Cervical Incompetancy:
Cervical incompetence refers to a kind of cervix that is not strong enough to stay closed during a pregnancy, thus giving birth to premature babies and in most occasions the baby dies as it does not get enough of gestational time to develop. Cervical Incompetancy is understood that due to cervical incompetence about 20 to 25% of all pregnancies get terminated in the second trimester itself. This incompetence can surface from as early as the second trimester to as later as the third trimester. There is no definite time of its surfacing. The treatment of an incompetent cervix can either be manual or ultrasonographic. Ultrasonography is used when the cervical opening is more than 2.5 cm or the length has reduced to less than 20 mm. sometimes when the internal part of the cervix has begun to efface, funneling is also used to treat an incompetent cervix. The external opening is usually safe when the diagnosis takes place in time. The reasons that make the chances of a woman suffering from an incompetent cervix are cervical trauma, DES exposure, hormonal imbalances, forced D & C, uterine anomalies and congenitally short cervixes.
If you are diagnosed with an incompetent cervix near the second trimester or just before delivery, it is definite that you will have trouble with the strength of your cervix. If you are between your 14th and 16th pregnancy week, your cervix can be stitched closed and what is more important is that the earlier you get a cerclage done, the higher are the chances of your pregnancy continuing. For this cerclage to be performed you have to fulfill a few criterion. You will not qualify for the cerclage if the following are true – hyperirritability of the cervix, if the baby is already dead, if the dilation of the cervical opening is more than 4 cm or if your water has broken. While these cerclage is very hopeful, it brings along with it a number of risks too. There are chances or premature rupture of the membranes, infection of the amniotic sac, preterm labour, cervical amputation, bladder injury, maternal hemorrhage, cervical dystocia and uterine rupture.
The actual method before carrying out a cerclage is to check the patient for at least 24 hours. The patient would be checked for preterm labour and screened for infection during this period. Spinal anesthesia is used to help reduce pain while performing a cervical operation. Your bladder would be filled so that the membranes are moved away from the opening and you will also be given antibiotics to prevent contracting an infection.
After the operation you will be asked to get bed rest for at least 24 hours and you will be constantly monitored for uterine activity. Once you have been released after the operation, you will be instructed to not indulge in any form of sex as your pelvis requires rest. You will have to be extra careful during this period and also not indulge in any physical labour. You will also have to visit your doctor regularly for check ups. If you do sense contractions, contact your doctor immediately. Cerclage is a very hopeful treatment for incompetent cervixes especially if they are performed early in your pregnancy.
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