Cervical insufficiency (CI) [previously cervical incompetence] is the premature widening and thinning of the cervix. If left untreated, cervical insufficiency can lead to premature birth and miscarriage in women in their second and third trimesters. Typically, cervical insufficiency is a recurring problem and many women who experience multiple miscarriages suffer from this condition. The following information has been compiled in order to help you mitigate the risks associated with cervical insufficiency and to help ensure you carry your baby to full-term.

Causes
CI is initiated when the cervix begins to change shape, typically between 14-16 weeks. As the weight of the baby increases and begins to press down on the cervix, it may begin to widen, shorten and thin out at a faster rate than is acceptable. Evidence shows that a shorter than average cervix is the main cause in this process occurring as the cervix will have less leeway to change before reaching a critical point. Usually there are no preemptive symptoms to identify this process is happening short of visiting a physician and having an exam to see the current situation of the cervix.  

Diagnosis
Most diagnoses of cervical insufficiency are determined by trans-vaginal ultrasounds coupled with prior issues with pregnancies. Individuals who have suffered multiple second and third trimester miscarriages and/or who have delivered one or more early preterm births are likely to suffer from cervical insufficiency. Beginning at 16-20 weeks, a practitioner may use trans-vaginal ultrasounds to inspect and measure the length of the cervix and by periodically monitoring the change in the shape and size of the cervix can determine whether or not cervical insufficiency may develop. If your practitioner discovers rapid changes between ultrasounds, this indicates that you are at a much higher risk of cervical insufficiency. Initial measurements of the cervix may also indicate the likelihood of CI as the shorter the cervix, the higher the risk.

Treatment
Due to the sensitive nature of the disorder, there is no sure-fire way to guarantee that a pregnant mother will not suffer from cervical insufficiency. One method that can assist in combating CI is the cerclage, a stitched band around the cervix that supposedly reinforces it and helps keep it closed. Recent evidence suggests that a cerclage may not assist in the majority of cases in which it is implemented due to it being implemented after cervical changes have already begun and because the cerclage can cause infections, ruptured membranes and other problems that lead to preterm delivery. New evidence suggests that in cases where multiple miscarriages or instances of CI has occurred, the cerclage can be installed 13-16 weeks into pregnancy and is shown to be notably more effective at preventing the cervix from prematurely morphing.

Prognosis
While cervical insufficiency poses little serious threat to the mother, it can pose serious risks and even death for babies depending on what stage of pregnancy they are in when the situation develops. By visiting your practitioner and having periodic monitoring of changes in the cervix, you can begin to anticipate what may happen and make the best choice on how to remedy the situation.