Incompetent Cervix Nursing Care Plan & Management


  1. Incompetent cervix is characterized by a painless dilation of the cervical os without contractions of the uterus.
  2. Incompetent cervix commonly occurs at about the 20th week of pregnancy.
  1. History of traumatic birth
  2. Repeated dilation and curettage
  3. Client’s mother treated with diethylstilbestrol (DES) when pregnant with the client
  4. Congenitally short cervix
  5. Uterine anomalies
  6. Unknown etiology
  • Connective tissue structure of the cervix is not strong enough to maintain closure of the cervical os during pregnancy.
Assessment findings

1. Associated findings

  1. History of cervical trauma
  2. History of repeated, spontaneous, second trimester terminations
  3. Possibly spontaneous rupture of the membranes

2. A common clinical manifestation is appreciable cervical dilation with prolapsed of the membranes through the cervix without contractions.

Nursing Management

1. Provide client and family teaching. Describe problems that must be reported immediately (ie,pink-tinged vaginal discharge, increased pelvic pressure, and rupture of the membranes).

2. Maintain an environment to preserve the integrity of the pregnancy.

  1. Prepare for cervical cerclage, if appropriate.
    Maintain activity restrictions as prescribed.
    c. Discuss the need for vaginal rest (ie, no intercourse or orgasm)

3. Prepare for the birth if membranes are ruptured.

4. Address emotional and psychosocial needs.


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Nursing Care Plan

Premature Dilation of the Cervix Nursing Care Plans

Risk for Disturbed Maternal-Fetal Dyad

Risk for Disturbed Maternal-Fetal Dyad: At risk for disruption of maternal-fetal dyad as a result of a comorbid or pregnancy-related conditions.

Related to:
  • Complication of pregnancy (e.g. premature dilation of cervix)
  • Physical or substance abuse
  • Treatment-related side effects (e.g. medications)
Possibly evidenced by:
  • Painless bleeding
  • Rupture of membranes
  • Uterine contractions
  • Increased pelvic pressure
Risk factors:
  • Increased maternal age
  • Congenital structural defects
  • Trauma to the cervix
Desired outcomes:
  • Patient will verbalize understanding of individual risk factors or conditions that may impact pregnancy.
  • Patient will engage in necessary alterations in lifestyle and daily activities to manage risks.
  • Patient will identify signs and symptoms requiring medical intervention or evaluation.
  • Patient will display fetal growth within normal limits and carry pregnancy to term.
Nursing InterventionsRationale
Review history of previous pregnancies.To check for presence of complications.
Obtain history about prenatal screening and amount and timing of care.Lack of prenatal care can place both mother and fetus at risk.
Note conditions potentiating the condition.may directly affect uteroplacental circulation and gas exchange.
Note maternal age.Maternal age above 35 years old is associated with increased risks. In pregnant adolescents, the most common high risk conditions include preterm delivery.
Investigate current home situation.May have history of unstable relationship or inadequate/lack of housing that affects safety as well as general well being.
Provide information and assist in ultrasonography as indicated.Detects presence of complications that may affect pregnancy.
Screen for abuse during pregnancy.Prenatal abuse is correlated with preterm delivery and premature dilation of cervix.
Instruct client in reportable symptoms and monitor for unusual symptoms at each prenatal visit.Provides opportunity for early intervention in event of developing complications.
Facilitate positive adaptation to situation through active listening, acceptance and problem solving.Helps in successful accomplishment of the psychological tasks of pregnancy.
Review medication regimen.Prepregnancy treatment for maternal conditions may require alteration for maternal and fetal safety.
Encourage modified or complete bed rest as indicated.Activity level may need modification, depending on symptoms of uterine activity and cervical changes.
Emphasize normalcy of pregnancy, focus on pregnancy milestones, “countdown to birth”.Promotes sense of hope that modifications or restrictions serve a worthwhile purpose.
Discuss implications of preexisting condition and possible impact on pregnancy.Pregnancy may have no effect, or may reduce or exacerbate severity of symptoms of chronic conditions.

Deficient Knowledge

May be related to
  • Lack of exposure and/or recall
  • Misinterpretation of information
Possibly evidenced by
  • Questioning
  • Request for information
  • Statement of misconception
  • Inappropriate or exaggerated behaviors
Desired Outcomes
  • Verbalize understanding of her own circumstances and treatment
  • Demonstrate self-care behavior to maintain pregnancy