Cervical Incompetence and Cervical Stenosis
Cervical incompetence and cervical stenosis are conditions affecting the cervix that can lead to significant reproductive and gynaecological challenges.
Cervical incompetence occurs when the cervix weakens and opens prematurely, increasing the risk of miscarriage or preterm birth. Conversely, cervical stenosis, characterized by the narrowing of the cervical canal, can result in menstrual irregularities, infertility, or complications during pregnancy and childbirth.
For patients seeking cervical incompetence and cervical stenosis treatment in Dubai, Dr Ibrahim Abd Elrahman offers expert care. His personalized treatment plans include advanced surgical interventions and minimally invasive procedures, ensuring optimal outcomes for every patient.
Understanding Cervical Incompetence: Causes & Symptoms
Before pregnancy, the cervix is naturally closed and firm. As the due date approaches, the cervix undergoes changes—it softens, shortens (effaces), and opens (dilates)—to allow the baby to pass through the vaginal canal during delivery.
In the case of cervical incompetence, also known as cervical insufficiency, the cervix may prematurely soften, open, or shorten before the fetus reaches a viable stage of development. This increases the risk of miscarriage and preterm birth, potentially before the baby’s organs are fully formed
Cervical Incompetence Causes
Several factors can contribute to cervical incompetence, including:
- Congenital abnormalities: Structural issues present from birth.
- Trauma to the cervix: Procedures like cervical dilation or cone biopsy, or trauma during a previous delivery.
- Hormonal imbalances: Insufficient production of progesterone can weaken cervical tissues.
- Disorders: Conditions like Ehlers-Danlos syndrome can compromise cervical strength.
Cervical Incompetence Symptoms
- A feeling of pelvic pressure
- Lower back pain or abdominal cramping
- Changes in vaginal discharge
- Light vaginal bleeding
- Premature rupture of membranes (water breaking)
Understanding Cervical Stenosis: Causes & Symptoms
Cervical stenosis refers to the narrowing or complete closure of the cervical canal, obstructing the passage between the uterus and the vaginal canal.
This narrowing or blockage not only makes pregnancy and conception more challenging but can also disrupt menstruation.
Cervical Stenosis Causes
Common causes include:
- Cancer: Cancer of the cervix or the uterus lining can cause obstruction or narrowing.
- Endometriosis or fibroids: These conditions may physically obstruct the cervical canal.
- Menopause: Hormonal changes can lead to atrophy and narrowing.
- Endometrial Ablation: Procedures that destroy or remove the lining of the uterus, performed for persistent vaginal bleeding, can lead to stenosis.
- Radiation therapy: Radiation for pelvic cancers can damage cervical tissues.
- Surgical Interventions: Surgeries involving the cervix, such as those treating precancerous changes (dysplasia), may result in scarring.
Cervical Stenosis Symptoms
- Painful periods
- Irregular periods and abnormal bleeding
- Chronic pelvic pain
- Bulging in the pelvic area
- Infertility
Diagnosis
Cervical Incompetence: An incompetent cervix can be found only during pregnancy. Diagnosis often involves a transvaginal ultrasound to assess the cervix’s length and shape. A pelvic exam may be done to check if the amniotic sac is detectable through the opening.
Cervical Stenosis: A pelvic exam and imaging tests like MRI or ultrasound can help detect the narrowing or closure of the cervical canal. A hysteroscopy may also be performed for a closer examination.
Treatment Options
Both conditions require tailored treatment plans based on severity and the patient’s reproductive goals.
Cervical Incompetence Treatment
- Cervical Cerclage: A cervical cerclage is a surgical procedure in which the cervix is stitched tightly closed to prevent premature dilation. This procedure is typically recommended for women with a history of recurrent pregnancy losses due to cervical incompetence. The procedure is often carried out vaginaly but may be performed with a higher cerclage laparoscopically.
- Progesterone Supplementation: If you have a short cervix without a history of preterm birth, progesterone supplementation can reduce the risk of early labor. Progesterone strengthens the cervix and helps maintain pregnancy.
- Repeated Ultrasounds: Women with a history of premature birth or cervical incompetence may undergo ultrasounds every 2 weeks between weeks 16 and 24 of pregnancy to monitor cervical length and allow timely intervention if needed.
- Pessary Insertion: A pessary is a medical device placed into the vagina to support the uterus and reduce pressure on the cervix.
Cervical Stenosis Treatment
- Cervical Dilation: The most common treatment for cervical stenosis is cervical dilation, in which the cervix is gradually widened using a series of instruments called dilators. These are thin, lubricated rods that come in progressively larger sizes and are inserted one by one into the cervix.
- Cervical Stent Insertion: In some cases, after dilation, a cervical stent may be inserted. This tube-like device helps keep the cervix open and prevents it from reclosing. The stent is typically left in place for about 4-6 weeks to maintain the dilation and allow for healing.
- Surgical Intervention: In more severe cases of cervical stenosis, surgical intervention may be necessary. This involves the excision of cervical tissue, which surgically removes obstructing tissue to open the cervical canal.
- Combination Treatment: In certain cases, an effective approach involves combining dilation with estrogen therapy. A common treatment involves the use of a copper intrauterine device (IUD) alongside oral contraceptives.
Contact Dr Ibrahim Abd Elraham for Cervical Incompetence and Cervical Stenosis Treatment in Dubai
Dr Ibrahim Abd Elrahman is a renowned expert in treating cervical conditions, including cervical stenosis and cervical incompetence, using advanced and personalised care. With his extensive experience and a patient-centric approach, he offers effective solutions tailored to your unique needs.
Whether you are seeking cervical stenosis treatment in Dubai, exploring fertility-preserving options, or need support during a high-risk pregnancy, he provides compassionate care in a state-of-the-art medical setting. Schedule your appointment today.
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