Incompetent cervix is a common cause of premature birth and birth injuries, like cerebral palsy, that are associated with prematurity. Birth injuries are a common source of medical malpractice claims in Ohio. A recent study shows that a pessary, a therapeutic device that supports the structures of the birth canal, can effectively prevent many premature births. The use of a pessary was far more effective than bedrest as an intervention. Interestingly, the study’s authors were unable to reach a clear conclusion as to why the pessary worked.
The British medical journal Lancet reported the study results here: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60030-0/fulltext. Currently, the use of a cervical cerclage (also called a “stitch”) is most commonly used to protect women with a short or incompetent cervix from premature delivery.
Premature or preterm birth, has many potential causes, but a shortened cervix is recognized as the strongest predictor of preterm delivery. A short cervix can result from a cone biopsy, when a portion of the cervix is amputated for treatment or testing purposes, or as a normal anatomic variation. Shortened cervices can be identified using ultrasound as part of routine prenatal care. Precautionary treatment of a short cervix is important since prematurity is associated with numerous devastating complications of birth, including cerebral palsy, mental retardation, blindness, deafness and respiratory problems.
Birth injury is a devastating occurrence. The lifetime costs associated with treating children with certain birth-related injuries can be tens of millions of dollars, depending on the type and severity of the injury. As such, preventative measures, when available, must be undertaken to protect against such catastrophic outcomes.