smear test. Only women who have symp-
toms need treatment. Abnormal tissue
may be destroyed using cauterization,
cryosurgery, diathermy, or laser treatment.
cervical incompetence Abnormal weak-
ness of the cervixthat can result in
recurrent miscarriages. An incompetent
cervix may gradually widen under the
weight of the fetus from about the 12th
week of pregnancy onwards, or may sud-
denly open during the second trimester.
The condition is detected by an internal
examination or by ultrasound scanning.
Treatment is with a suture (stitch)
applied like a purse string around the
cervix during the 4th month of pregnan-
cy. The suture is left in position until
the pregnancy is at or near full term and
is then cut to allow the mother to deliv-
er the baby normally.
cervical intraepithelial neoplasia Also
known as CIN, abnormalities in the cells
of the cervix which may become cancer-
ous. The CIN grading system is used to
distinguish levels of change in the sur-
face cells of the cervix in biopsy samples
taken during colposcopy, a procedure us-
ually performed following an abnormal
cervical smear test. Grades CIN 1–3 broad-
ly correspond to mild to severe cervical
dysplasiain cells obtained from a smear.
cervical mucus methodA form of
contraception based on identifying
periods for abstinence from intercourse
according to the changes in the mucus
secreted by a woman’s cervix(seecon-
traception, natural methods of).
cervical osteoarthritisA degenerative
disorder, also known as cervical spon-
dylitis, that affects the joints between
the cervical vertebrae(bones in the neck).
Cervical osteoarthritis mainly affects
middle-aged and elderly people, but
occasionally the degeneration begins
earlier due to an injury.
Symptoms of cervical osteoarthritis
may include pain and stiffness in the
neck, pain in the arms and shoulders,
numbness and tingling in the hands,
and a weak grip. Other symptoms such
as dizziness, unsteadiness, and double
vision when turning the head may also
occur. Rarely, pressure on the spinal
cord can cause weakness or paralysis in
the legs and loss of bladder control.
Treatments include heat treatmentand
analgesics. Physiotherapymay improve
neck posture and movement. Pressure
on the spinal cord may be relieved by
surgery (see decompression, spinal canal).
cervical ribA congenitalabnormality in
which the lowest of the 7 cervical verte-
brae(neck bones) has overdeveloped to
form an extra ribparallel to and above
the 1st normal rib. Symptoms may occur
if the rib begins to press on the lower
brachial plexus (the group of nerves
passing from the spinal cord into the
arm), causing pain, numbness, and pins-
and-needles in the forearm and hand.
Exercises to strengthen the shoulder
muscles and improve posture may bring
relief. Severe or persistent symptoms
may require surgery to remove the rib.
cervical smear testA test to detect
cervical dysplasia(abnormal changes in
the cells of the cervix) that could devel-
op into cervical cancer (see cervix, cancer
of). A smear test also detects viral infec-
tions of the cervix, such as herpes
simplexand papilloma (see warts, geni-
tal). The test should be carried out 6
months after a woman starts to have
sexual intercourse, with a repeat test 6–12
months later, and then every 3 years.
A sample of cells is taken from the
surface of the cervix using a spatula and
examined under a microscope. If cells
appear normal, nothing further needs to
be done. If cells show dysplasia, further
investigations may be required.
cervical spondylosisAn alternative
name for cervical osteoarthritis.
cervicitisInflammation of the cervix,
usually due to an infection, such as gon-
orrhoea,chlamydial infections, or genital
herpes (see herpes, genital). Cervical
infection may follow injury to the cervix
during childbirth or surgery. The acute
form of cervicitis often does not pro-
duce symptoms, although there may be
a discharge from the inflamed cervix.
The chronic form may produce a vaginal
discharge, irregular bleeding from the
vagina, and pain low in the abdomen.
Untreated cervicitis can spread to cause
endometritis, salpingitis, or pelvic inflam-
matory disease. If cervicitis is present in
the mother, her baby may be infected
during delivery resulting in neonatalCERVICAL INCOMPETENCE CERVICITIS
C