Cervical Incompetence (CI) is a condition in which the cervix of a pregnant woman begins to open (dilate) and thin (efface) before the pregnancy has reached term. "Incompetence" refers to the weakness of the muscle of the cervix, which can not be voluntarily controlled. CI is a cause of miscarriage and preterm birth in the second and third trimesters.
In CI, the cervix dilates and effaces without pain or uterine contractions because of the growing pressure of the pregnant uterus. If these changes are not halted, rupture of the membranes and premature delivery can result.
CI occurs in only 1-2% of all pregnancies, however it is the cause of 20-25% of miscarriages in the second trimester as well as 10% of preterm deliveries.
The goal of intervention is the successful prevention of premature delivery. This allows the fetus time to develop as fully as possible, thus preventing the multitude of complications associated with prematurity.
Treatment consists mainly of a procedure called cerclage, along with bedrest and possibly medications to prevent contractions and premature delivery. Even with cerclage and additional therapies, the risk of preterm birth is high (about 25%).
The Medifocus Guide on Cervical Incompetence provides answers to the following important questions and medical issues:
What are the most common symptoms of cervical incompetence?
Are there any recognized risk factors for developing cervical incompetence?
What kinds of medical tests are used to establish the diagnosis of cervical incompetence?
What is the current standard of care for the treatment of cervical incompetence?
What treatment options are available for the management of cervical incompetence?
Are there any promising new developments or potential breakthroughs in treatment?
Who are the most notable medical authorities who specialize in cervical incompetence?
Where are the leading hospitals and centers of research for cervical incompetence?
What are the most important questions to ask my doctor about cervical incompetence?
What Your Doctor Reads:
This MediFocus Guide contains an extensive listing of citations and abstracts of recent journal articles that have been published about this condition in trustworthy medical journals. This is the same type of information that is available to physicians and other health care professionals. A partial selection of journal articles that are abstracted in this MediFocus Guide includes:
Management of cervical cerclage after preterm premature rupture of membranes. Obstetrical & Gynecological Survey. 1999
Can examination of the cervix provide useful information for prediction of cervical incompetence and following preterm labour?. Australian & New Zealand Journal of Obstetrics & Gynaecology. 1999
Prevention of preterm birth. Baillieres Clinical Obstetrics & Gynaecology. 1995
Emergency cerclage: a review. Obstetrical & Gynecological Survey. 1995
Short cervical length by ultrasound and cerclage. Journal of Perinatology. 2000
Amniocentesis for selection before rescue cerclage. Obstetrics & Gynecology. 2000
Scanning electron microscopy and X-ray diffraction studies in the analysis of medical materials: Gore-Tex versus braided polyester tape for repair of the incompetent cervix. Micron. 2000
Cervical incompetence: elective, emergent, or urgent cerclage. American Journal of Obstetrics & Gynecology. 1999
Pregnancy outcomes in women treated with elective versus ultrasound-indicated cervical cerclage. Ultrasound in Obstetrics & Gynecology. 1998
Comparison of elective and empiric cerclage and the role of emergency cerclage. Journal of Maternal-Fetal Medicine. 1998
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