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Incompetent Cervix: Now what?

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This blog post is the first part of a three-part series. The next blog post will be all about the cervical cerclage procedure what to expect before, during, and after. The final post will be about how to continue working with a cervical cerclage.

In 2019 I was diagnosed with an incompetent cervix and told that I was going to need a cervical cerclage to continue with my pregnancy.

More than likely, you are not reading this out of pure curiosity. Chances are you are a lot like I was at the time, googling your fingers off about any information you can find out about a weak cervix after your doctor has diagnosed you.

Well, have no fear, I wrote this just for you! I sat back and thought about everything that I wanted to know after my diagnosis, and attempted to put it all in one place for you.

I’ve even included my personal experience so that maybe you can have some peace of mind.

*Disclaimer: I am not a doctor, however all the information is first hand knowledge from my own personal experience receiving a cervical cerclage. Any unknown information was carefully researched through credible resources which are cited below*

What is an “Incompetent” Cervix

First off, let’s at least acknowledge that using the word “incompetent” or “weak” to describe a woman’s womb is very degrading. However, that is the term that some doctor came up with (I’m pretty sure they were not a woman).

An incompetent cervix or also referred to as a weak cervix is when a woman’s cervix is not strong enough to hold a fetus until complete gestation, which can result in a miscarriage or preterm labor.

What Happens After Diagnosis?

There are normally two main options after a woman is diagnosed with an incompetent cervix: A cervical cerclage procedure or progesterone shots.

Cerclage Procedure

When a woman is diagnosed with an incompetent cervix she is often recommended to get a cervical cerclage, if the cervix is deemed shorter than normal, or if the cervix has already begun to open.

A cerclage procedure is an outpatient procedure where the doctor stitches the cervix shut in hopes of prolonging the pregnancy to 37 weeks. The stitch is removed by your OBGYN in the office.

Other Reasons Your Doctor May Recommend a Cerclage. 

According  to the Mayo Clinic,  there are several reasons that your doctor may recommend a cerclage including:

  • Having a history of miscarriages in the second trimester
  • Having a prior cerclage 
  • Painless cervical dilation in the second trimester 
  • Having a short cervical length which is less than 25 mil before 24 weeks of pregnancy.
Cervical Cerclage up close
File:Cervical Cerclage-(international).png” by User:BruceBlaus is marked with CC BY-SA 4.0.

Types of Cerclage’s 

Emergency Cerclage

An emergency cerclage is done when a woman’s cervix begins to shorten prematurely and begins to open (This is the route I had to go).

Elective Cerclage

Doctors may also recommend an elective cerclage when you have had previous miscarriages in the second trimester. It is done normally around the 12 week mark of pregnancy. This procedure is done to prevent preterm labor & miscarriage. 

Progesterone Shots

Another option that a woman may have is progesterone shots. Progesterone shots are an alternative option to a cervical cerclage.

Typically, they are given to women who have a former history of miscarriage.

Progesterone can help prevent premature contractions, and ultimately reduce the chance of premature labor.

How I found out I had an Incompetent Cervix

My doctor recommended a cervical cerclage during my 20 week ultrasound.

The ultrasound tech was going through her normal routine of gliding the probe from one side of my jellied tummy to another. She began taking measurements of the baby as she told us what we were looking at on the screen.

When she started taking my cervix measurements I could sense something seemed off. She was taking longer than usual, and I noticed that she kept going to one side over and over again.

She got up and said that she needed to go get the doctor. I knew something was wrong because normally the doctor is not a part of the ultrasound appointment. 

A few moments later, the doctor came in and told me that my cervix was measuring short.

He told me that my cervix should be measuring around 4.0 cm during this timeframe of my pregnancy, but mine measuring at 0.91 cm.

Needless to say this was very shocking and scary to hear. I had just experienced a miscarriage prior to this pregnancy, and I was finally starting to feel a little less nervous about this one.

What happens after you find out your have an incompetent cervix?

Once I was diagnosed with an incompetent cervix my pregnancy was now considered “high risk.

My OBGYN referred me to a high-risk OB because he did not specialize in high-risk pregnancies.

My doctor told me that I would have to either get a cervical cerclage which is removed at 37 weeks, or progesterone shots weekly until I reach 37 weeks. This would depend on the doctor’s recommendation. 

I was scheduled to see the high-risk doctor the very next day, and he put me on immediate bed rest until further notice. 

One thing I’d like to note is that According to the American Pregnancy Association,  once a woman is determined to have an “incompetent” cervix, cervical cerclage is necessary with each pregnancy afterward.

Side note: I fact-checked this with my OB and he told me that because I have had a cerclage once, I have to have it with each pregnancy after. Hence my reason why I have decided to stay a mother of two.

Follow-up with the High Risk Doctor

The next day after my diagnosis, I was sent to a high risk doctor. They did another ultrasound and then the doctor came in and gave me a consult. He basically told me that I indeed had an “incompetent cervix”, and that the best option for the survival of my baby was to have the cerclage procedure done.

He gave me a moment to discuss this with my husband, but we didn’t need a moment, it was a “no brainer” for us. After we agreed, he scheduled our appointment and told us to grab a bite to eat, and me to check into the hospital that night.

If you have any questions about anything mentioned in this post leave your comment below.

Sources

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