four centimeters dilated and the amniotic sac had partially descended through my cervix," says Alvarado. In addition to excessive discharge, vaginal bleeding, pelvic pressure, and heaviness in the lower abdomen, are also cited as possible symptoms of incompetent cervix.

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