In medicine, cervical incompetence is a condition in which a pregnant woman's cervix begins to dilate (widen) and efface (thin) before her pregnancy has reached term. Medicine is the art and science of healing It encompasses a range of Health care practices evolved to maintain and restore Human Health by the Pregnancy ( Latin graviditas) is the carrying of one or more offspring known as a Fetus or Embryo, inside the Uterus of a Female The cervix (from Latin "neck" is the lower narrow portion of the Uterus where it joins with the top end of the Vagina. Cervical dilation is the opening of the Cervix, the entrance to the uterus during Childbirth, Miscarriage, induced abortion, or gynecological Effacement is the shortening or thinning of the Cervix before or during early labour. Cervical incompetence is a cause of miscarriage and preterm birth in the second and third trimesters. Miscarriage or spontaneous abortion is the natural or spontaneous end of a Pregnancy at a stage where the embryo or fetus is incapable of surviving generally defined Premature birth (also known as preterm birth) is the Birth of a Baby before the standard period of Pregnancy is completed Pregnancy ( Latin graviditas) is the carrying of one or more offspring known as a Fetus or Embryo, inside the Uterus of a Female
In a woman with cervical incompetence, dilation and effacement of the cervix occur without pain or uterine contractions. In Medicine ( Obstetrics) a contraction is a forceful and painful motion of the Uterus as part of the process of Childbirth. Instead of happening in response to uterine contractions, as in normal pregnancy, these events occur because of weakness of the cervix, which opens under the growing pressure of the uterus as pregnancy progresses. If the changes are not halted, rupture of the membranes and birth of a premature baby can result. According to statistics provided by the Mayo Clinic, cervical incompetence is relatively rare in the United States, occurring in only 1—2% of all pregnancies, but it is thought to cause as many as 20—25% of miscarriages in the second trimester. Mayo Clinic is a Non-profit medical practice Its headquarters the Mayo Medical School and its research facilities are in Rochester Minnesota in
Risk Factors
Risk factors for premature birth or stillbirth due to cervical incompetence include:[1]
- diagnosis of cervical incompetence in a previous pregnancy,
- previous preterm premature rupture of membranes,
- history of conization (cervical biopsy),
- diethylstilbestrol exposure, which can cause anatomical defects, and
- uterine anomalies. Diethylstilbestrol ( DES) is a drug, an orally active synthetic nonsteroidal Estrogen that was first synthesized in 1938
Repeated procedures (such as mechanical dilation, especially during late pregnancy) appear to create a risk. [2] Additionally, any significant trauma to the cervix can weaken the tissues involved.
Treatment
Cervical incompetence is not generally treated except when it appears to threaten a pregnancy. Cervical incompetence can be treated using cervical cerclage, a surgical technique that reinforces the cervical muscle by placing sutures above the opening of the cervix to narrow the cervical canal. Cervical cerclage ( tracheloplasty) also known as a cervical stitch, is used for the treatment of Cervical incompetence, a condition where the cervix has Surgery (from the χειρουργική cheirourgikē, via chirurgiae meaning "hand work" is a medical specialty that uses operative manual and instrumental In the anatomy of the Female reproductive system, the canal of the cervix (also called the endocervical canal, cervical canal, cervical canal
Cerclage procedures usually entail closing the cervix through the vagina with the aid of a speculum. The vagina (from Latin, literally " Sheath " or " Scabbard " is a fibromuscular tubular tract leading from the Uterus Another approach involves performing the cerclage through an abdominal incision. Transabdominal cerclage of the cervix makes it possible to place the stitch exactly at the level that is needed. It can be carried out when the cervix is very short, effaced or totally distorted. The complications described in the literature have been rare: hemorrhage from damage to the veins at the time of the procedure; and fetal death due to uterine vessels occlusion. Bleeding, technically known as hemorrhaging / haemorrhaging (see American and British spelling differences) is the loss of Blood from Perinatal mortality (PNM also perinatal death, refers to the death of a Fetus or Neonate and is the basis to calculate the perinatal Mortality
Note: The first revision of this article was adapted from material from the public domain source "Summary Report: ICD-9-CM coordination and maintenance committee", published at http://www.cms.hhs.gov/paymentsystems/icd9/icd111700.pdf. The public domain is a range of abstract materials &ndash commonly referred to as Intellectual property &ndash which are not owned or controlled by anyone
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