Cervical Insufficiency

The mucus produced is sperm-friendly when the egg is released, while at other times it takes on a structure that opposes the sperm.

The cervix is tightly closed in a woman who has never had a vaginal delivery before, but it is more open in women who have had a vaginal delivery. In women who have had a normal pregnancy process without any health problems, the cervix is closed towards the end of the last trimester, that is, until the time of birth, and as the birth approaches, it softens, shortens and begins to open.

What is Cervical Insufficiency (Cervical Insufficiency)?

Cervical insufficiency is the condition of the cervix (neck) softening and opening before its time with the pressure of the baby growing in the uterus and the amniotic fluid in which it swims. Mostly, 16-24 days without any symptoms such as bleeding or pain. It is one of the most important causes of preterm birth and miscarriage.

Cervical insufficiency is seen in 1 or 2 percent of pregnancies, while in the second trimester of pregnancy, 4-6. It is seen as the main cause of a significant part of all miscarriages that occur between months.

The main causes of cervical insufficiency include genetic (congenital) weakness, multiple pregnancies, excessive stretching or rupture of the cervix in previous births, and cervical cancer.

Who are at risk?

• If cone biopsy or LEEP procedures have been applied to the cervix,
• If the cervix has been seriously injured in previous births,
• If miscarriage was made in the second trimester (between the 4th and 6th months) without any reason,
• One or more premature births
• If cervical insufficiency has been experienced in previous pregnancies,
• If there is a congenital uterine and cervix disorder,
• If your mother took a medicine called Diethylstilbestrol while she was pregnant with you,

Cervical insufficiency may occur.

How to Tell if Cervical Insufficiency Is Present?

Cervical insufficiency is usually not noticed in first pregnancies. And yet there is no definitive way to measure cervical length. However, in a pregnant woman, the cervix 4-6. It is understood when a miscarriage occurs without contraction or bleeding in the uterus after the painless thinning and opening of the uterus between months.

This disease, which generally does not give any symptoms, may occur between 12-20 years in some pregnant women. may show the following symptoms in weeks;

• Feeling of pressure under the uterus (in the pelvic area),
• Premenstrual cramp-like pain
• Back and waist pain,
• increase in vaginal discharge,
• White, clear or light yellow discharge turning pink or brown,
• Mild vaginal bleeding
• If you see one or more of the above symptoms between the specified weeks, you should apply to your doctor immediately by reporting your complaints. If there is cervical insufficiency, your doctor will follow you by performing an ultrasound examination from the 12th week to the 23rd week.

And if he deems it necessary (if the cervix is shorter than 25 mm), he applies the suturing process called cerclage to ensure that the cervix remains closed until delivery (at the end of the 37th week on average). Cerclage, usually 12-16. It is an easy operation performed with local anesthesia from the vagina between weeks. While you can return to your normal life 12 hours after this procedure, sexual intercourse may be prohibited during the rest of the pregnancy.

Cervical insufficiency and cerclage procedure

Afterwards, the stitches are checked at each visit and they are usually removed a few weeks before the expected delivery date. If cerclage was applied in the first pregnancy, it does not need to be applied again in other pregnancies. However, if the doctor deems it necessary, it can be repeated.

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