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Heather Hanks
Written by Heather Hanks

Reviewed by Dr Jessica Gunawan and Physician Brandon Yew on October 16, 2022

What Is an Incompetent Cervix And Does It Cause Miscarriage?

An incompetent cervix is a heartbreaking condition that leads to miscarriages. However, many women don't know they have it until they've had several miscarriages.

Miscarriage min scaled

Have you been told that your miscarriages are due to an incompetent cervix? If so, you are not alone. The condition is reported to be involved in 1 in 500 to 2000 pregnancies.

However, the condition is difficult to diagnose. Therefore, a woman may experience several miscarriages before she finds out why. After you are diagnosed, it can be very easy to manage.

Read on to learn what an incompetent cervix is and why it may lead to miscarriage. Our experts also provide tips for supporting your womb health so you can carry a healthy baby full-term.

What Is An Incompetent Cervix?

An incompetent cervix occurs when the cervix shortens or opens too soon during pregnancy.

Cervical incompetence or cervical insufficiency occurs when the cervix opens before a woman goes into labor. 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 labor 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 realize 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.

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, a sensation of pelvic pressure, light vaginal bleeding, and 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 labor 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 visualize. 

What Does TCM Say About An Incompetent Cervix?

According to Traditional Chinese Medicine (TCM), 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, 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 Qiand blood clots within the Penetrating Vessel (Chong Extraordinary Meridian) and Conception Vessel (Ren Extraordinary Meridian). This interferes with the 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. 

Tips For Managing 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:  

Practice good prenatal care 

Seeing your doctor regularly and eating a healthy diet can help support your pregnancy.

Be regular with your prenatal 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 prenatal supplements.

You can also add several Chinese herbs to your diet to support a healthy pregnancy. Bird’s nest can help relieve Heat in the body. Meanwhile, Codonopsis and red dates tea can improve vitality and Stagnated Qi.

During early pregnancy, try to reduce the ‘cooling effects’ of vegetables by grilling them because many vegetables are cooling in nature. Incorporate more warming herbs into your diet, such as ginger. Avoid foods or beverages that are yin (cold) in nature, such as lettuce, sashimi, white cabbage, and drinks prepared using barley grains and tea leaves.

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. 

Consider progesterone injections during pregnancy

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.

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 toward 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 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, acupuncturecuppinggua 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, it’s best to always first consult a TCM physician for a proper assessment,” he emphasizes. 

Below are some herbal formulas that can help lower the risk of recurring miscarriages:  

  • An Dian Er Tian Tang: Regenerates Spleen qi and Kidney essence to nourish, strengthen and stabilize Penetrating and Conception vessels. 
  • Shen Qi Wan: Regenerates Kidney yin and yang energies to nourish, strengthen and stabilize Penetrating and Conception vessels.  
  • Zuo Gui Wan: Regenerates Kidney yin energy and essence to nourish, strengthen and stabilize Penetrating and Conception vessels.  
  • Tai Shan Pan Shi San: Regenerates qi and blood to strengthen and stabilize Penetrating and Conception vessels. 
  • Gui Zhi Fu Ling Wan: Dispels blood clots to unblock and stabilize penetrating and conception vessels.  
  • Shou Tai Wan: Regenerates blood, yang energy, and essence to nourish Liver and Kidneys, and dispels blood clots to unblock and stabilize penetrating and conception vessels. 

Bak Foong pills can also be taken prior to pregnancy to support womb health, alleviate menstrual symptoms and help you maintain vitality. It also helps prepare the body for pregnancy while you are trying to conceive.

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: Cervical Incompetence – an overview | ScienceDirect Topics
  2. Statpearls Treasure Island, 2021, Cervical Incompetence [online], Available at: https://www.ncbi.nlm.nih.gov/books/NBK525954/
  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

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