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4 Ways to Treat an Incompetent Cervix and Lower the Risk of Miscarriages

An incompetent cervix is a common condition causing preterm births and miscarriages. Here are treatments that can ensure a full-term delivery.

Premature baby holding to its mother’s finger

Did you know that 1 in every 100 pregnancies involves an incompetent cervix? Cervical incompetence or cervical insufficiency occurs when the cervix opens before a woman goes into labour. This leads to a miscarriage or preterm birth. As the condition is difficult to diagnose, women with an incompetent cervix often have to go through the trauma of repeated miscarriages or preterm birth before it is suspected. However, once diagnosed, the condition can be effectively managed. 

A woman’s cervix is closed and firm before pregnancy. As pregnancy progresses, the cervix softens, decreases in length and opens in preparation for labour and delivery. An incompetent cervix undergoes these changes and opens too soon, sometimes even in the second trimester, causing a miscarriage. If the cervix opens later in the pregnancy, it may result in preterm birth. 

Do You Have an Incompetent Cervix? 

You may not realise that you have an incompetent cervix, and many women don’t have any known risk factors. You might be at a higher risk of cervical incompetence if you had a surgical procedure on your cervix. Certain congenital conditions that result in uterine abnormalities or connective tissue disorders also predispose you to an incompetent cervix, especially during early pregnancy.

Pregnant woman sitting on a bed holding her stomach and smiling
Be sure to speak to your doctor if you have any concerns during your pregnancy. 

There may be no signs and symptoms of the condition. Some women have mild pelvic pain or spotting between the 14 and 20 weeks of pregnancy. Backache, mild abdominal cramps or a change in the vaginal discharge may also be noted. Though these symptoms might be common in any pregnancy, do let your doctor know if you’ve suffered from a past pregnancy loss or a surgical procedure on your cervix. A history of painless labour and preterm deliveries may also hint at the condition.

Your obstetrician may ask you to undergo a few tests to check for an incompetent cervix and rule out any infections. A transvaginal ultrasound can determine the length of your cervix and check if the membranes are protruding. This type of ultrasound uses a slender probe placed inside the vagina to visualise. 

What TCM Says about an Incompetent Cervix

Several lifestyle factors contribute to this imbalance. These are work stress, work-life imbalance, insufficient and low quality rest and sleep, lack of emotional management, an unhealthy diet and poor eating habits, and binge-drinking and smoking.

“These habits disrupt qi (vital life force) and blood circulation, causing the formation and accumulation of pathogens like Cold, Heat, Dampness, phlegm, Stagnated Qi and blood clots within the Penetrating Vessel (Chong Extraordinary Meridian) and Conception Vessel (Ren Extraordinary Meridian). This interferes with proper functioning of the cervix, greatly increasing the risk of miscarriages and preterm birth,” explains Real Medical Senior Physician Brandon Yew.

Over time, deficiencies of vital fundamental substances like qi, blood, yin (cooling energy and body fluids) and yang (warming energy) can arise.. This causes a weakening of the Penetrating and Conception vessels and vital organs like the Liver, Spleen and Kidneys, further worsening the cervix’s functional state. 

What to Do if You Have an Incompetent Cervix 

If you have been diagnosed with an incompetent cervix, be assured that several treatments can manage the condition. You can’t prevent an incompetent cervix, but you can take care to ensure it doesn’t cause problems during your pregnancy.

Here are some ways to manage the condition:  

Practise good antenatal care 

Be regular with your antenatal visits to the doctor and voice your concerns, no matter how minor they may seem to you. Eat a healthy and balanced diet and ensure you take all your antenatal supplements. If you have a history of early premature births or are suspected of having an incompetent cervix, your doctor will monitor your cervix with repeated transvaginal ultrasounds. 

If you have been diagnosed with an incompetent cervix, the condition will likely recur in subsequent pregnancies so it’s best to keep your doctor informed. 

Supplement your pregnancy with progesterone injections 

If you have a history of premature births, your doctor might suggest supplementations with progesterone hormone after the first trimester. This is available as weekly injections.

Pregnant woman getting her unborn baby checked up by a doctor
A cervical cerclage is successful in more than 90% of cases of incompetent cervixes.

Close the cervix with a cervical stitch 

If your doctor may also recommend a surgical procedure known as the cervical cerclage to prevent premature birth. In this procedure, the cervix is closed with strong stitches that are removed only towards the end of pregnancy. This is a safe procedure that has been in use for decades and significantly reduces the chances of preterm birth.

Strengthen your body to support the pregnancy 

Physician Yew advises that in Traditional Chinese Medicine (TCM), pregnant women with recurring miscarriages should strengthen their bodies and address any imbalance in the body’s constitution. 

He cautions against self-medicating with herbal medicines. “TCM can lower the risk of repeated miscarriages through herbal medication, acupuncture, cupping, gua sha, moxibustion, tuina and blood-letting. These are formulated carefully by the TCM physician to address specifically the unique body constitution of every individual patient. Hence best to always first consult the TCM physician for a proper assessment,” he emphasises. 

Below are some herbal formulas recommended by Physician Yew that can help lower the risk of recurring miscarriages:  

  • An Dian Er Tian Tang (安奠二天汤) – Regenerates Spleen qi and Kidneys’ essence to nourish, strengthen and stabilise Penetrating and Conception vessels. 
  • Shen Qi Wan (肾气丸) – Regenerates Kidneys’ yin and yang energies to nourish, strengthen and stabilise Penetrating and Conception vessels.  
  • Zuo Gui Wan (左归丸) – Regenerates Kidney’s yin energy and essence to nourish, strengthen and stabilise Penetrating and Conception vessels.  
  • Tai Shan Pan Shi San (泰山磐石散) – Regenerates qi and blood to strengthen and stabilise Penetrating and Conception vessels. 
  • Gui Zhi Fu Ling Wan (桂枝茯苓丸) – Dispels blood clots to unblock and stabilise Penetrating and Conception vessels.  
  • Shou Tai Wan (寿胎丸) – Regenerates blood, yang energy and essence to nourish Liver and Kidneys, dispels blood clots to unblock and stabilise Penetrating and Conception vessels. 

An incompetent cervix can cause worry for young couples looking to expand their families. With the combination of modern medicine and the wisdom of TCM, you can be sure of a healthy pregnancy until full term.

References

  1. Ultrasound, Second Edition, 2004, Incompetent Cervix [online], Available at: https://www.sciencedirect.com/topics/medicine-and-dentistry/incompetent-cervix. [Accessed 14 July 2022] 
  2. Statpearls Treasure Island, 2021, Cervical Incompetence [online], Available at: https://www.ncbi.nlm.nih.gov/books/NBK525954/, [Accessed 14 July 2022] 
  3. Annals of Translational Medicine, 2020, Diagnosis and treatment of cervical incompetence combined with intrauterine adhesions, [online] Available at: https://atm.amegroups.com/article/view/36488/html, [Accessed 14 July 2022] 

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