Cervical insufficiency (also called CI) means that a woman's cervix opens too early, before the baby is full term. This condition is also called incompetent cervix. The cervix is the opening to the uterus that sits at the top of the vagina. When the cervix is healthy, it thins out and opens at the end of pregnancy when labor begins. The baby then moves through the cervix and birth canal (vagina) to be born.
With CI, the cervix opens without labor starting. Usually the woman has no symptoms. Few women know they have cervical insufficiency until they have a miscarriage or premature birth. The woman may give birth to the baby without feeling contractions.
If you've had a pregnancy affected by CI, the condition is likely to happen again in later pregnancies.
What causes CI?
Medical experts do not always know why incompetent cervix occurs. Theories include damage to the cervix during surgery, injury during a previous birth, and exposure to certain drugs.
Cervical length appears to be a factor. The shorter the cervix, the more likely you are to have cervical insufficiency. Ask your health care provider about having an ultrasound to check for short cervix.
How is CI diagnosed?
Providers have not found a reliable way to routinely check all women for cervical insufficiency. If a woman has previously lost a pregnancy in the second or third trimester, vaginal ultrasound during the next pregnancy may help predict she's at risk for preterm birth.
How is CI treated?
Providers sometimes recommend:
- Bed rest and reduced physical activity. While these methods are common, research has not proven them to be effective.
- Pelvic rest. This means no sex, tampons or douching.
- Cerclage. The doctor puts a stitch in the cervix to keep it from opening too early. The stitch is removed at about 37 weeks of pregnancy. Join the discussion group about cerclage on the March of Dimes online community Share Your Story.
Last reviewed April 2012
Frequently Asked Questions
What is mononucleosis?
Mononucleosis (also called mono) is an infection usually caused by the Epstein-Barr virus (EBV). It’s sometimes caused by another virus called cytomegalovirus (CMV). EBV and CMV are part of the herpes virus family. Mono is most common in teenagers and young adults, but anyone can get it. Mono is called the “kissing disease” because it’s usually passed from one person to another through saliva. In addition to kissing, it can also be passed through sneezing, coughing or sharing pillows, drinks, straws, and toothbrushes.
You can have mono without having any symptoms. But even if you don’t get sick, you can still pass it to others. Symptoms can include:
- Achy muscles
- Belly pain
- Fatigue (feeling tired all the time)
- Sore throat
- Swollen glands in your neck
If your symptoms don’t go away or get worse, tell your health care provider. He’ll most likely do a physical exam and test your blood to find out for sure if you have mono.
There’s no vaccine to prevent mono. There’s also no specific treatment. The best care is to take it easy and get as much rest as you can. It may take a few weeks before you fully recover.
Can Rh factor affect my baby?
The Rh factor may be a problem if mom is Rh-negative but dad is Rh-positive. If dad is Rh-negative, there is no risk.
If your baby gets her Rh-positive factor from dad, your body may believe that your baby's red blood cells are foreign elements attacking you. Your body may make antibodies to fight them. This is called sensitization.
If you're Rh-negative, you can get shots of Rh immune globulin (RhIg) to stop your body from attacking your baby. It's best to get these shots at 28 weeks of pregnancy and again within 72 hours of giving birth if a blood test shows that your baby is Rh-positive. You won't need anymore shots after giving birth if your baby is Rh-negative. You should also get a shot after certain pregnancy exams like an amniocentesis, a chorionic villus sampling or an external cephalic version (when your provider tries to turn a breech-position baby head down before labor). You'll also want to get the shot if you have a miscarriage, an ectopic pregnancy or suffer abdominal trauma.
I had a miscarriage. How long should I wait to try again?
Before getting pregnant again, it's important that you are ready both physically and emotionally. If you don't need tests or treatments to discover the cause of the miscarriage, it's usually OK for you to become pregnant after one normal menstrual cycle. However, it may take longer for you to feel emotionally ready to be pregnant again. Everyone responds differently to a miscarriage. Only you will know when you are ready to try to get pregnant again.
Are gallstones common during pregnancy?
Not common, but they do happen. Elevated hormones during pregnancy can cause the gallbladder to function more slowly, less efficiently. The gallbladder stores and releases bile, a substance produced in the liver. Bile helps digest fat. When bile sits in the gallbladder for too long, hard, solid nuggets called gallstones can form. The stones can block the flow of bile, causing indigestion and sometimes serious pain. Staying at a healthy weight during pregnancy can help lower your risk of gallstones. Exercise and eating foods that are low in fat and high in fiber, like veggies, fruits and whole grains, can help, too. Symptoms of gallstones include nausea, vomiting and intense, continuous abdominal pain. Treatment during pregnancy may include surgery to remove the gallbladder. Gallstones in the third trimester can be managed with a strict meal plan and pain medication, followed by surgery several weeks after delivery.