Cervical insufficiency is a condition where the cervix begins to open too early during pregnancy, sometimes without any noticeable contractions or pain. It typically occurs in the second trimester and can lead to preterm birth or pregnancy loss if it is not identified and managed in time. The condition is also sometimes referred to as an incompetent cervix, though many providers have moved away from that term because it can feel discouraging to patients.
The cervix normally stays firm and closed throughout most of pregnancy, gradually softening and opening only as labor approaches. With cervical insufficiency, that process happens much sooner than it should. Understanding the condition and knowing your risk factors can help you and your care team take steps to protect your pregnancy.
How Is Cervical Insufficiency Detected?
One of the most reliable ways to identify cervical insufficiency is through cervical length screening, which is done using a transvaginal ultrasound. During this quick and painless exam, your provider measures the length of your cervix. A cervix that measures shorter than expected for your stage of pregnancy may be a sign that it is beginning to open or thin out too early.
Cervical length screenings are usually performed between 16 and 24 weeks of pregnancy. For patients with known risk factors, these screenings may happen on a regular schedule so that changes can be caught early. Tracking cervical length over time gives your maternal-fetal medicine team important information about whether intervention is needed.
Who Is at Risk?
Certain factors can increase your chances of developing cervical insufficiency. Women who have experienced a prior second-trimester pregnancy loss or an early preterm birth are among those at the highest risk. A history of cervical procedures, such as a Loop Electrosurgical Excision Procedure (LEEP) or cone biopsy, can also weaken the cervix over time.
