Cervical insufficiency (cervical ischemia) is dangerous?

The article is professionally consulted by an Obstetrician and Gynecologist - Department of Obstetrics and Gynecology - Vinmec Phu Quoc International General Hospital

Cervical insufficiency (cervical ischemia) is a condition in which the cervical parenchyma is deprived of local blood supply, affecting the structure and function of the cervix. If during pregnancy, cervical ischemia can cause miscarriage, premature birth or other dangerous complications.

Cervical insufficiency, also known as cervical ischemia, is a condition that occurs when the cervical parenchyma weakens due to local causes of lack of blood supply.
Normally, during a woman's pregnancy, the cervix has two main functions. First, the cervix closes into a solid mass to form a physical integrity during pregnancy while the volume of the uterus increases dramatically. This physical integrity is crucial for the developing fetus to be retained in the womb until the right time for labor and delivery. Second, to prepare for vaginal labor, the cervix will soften and widen. This is a process called cervical ripening. Physical and chemical changes are necessary for the fetus to move out of the cervix and out.
However, because of any cause of local ischemia, the cervix can no longer ensure the above two functions, pregnancy and labor will be in danger. Women with cervical insufficiency will increase the risk of miscarriage, premature birth or prolonged labor, affecting the prognosis of the birth and the baby in the future if there are complications of preterm birth.

Cervical incompetence is the result of a variety of causes leading to local structural changes. These causes may be due to early cervical degeneration due to progressive cervical functional defects, possibly to congenital anatomical abnormalities such as the Müllerian congenital malformation of the cervix. embryogenesis, due to exposure to diethylstilbestrol (DES) or systemic collagen dysregulated forms in Ehlers-Danlos syndrome.
In addition, there are causes of complications causing cervical ischemia such as: trauma in the urogenital region, local interventional procedures, including trauma caused by cervical tear during labor. Prior to this, cervical dilation in gynecological procedures involving transcervical instruments and partial cervicectomy.
Besides, endovascular interventions in the abdomen and pelvis because of other diseases can also cause blood vessel embolism to the cervix and cause uterine ischemia.

Most women do not notice any signs or symptoms of cervical incompetence without causing complications. Accordingly, this diagnosis can only be detected if the woman has regular antenatal check-ups and colposcopy.
On the other hand, once there are symptoms of cervical incompetence, women will come to the doctor when there are signs of miscarriage or threatened miscarriage in the first trimester and preterm or threatened premature birth in the second half of the trimester. second, entire third trimester. Usually, especially in women who give birth with a time frame from 14 to 20 weeks of pregnancy, the feeling when the cervix begins to open due to cervical incompetence is the following signs:

Feeling of pressure in the lower part of the pelvis Less back pain as the fetus has moved down Slight cramping in the abdomen under the legs due to the fetus pressing on the blood vessels in the pelvis Vaginal discharge Hemorrhage religion

Regardless of the cause, if cervical incompetence occurs during pregnancy, the primary goal of treatment should be to continue to keep the pregnancy stable in the uterus.
Pregnant women go to the doctor when the above signs appear, if the doctor suspects that this condition may be encountered, the next steps of treatment need to be taken quickly and urgently, especially when the mother threatens to have a miscarriage. pregnancy or threatened labor, especially in women who have had previous uterine interventions. Treatment options at this time include:
Cervical suture: If the fetus is less than 20 weeks pregnant or the woman has a history of preterm birth, and ultrasound also shows that the cervix is ​​dilated, the mother needs to be intervened. cervical stitch card. This procedure essentially uses sutures to harden the edge of the uterus to strengthen and strengthen the sealing nature of the uterus, keep the fetus in the uterus and can help prevent premature birth. Until the last week of pregnancy or signs of labor, the woman will be removed only to allow the cervix to enter the ripening process and the birth will take place as usual. Progesterone supplements: If you've had a history of preterm labor, your doctor may prescribe weekly injections of a form of the hormone progesterone called hydroxyprogesterone caproate starting in the second trimester. High levels of exogenous hormones will help maintain stability, ensuring that the cervix continues to close for the rest of the pregnancy. In the case that only partially dilated cervix is ​​seen through clinical examination, colposcopy and transvaginal ultrasound, and there is no risk of threatened miscarriage or threatened preterm birth, the mother will be instructed on preventive measures. To preserve the fetus, avoid vigorous activity or trauma on the lower abdomen. If contractions are present, your doctor will monitor the frequency and intensity of your contractions in order to administer tocolytics as soon as indicated.
In addition, the mother herself also needs to have a suitable lifestyle, increase the time of rest and pregnancy, avoid standing for a long time or sitting for a long time because it will put gravity on the cervical area, causing the This regional architecture is less sustainable. In addition, sexual activities involving vaginal penetration should also be avoided or required to adhere to absolute bed rest if the doctor has intervened but there are still signs of threatened miscarriage or premature birth.
In summary, a pregnancy with cervical incompetence is a high-risk pregnancy. This can only be detected early if the mother has regular antenatal check-ups as well as instructions on warning signs. In addition, because procedures in the abdomen, pelvis or right on the cervix have the risk of leading to cervical incompetence, choosing a reputable and professional medical facility is a way to prevent complications later. .
At Vinmec International General Hospital, there is a package maternity service as a solution to help pregnant women feel secure because of the companionship of the medical team throughout the pregnancy. When choosing Package Maternity, pregnant women can:
The pregnancy process is monitored by a team of qualified doctors Regular check-up, early detection of abnormal problems Maternity package helps to facilitate the process of pregnancy. birthing process Newborns get comprehensive care