Cervical incompetence, also known as incontinence or cervical insufficiency, is a condition that can occur during pregnancy. It means that the cervix has become weak and may dilate (or open) to such an extent that you risk a miscarriage. Fortunately, there are a few things you can do to prevent this problem from developing and to prevent it from affecting the baby if this complication does arise. Read on to learn more.
Steps
Part 1 of 4: Work with Your Doctor to Prevent This Condition
Step 1. Understand what an incompetent or insufficient cervix is
It occurs when the cervix shortens, channels, or dilates during the second trimester of pregnancy. If the shape of the cervix changes, it creates a potential risk of miscarriage. The cervix can change for many reasons, including (among others):
- Previous cervical surgery and trauma.
- Previous cervical lacerations with vaginal delivery.
- Congenital defects (anatomical anomalies).
Step 2. Know the symptoms of an incompetent cervix
If you are concerned that you are predisposed to this condition and have any health problems, it is important to know what to look for to determine if you have it or not. Although they present differently for every woman, symptoms to look for include:
- Abdominal cramps and back pain.
- Vaginal discharge.
- Vaginal bleeding.
Step 3. Give your doctor your complete medical history
You must be absolutely honest and open about your medical past, including any miscarriages you may have had. This information can play an important role in determining whether or not you are prone to developing cervical incontinence. The information you will need to give includes:
- Surgical procedures undergone in the past.
- Previous miscarriages (both in the first and second trimester).
- Premature births.
Step 4. Schedule an appointment for a visit
Examination is in fact the only real way to determine if you have this problem or if it could develop. If you are worried, undergo a transvaginal ultrasound in the 14th-16th week of pregnancy. The doctor will be able to see if the cervix is abnormally dilated (or open).
- In the 18th-22nd week, you can do an ultrasound to measure the cervix.
- If you are not pregnant but fear that you may have a poor cervix and are worried about your future children, you can undergo a physical exam, during which your cervix will be examined and measured to determine if the cervix is at risk..
Step 5. Discuss possible cerclage with your doctor
Cerclage is a type of suture placed under the internal opening of the cervix; the cervix is tightened by suturing in a circular fashion (which means it is closed so that it cannot dilate or open more than it should). This is the best way to prevent cervical insufficiency, so if you are at high risk, contact your doctor to undergo this procedure.
The sutures are placed around the 12th-14th week of pregnancy and removed around the 36th or 38th week
Part 2 of 4: Changing the Lifestyle
Step 1. Avoid intense exercises
You should avoid all exercises that put pressure on the body, as they can affect the strength of the cervix and cause it to become incompetent. The only definitely beneficial exercise you can do is yoga. You should practice this with a certified instructor who teaches yoga in pregnancy. You should avoid:
Running, gymnastics and any sport that makes the body jump
Step 2. Get more rest
If you are stressed or doing physical work, you can facilitate the development of the incontinent cervix, especially if the cervix is already a little weak. Stress plays an important role in blood pressure and glucose levels; both can affect your baby's health and the strength of your cervix. Rest and relax during pregnancy to avoid any complications.
- Do breathing exercises to stay calm.
- Meditate every day to stay relaxed.
- Avoid lifting heavy loads and most other physical jobs.
Step 3. Do not take toxic substances such as alcohol and cigarettes
They are bad for your baby, so you should avoid them whether you have a weak cervix or not. Specifically, with regard to cervical insufficiency, substances such as alcohol and drugs alter the decision-making process, and could lead you to injure yourself, developing this condition. Stay away from:
- Alcohol.
- Tobacco of any kind.
- Drugs you may be abusing.
- Caffeine.
Step 4. Avoid using certain medications
You don't have to take tocolytic drugs. Tocolitico is a term that describes the stimulation of uterine contractions. In particular, try to avoid these medicines (unless otherwise directed by your doctor):
- Misoprostol (Cytotec).
- Dinoprostone (Cervidil).
- Methylergometrine (trade name Methergin).
- Ergotamine (Ergomar).
- Oxytocin.
Step 5. Make an appointment with your gynecologist every month
If you are concerned about developing an incompetent cervix, you should have a check-up at the gynecologist at least once a month (if not more often) to make sure your pregnancy goes smoothly.
Part 3 of 4: Enrich the Diet
Step 1. Supplement your diet with a rich amount of folic acid every day
Folic acid (also known as vitamin B) is especially important during pregnancy because it stimulates cell division and growth.
You can take a large amount by taking prenatal multivitamins with 0.5 mg of folic acid twice a day, unless otherwise directed by your doctor
Step 2. Increase your daily amount of calcium
Calcium acts positively in the baby's teeth, bones, blood vessels and muscle development. It also helps strengthen the cervix. You can take it in supplement form, but you can also increase your intake of foods that are rich in it such as:
- Milk and other dairy products such as yogurt and cheese.
- Vegetables such as broccoli, kale, okra, and chickpeas.
- Nuts such as almonds, Brazil nuts, hazelnuts and sesame seeds.
- Fruits such as apricots, figs, and raisins.
Step 3. Increase the amount of magnesium
Some studies have recently shown that magnesium can reduce the chances of having premature uterine contractions (these contractions can lead to the development of an incompetent cervix). Good sources of magnesium are:
- Spinach and Swiss chard.
- Pumpkin, soy, sesame and sunflower seeds.
- Black, navy and soy beans, quinoa.
Step 4. Get enough vitamin D
It is important to maintain adequate levels of vitamin D during pregnancy and immediately after childbirth, because it helps regulate the levels of phosphate and calcium in the body. You should aim to get 10 micrograms of vitamin D every day. You can take a supplement or eat foods that are rich in it such as:
- Wild salmon.
- Mackerel.
- Mushrooms.
- Milk, yogurt and cheeses.
- Egg yolks.
Part 4 of 4: Coping with Cervical Insufficiency
Step 1. Know that the baby can still be born healthy
It is important not to panic if you have been diagnosed with an incompetent cervix. You can still give birth to a happy and healthy baby, but you need to follow your doctor's directions. There are two different methods to overcome an incompetent cervix: the medical approach and the surgical approach.
Step 2. Talk to your gynecologist about the medical approach
If the insufficient cervix is not very serious (it has not dilated too much), you can consider medical attention. This means staying in bed most of the time, stopping all sexual intercourse and taking medications. The drug indicated is indomethacin.
Indomethacin: This drug is also referred to by the trade names Indocin, Indocin Sr, and Tivorbex. It is an NSAID (non-steroidal anti-inflammatory drug), which reduces the risk of premature birth for patients with a small cervix before 24 weeks of pregnancy. The dosage used is 100 mg once, followed by 50 mg every 6 hours for 48 hours, unless otherwise prescribed. This treatment should only be administered by a specialist
Step 3. Discuss the surgical approach with your doctor
Cerclage has already been discussed in Part 1 as a way to prevent incompetent cervix, but it is also a technique to treat the condition. As mentioned above, sutures are inserted into the opening of the cervix, keeping it closed to avoid a miscarriage. Before giving birth, they will be removed so that you can give birth naturally.
