Dealing with the Legal Consequences of Incompetent Cervix (Cervical Insufficiency) and Medical Negligence
A healthy and smooth pregnancy, one that’s free from any form of complications, does not always happen. Sometimes, there are medical situations that may make the journey to parenthood less pleasant. Although these circumstances are beyond anyone’s control, managing these can be possible when given proper monitoring and treatment.
One example of such a medical condition is incompetent cervix. According to the American Pregnancy Association, incompetent cervix occurs in about 2% of pregnancies, affecting 1 in 100. It can affect any pregnant women, especially those in the high-risk group. Read on about incompetent cervix and what to expect from your doctor if you happen to have this condition.
What is Incompetent Cervix?
Also called cervical insufficiency, an incompetent cervix is a preterm birth syndrome characterized by the inability of the cervix to hold the fetus. The cervix is a small opening located just below the uterus and on top of the vagina. Normally, the cervix is closed and firm before pregnancy. It gradually softens, thins out, and opens up during pregnancy as the delivery date approaches.
Cervical insufficiency typically occurs during the second or third trimester of the pregnancy. During pregnancy, the weight of the fetus presses on the cervix; the pressure does not usually cause a problem. But in the case of a weakened cervix, it softens and opens up, or dilates, too soon when the baby is not ready to come out yet.
The mother would not be aware that this is already happening because it does not usually cause any pain or contractions. It can cause huge problems, with the baby being born preterm and the complications that come with it. The worst-case scenario would be a miscarriage.
Causes and Risk Determinants
Though the exact reason is unknown, a weakened cervix unable to withstand the pressure of the baby’s weight can result in cervical insufficiency. However, certain circumstances may contribute to this condition. These include:
- Having had surgery in the cervix in the past
- Having a damaged uterus from previous childbirth
- Having a short cervix
- Having had an abortion in the past
- History of pre-term delivery
- History of miscarriage
- History of multiple pregnancies (twins, triplets, etc.)
- A malformation of cervix or uterus (due to a birth defect)
- Cervical trauma from procedures, such as dilation and curettage (D&C) and Loop Electrosurgical Excision Procedure (LEEP).
- Exposure to Diethylstilbestrol (DES), a synthetic hormone that helps prevent complications during pregnancy
- Previous incompetent cervix diagnosis
- Other genetic disorders affecting the body’s connective tissues
Symptoms and Diagnosis
The thing about incompetent cervix is does not typically get checked; thus, it is not diagnosed soon enough during routine check-ups. But pregnant women may be evaluated based on their risk factors. When at risk, they can be diagnosed through lab tests, a transvaginal ultrasound, and pelvic examination. These diagnostic procedures can determine if the cervix is in its normal state.
Some pregnant women who were diagnosed with incompetent cervix reported the following:
- Mild discomfort or spotting (between 14-20 weeks of pregnancy)
- Subtle pressure in the pelvis
- Back pain that is new or different than the usual
- Mild abdominal cramps
- A sudden change in vaginal discharge
- Light vaginal bleeding
- A sensation of labor pain or contraction, but very minimal
Treatment Option and the Doctor’s Role
If the patient happens to have this condition, the next step would be to determine the best treatment option. There are different approaches to treat and manage incompetent cervix, and a medical specialist should carefully evaluate the best option for the patient. Common treatment options include:
- Progesterone Supplementation
This option entails a weekly shot of synthetic hormone called hydroxyprogesterone caproate on the second and third trimester. This progesterone hormone shot prevents the risk of pre-term birth. Patients with a medical history of premature birth usually receive this.
- Repeated Ultrasounds
Here, the doctor monitors the cervix and fetus once every two weeks, starting on the 16th week through the 24th week of the pregnancy. By closely monitoring the cervix and fetus, the doctor will be able to take precautions and immediate actions in case of dilation.
- Cervical Cerclage
Perhaps the most aggressive option, cervical cerclage is a surgical procedure wherein the cervix is stitched closed. It reinforces the cervix and allows it to bear the weight of the growing fetus.
Cervical cerclage typically uses a strong suture, but nowadays, synthetic tapes are also common. The procedure is carried out between the 14th-16th weeks of pregnancy and gets removed between 36th-38th weeks.
This new approach to treating incompetent cervix still requires further research. Pessary involves the insertion of a prosthetic device into the vaginal canal to support and minimize the pressure on the cervix.
Doctors must monitor carefully a patient suspected of cervical insufficiency. By assessing their risks and evaluating possible indications of cervical dilation, threats of preterm delivery, birth injuries, and miscarriage are preventable.
Medical practitioners should likewise to thoroughly discuss treatment options and their accompanying risks with their patients. It is their obligation to take necessary actions to prevent the complications of cervical insufficiency and to minimize the risk of birth injury in case of inevitable preterm birth.
Need Legal Help with Birth Injury Due to Preventable Cause?
In the case of preventable birth injury, you’ll need an expert birth injury lawyer to go over the facts of the case and provide legal advice. At The Clark Law Office, we have birth injury attorneys with years of experience in the field to help you. With their skills and expertise, these lawyers will carefully investigate and study your case and discuss your best legal options. Contact us now to schedule a free legal consultation.