The following factors can increase your risk of cervical weakness:
- Connective tissue disease at birth (congenital), such as Ehlers-Danlos syndrome
- Damage to the cervix
- Congenital malformations of the uterus, including abnormalities of the Müllerian duct
- Previous miscarriages in the 2nd trimester
During previous births, the cervix may have been injured. Damage that can occur when a large piece of tissue is removed from the cervix for biopsy or when instruments are used to dilate the cervix
Most women with cervical insufficiency do not have the above problems.
Isthmic-cervical insufficiency is usually not detected until the woman gives birth prematurely. She is suspected if the woman has previously had miscarriages in the 2nd trimester.
A doctor may also suspect cervical insufficiency if he detects that the cervix is dilated too early on regular check-ups during pregnancy.
If you suspect isthmic-cervical insufficiency, an ultrasound examination is performed using a sensor inserted through the vagina. Ultrasound findings may indicate isthmic-cervical insufficiency. For example, if an ultrasound scan shows that a woman has a short cervix, particularly a woman who is at risk of cervical insufficiency, doctors may closely monitor the woman for signs of premature birth.
Suturing the cervix to prevent it from opening too early
The doctor may put stitches around or through the cervix to keep it from opening too early. This is called cervical stitching.
A suture is placed on the cervix in the 1st trimester if the risk of ischemic-cervical insufficiency is high, as well as if the woman has previously had miscarriages in the 2nd trimester. A suture on the cervix can be placed up to 24 weeks if the doctor does not know how previous pregnancies were, but suspects that the woman has had problems if she has a short cervix.
Before suturing the cervix, the woman is given general anesthesia or local anesthesia. The doctor then inserts instruments through the vagina to create stitches. The stitches are usually removed before delivery. Sometimes they are left and have a caesarean section.