Incompetent Cervix

Modifiable factors miscarriage/abortion mothers taking DES forced D & C cervical trauma exposure to DES / certain drugs coitus during pregnancy

Non-Modifiable Factor pregnant women history of miscarriages in previous pregnancies physical cervical abnormalities cervical birth defects congenitally short cervix uterine anomalies hormonal influences Hx of 2nd trimester losses

Defective cervix spontaneously dilates

Have Less elastin both morphologically and biochemically when compared with normal cervix
Contractions are absent

Continuous cervical dilation

Signs and symptoms

Reproductive vaginal spotting increased discharge gush of warm liquid from the vagina mucous like vaginal discharge menstrual like cramping bloody discharge feeling of a lump in the vagina

Musculoskeletal backache feeling some heaviness in pelvis

GI discomfort or pressure in the lower abdomen

Nursing management
Provide client and family teaching. Describe problems that must be reported immediately. Maintain an environment to preserve the integrity of the pregnancy. a. Prepare for cervical cerclage, if appropriate. b. Maintain activity restrictions as prescribed. c. Discuss the need for vaginal rest. Prepare for the birth if membranes are ruptured. Address emotional and psychosocial needs. Assess complaints of vaginal drainage and investigate history of previous cervical surgeries.

Drug:
Diethylstilbestrol (DES) Category X

D end