Risk factorsBy Mayo Clinic staff
Various factors can increase your risk of an incompetent cervix. For example:
- Congenital conditions. Uterine abnormalities and genetic disorders affecting a fibrous type of protein that makes up your body's connective tissues (collagen) might cause an incompetent cervix. Exposure to diethylstilbestrol (DES), a synthetic form of the hormone estrogen, before birth also has been linked to cervical insufficiency.
- Obstetric trauma. If you experienced a cervical tear during a previous labor and delivery, you could have an incompetent cervix.
- Certain cervical procedures. Various surgical procedures — including a procedure used to take a sample of cervical tissue (cervical biopsy) and a treatment that uses an electrical current to remove diseased tissue from the cervix (loop electrosurgical excision procedure, or LEEP) — can contribute to cervical insufficiency.
- Dilation and curettage (D&C). This procedure is used to diagnose or treat various uterine conditions — such as heavy bleeding — or to clear the uterine lining after a miscarriage or abortion. It can cause structural damage to the cervix.
Limited research also suggests that black women might be at increased risk of cervical insufficiency. Further studies are needed to determine the underlying causes.
If you have an unusually short cervix, you're at increased risk of premature birth. However, many women who have a naturally short cervix deliver at term.
- Johnson JR, et al. Cervical insufficiency. http://www.uptodate.com/index. Accessed Jan. 31, 2012.
- Fox NS, et al. Cervical cerclage: A review of the evidence. Obstetrical and Gynecological Survey. 2008;63:58.
- Gabbe SG, et al. Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2007. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-443-06930-7..50027-X&isbn=978-0-443-06930-7&uniqId=301267705-3. Accessed Nov. 14, 2011.
- Annum EA, et al. Health disparities in risk for cervical insufficiency. Human Reproduction. 2010;25:2894.
- Jakobsson M, et al. Cervical intraepithelial neoplasia: Reproductive effects of treatment. http://www.uptodate.com/index. Accessed Feb. 8, 2012.
- Preterm labor. American College of Obstetricians and Gynecologists. http://www.acog.org/publications/faq/faq087.cfm. Accessed Sept. 22, 2011.
- Preterm labor and birth. National Institute of Child Health and Human Development. http://www.nichd.nih.gov/health/topics/Preterm_Labor_and_Birth.cfm. Accessed Feb. 9, 2012.
- Tita ATN. Intraamniotic infection (chorioamnionitis). http://www.uptodate.com/index. Accessed Feb. 10, 2012.
- Berghella V. Transvaginal ultrasound assessment of the cervix and prediction of spontaneous preterm birth. http://www.uptodate.com/index. Accessed Feb. 10, 2012.
- Marc I, et al. Mind-body interventions during pregnancy for preventing or treating women's anxiety (review). Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007559.pub2/abstract. Accessed Feb. 13, 2012.
- Tsekiri O'Brien E, et al. Women's views of high risk pregnancy under threat of preterm birth. Sexual and Reproductive Healthcare. 2010;1:79.
- Yang M, et al. Music therapy to relieve anxiety in pregnant women on bedrest: A randomized controlled trial. 2009;34:316.
- Frequently asked questions. Number 87. Preterm labor. American College of Obstetricians and Gynecologists. http://www.acog.org/publications/faq/faq087.cfm. Accessed Feb. 13, 2012.
- Zaichkin J. Newborn Intensive Care: What Every Parent Needs to Know. 3rd ed. Ann Arbor, Mich.: Sheridan Books; 2009:77.
- Healthy pregnancy: Staying healthy and safe. U.S. Department of Health and Human Services Office on Women's Health. http://www.womenshealth.gov/pregnancy/you-are-pregnant/staying-healthy-safe.cfm. Accessed Feb. 13, 2012.
- Norwitz ER. Prevention of spontaneous preterm birth. http://www.uptodate.com/index. Accessed Feb. 13, 2012.
- Makena (prescribing information). Bridgeton, Mo.: Ther-Rx Corp.; 2011. http://www.makena.com/media/PDFs/full-pi.pdf. Accessed Feb. 13, 2012.
- FDA approves drug to reduce risk of preterm birth in at-risk pregnant women. U.S. Food and Drug Administration. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm242234.htm. Accessed Feb. 13, 2012.
- Berghella V, et al. Patients with prior second-trimester loss: Prophylactic cerclage or serial transvaginal sonograms? American Journal of Obstetrics and Gynecology. 2002;187:747.
- Baramki TA. Hysterosalpinography. http://www.uptodate.com/index. Accessed Feb. 13, 2012.
- Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 15, 2012.