Cervical Incompetence – This course is designed to understand the care of pregnant women and newborn: antenatal, intra-natal and postnatal; breast feeding, family planning, newborn care and ethical issues, The aim of the course is to acquire knowledge and develop competencies regarding midwifery, complicated labour and newborn care including family planning.
Cervical Incompetence
Cervical Incompetence:
Cervical incompetence or cervical insufficiency is a well-known cause of inability to continue pregnancy and recurrent second or third trimester abortions.
Or
An incompetent cervix, also called a cervical insufficiency, is a condition that occurs when weak cervical tissue causes or contributes to premature birth or the loss of an otherwise healthy pregnancy.
Risk factors for cervical insufficiency:
There are a number of conditions that may lead to cervical-insufficiency, these are:
1. Previous history of unexplained pre-mature labor pains or miscarriage increases the doubt of a possible cervical-insufficiency and with two or more consecutive second trimester abortions, it is an indication to access pregnant woman for cervical-insufficiency.
2. Cervical surgery is also a strong risk factor by impairing normal control of muscles.
3. Cervical cone biopsy due to abnormal Pap smear is a common reason that may lead to cervical insufficient; however if done properly, risk is very minimal.
4. Chemical exposure like Diethylstilbestrol exposure during fetal life also leads to changes in cervix besides increasing the risk of cervical cancer.
5. Short cervix: Some women have inherently short cervix and so are risk for developing recurrent second trimester abortions.
Consequences of Cervical Incompetence:
Due to weak and open cervix, pregnancy may commence successfully until second or early third trimester where weight of fetus exerts excessive pressure on already opened cervix, leafing to:
1. Premature rupture of membranes.
2. Premature onset of labor pain.
3. Premature birth of the baby.
4. Miscarriage (if occurs in second trimester).
Incompetentos:
A defect in the muscular ring at the isthmus of the uterus, allowing premature dilation of the cervix during pregnancy.
Or
A uterine cervix that cannot maintain a diameter small enough to support the increasing weight o f the fetus. This conditionusually results in early second trimester abortion.
Causes of incompetemtos:
1. Previous surgery on the cervix.
2. Damage during a difficult birth.
3. Malformed cervix or uterus from a birth defect.
4. Previous trauma to the cervix, such as a D&C (dilation and curettage) from a termination or a miscarriage.
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