Cervical Incompetence Treatment Bangalore
Cervical incompetence (also called cervical insufficiency) is a condition in which the cervix — the lower part of the uterus — is too weak to remain closed during pregnancy, leading to premature dilation, pregnancy loss, or very preterm birth. At Aikya Fertility, we diagnose this silent yet serious condition early and offer evidence-based interventions, including Cervical Cerclage, to give your pregnancy the best chance of going full term.
About This Treatment
What you need to know
What Is Cervical Incompetence?
Under normal circumstances, the cervix stays firmly closed throughout pregnancy, only softening and dilating when labour begins. In cervical incompetence, the cervix begins to shorten and open silently — often without any pain or contractions — typically during the second trimester (14–24 weeks). This painless dilation increases the risk of pregnancy loss or extremely premature delivery. Women who have experienced recurrent second-trimester losses, a previous preterm birth, or have a structurally short cervix identified on ultrasound are at highest risk.
Causes & Risk Factors
Cervical insufficiency can be congenital (present from birth) or acquired. Common contributing factors include:
- Previous cervical surgeries such as LLETZ, cone biopsy, or repeated dilatation and curettage (D&C)
- Trauma to the cervix during a previous difficult delivery
- Congenital uterine anomalies, including a Septate or Bicornuate Uterus
- Exposure to DES (diethylstilboestrol) in utero
- Multiple prior pregnancy terminations
- Connective tissue disorders such as Ehlers-Danlos syndrome
How Aikya Diagnoses Cervical Incompetence
Diagnosis is primarily clinical and sonographic. Our specialists use transvaginal ultrasound (TVU) to measure cervical length precisely. A cervical length of less than 25 mm before 24 weeks is considered short and warrants careful management. We also review your obstetric history in detail, as a prior painless mid-trimester loss is itself a strong diagnostic indicator. Where necessary, a Diagnostic Hysteroscopy may be performed to rule out concurrent uterine anomalies.
Treatment Options at Aikya
1. Cervical Cerclage (Stitch Procedure)
Cervical cerclage is the gold-standard surgical treatment. A strong suture is placed around the cervix — usually between 12 and 14 weeks of pregnancy — to keep it closed until your baby is ready for delivery. At Aikya, we perform two main types:
- McDonald Cerclage: A purse-string suture placed vaginally around the upper cervix. Removed at 36–37 weeks to allow labour to proceed.
- Shirodkar Cerclage: A technique that places the suture higher up the cervix for a more secure closure, suitable for women with a very short or previously operated cervix.
In selected cases where transvaginal cerclage has failed or cannot be placed adequately, we offer Transabdominal Cerclage (TAC), performed laparoscopically for minimal invasiveness at our Facilities.
2. Progesterone Supplementation
Vaginal micronised progesterone is the first-line preventive treatment for women with a short cervix detected on ultrasound who have no prior preterm birth. It helps stabilise the cervix and reduce uterine contractility. Our team integrates progesterone therapy with other treatments under a personalised protocol.
3. Arabin Pessary
A cervical pessary is a silicone ring device placed non-surgically around the cervix to redistribute the weight of the pregnancy away from the internal os. It is an option for women who prefer to avoid surgery or in whom cerclage is technically difficult.
4. Intensive Ultrasound Surveillance
For women at moderate risk, serial transvaginal ultrasound scans every 1–2 weeks between 16 and 24 weeks allow us to monitor cervical length trends and intervene at the optimal moment. This "watch and act" approach is integrated with our High-Risk Pregnancy management protocol.
Why Choose Aikya for Cervical Incompetence in Bangalore?
- Early Detection: Routine cervical length screening for all at-risk patients from the first trimester.
- Surgical Expertise: Experienced laparoscopic and reproductive surgeons proficient in all cerclage techniques.
- Integrated Care: Seamless collaboration between our fertility specialists, maternal-foetal medicine team, and Neonatology unit.
- Personalised Protocols: Every management plan is tailored to your cervical length, obstetric history, and gestational age.
- Compassionate Support: Recurrent pregnancy loss is emotionally devastating. Our counselling team at Aikya provides dedicated psychological support throughout your journey.
Treatment Process
Step-by-step journey to better health
Detailed History & Risk Assessment
A thorough review of your obstetric history, previous surgeries, and pregnancy losses to identify risk factors for cervical insufficiency.
Transvaginal Ultrasound (TVU)
Precise measurement of cervical length to confirm diagnosis and determine the degree of insufficiency.
Personalised Management Plan
Selection of the most appropriate intervention — progesterone, pessary, or cerclage — based on your individual clinical profile and gestational age.
Procedure / Treatment Initiation
Cervical cerclage is performed under regional anaesthesia as a day-care procedure, typically between 12 and 14 weeks. Progesterone or pessary therapy begins immediately if indicated.
Close Pregnancy Surveillance
Regular transvaginal scans, activity modifications, and coordination with our High-Risk Pregnancy team until delivery.
Stitch Removal & Delivery Planning
The cerclage suture is removed at 36–37 weeks to allow natural labour, or earlier if premature labour begins. A detailed birth plan is finalised in advance.
Key Benefits
Why patients choose Aikya for cervical incompetence care
Who Should Consider This?
Is this treatment right for you?
You may benefit from cervical incompetence evaluation and treatment if you have:
- A history of one or more painless second-trimester pregnancy losses
- A previous spontaneous preterm birth before 34 weeks
- A short cervical length (<25 mm) detected on routine ultrasound
- Prior cervical surgeries (cone biopsy, LLETZ, repeated D&C)
- A known uterine anomaly such as a septate or bicornuate uterus
- An IVF pregnancy with a multiple gestation (twins or more), which places additional mechanical load on the cervix
Important Considerations
What to discuss with your doctor
Please consult our specialists to understand how these considerations apply to your individual case.
- Infection Risk (Chorioamnionitis): Any procedure that involves the cervix carries a small risk of ascending infection. Strict sterile technique and prophylactic antibiotics are used to minimise this.
- Premature Rupture of Membranes (PROM): Cerclage placement in the presence of exposed membranes carries a higher risk of PROM. Timing of the procedure is therefore critical.
- Cervical Dystocia: In rare cases the cerclage suture may not be easy to remove, potentially requiring medical assistance during labour. Our team plans for this in advance.
- Not a Universal Cure: Cerclage is most effective when placed before significant dilation occurs. Women with severe incompetence or advanced dilation at presentation have a more guarded prognosis.
- Bed Rest & Activity Restriction: Following cerclage, reduced physical activity and pelvic rest are typically recommended. Our team will provide detailed personalised guidance.
Frequently Asked Questions
Answers to common questions
Preterm labour involves uterine contractions causing cervical change. Cervical incompetence is a painless, silent weakening of the cervix without contractions. The distinction matters because treatments differ — cervical incompetence is managed with cerclage or progesterone, not tocolytics.
History-indicated cerclage is placed electively between 12 and 14 weeks. Ultrasound-indicated cerclage is offered when cervical length falls below 25 mm before 24 weeks. Emergency cerclage can be attempted even with early dilation, though the success rate is lower.
Not necessarily. Vaginal (McDonald or Shirodkar) cerclage sutures are removed at 36–37 weeks, after which normal vaginal delivery is possible. Only transabdominal cerclage, which is permanent, requires delivery by caesarean section.
Yes, absolutely. With appropriate management in subsequent pregnancies — including early cerclage and progesterone — many women with cervical incompetence go on to have successful, full-term pregnancies. Our team will prepare a detailed pre-conception plan for you.
You can schedule your consultation via our Online Appointment portal or visit our J.P. Nagar or Raghuvanahalli branches directly.