Materiały źródłowe

• #1 Incompetent Cervix: Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17912-incompetent-cervix

  Incompetent cervix occurs when your cervix opens, weakens or shortens too early in pregnancy. Its also known as cervical insufficiency. It can cause problems including miscarriage (loss of the pregnancy) and premature birth (being born before 37 weeks of pregnancy). […] If youre at risk for an incompetent cervix or your cervix shows signs of opening too soon, your pregnancy care provider may recommend preventative treatment to avoid pregnancy complications. […] Your provider diagnoses incompetent cervix with a pelvic exam and an imaging test called a transvaginal ultrasound (ultrasound using a wand inserted in the vagina). This test allows your provider to measure the length and opening of your cervix. […] The goal of treating incompetent cervix is to help you stay pregnant as long as possible. Because its hard to diagnose, knowing the risk factors are extremely important. Your provider will decide which treatment is best for you based on your condition and medical history.

• #2 Incompetent cervix – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/incompetent-cervix/symptoms-causes/syc-20373836

  An incompetent cervix happens when weak cervical tissue causes or plays a part in a premature birth or the loss of a healthy pregnancy. An incompetent cervix also is called cervical insufficiency. […] An incompetent cervix can be a hard problem to diagnose and treat. If your cervix begins to open early, or if you’ve had cervical insufficiency in the past, you might benefit from treatment. This might include having a procedure done to close the cervix with strong sutures, called a cervical cerclage. You also may take medicine to help the incompetent cervix and have ultrasound exams to check how things are going. […] Many women don’t have a known risk factor. Risk factors for an incompetent cervix include: Cervical trauma. A previous procedure or surgery on the cervix could lead to an incompetent cervix. This includes surgery to treat a cervical problem found during a Pap test. A procedure called a dilation and curettage (DC) also could be associated with an incompetent cervix. Rarely, a cervical tear during a previous labor and delivery could be a risk factor for an incompetent cervix. […] If you’ve had an incompetent cervix during one pregnancy, you’re at risk of premature birth or pregnancy loss in later pregnancies. If you’re considering getting pregnant again, talk with your doctor to understand the risks and what you can do to promote a healthy pregnancy.

• #3 Cervical insufficiency – UpToDate

  https://www.uptodate.com/contents/cervical-insufficiency

  Cervical insufficiency refers to painless cervical dilation that leads to second-trimester fetal expulsion (miscarriage or preterm birth). […] Although the diagnosis may be suspected in the first pregnancy in which it occurs, the diagnosis is confirmed when it recurs in consecutive pregnancies. […] The American College of Obstetricians and Gynecologists’ definition of cervical insufficiency is „the inability of the uterine cervix to retain a pregnancy in the second trimester in the absence of clinical contractions, labor, or both”. […] This topic will review issues related to diagnosis and management of patients with cervical insufficiency. […] Structural cervical weakness is the likely cause of cervical insufficiency. […] The weakness may be secondary to prior cervical trauma (eg, rapid mechanical cervical dilation, childbirth) […] decidual inflammation/infection, bleeding at the interface of the decidua and placenta, or uterine overdistension, which initiates biochemical changes that lead to premature cervical shortening.

• #4 Incompetent Cervix | American Pregnancy Association

  https://americanpregnancy.org/getting-pregnant/incompetent-cervix/?sw_cache=rebuild

  Incompetent cervix is not routinely checked for during pregnancy and therefore is not usually diagnosed until after a second or third-trimester miscarriage has occurred. […] Diagnosis can be made by your physician though a pelvic exam or by an ultrasound. The ultrasound would be used to measure the cervical opening or the length of the cervix. […] An incompetent or weakened cervix happens in about 1-2% of pregnancies. Almost 25% of babies miscarried in the second trimester are due to incompetent cervix. […] The treatment for an incompetent or weakened cervix is a procedure that sews the cervix closed to reinforce the weak cervix. This procedure is called a cerclage and is usually performed between week 14-16 of pregnancy.

• #5 Cervical Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525954/

  A shortened cervix is typically defined as a cervical length of less than 25 mm in patients undergoing serial screening ultrasounds. […] Before placing a cerclage, an obstetric ultrasound should be performed to ensure fetal viability, confirm the gestational age and cervical length, and exclude clinically relevant structural anomalies. […] The primary treatment options for cervical insufficiency include cerclage placement and vaginal progesterone. […] A cerclage is a nonresorbable suture placed around the cervix to improve mechanical strength and prevent premature dilation. […] Cervical insufficiency complicates up to 1% of pregnancies in the general population. […] Adverse outcomes associated with cervical insufficiency are primarily related to the effects of preterm birth.

• #6 Complexities of Pregnancy and Childbirth with an Incompetent Cervix

  https://pediatricmalpracticeguide.com/complexities-of-pregnancy-and-childbirth-with-an-incompetent-cervix/

  The strength and density of this muscular barrier are crucial in keeping a fetus safely inside the uterus, where it is nourished and protected. […] When it opens before 40 weeks gestation, the baby may be born premature or the pregnancy may end in miscarriage, depending on when an incompetent cervix opens. […] Roughly one-fourth of miscarriages result from an incompetent cervix. Overall, about 1 in 100 pregnant women have cervical incompetency. […] A diagnosis is more likely from a patients medical history. […] A treating physician should check for an incompetent cervix before 24 weeks and monitor the patient carefully. […] If a healthcare provider neglects to review a patients history, monitor them when their history reveals risk factors for cervical issues, or medically treat the condition when appropriate with hormones, surgery, or both, they may be deemed negligent and ultimately held legally responsible for the patients damages.

• #7 Cervical Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525954/

  Cervical insufficiency is the inability of the cervix to retain the fetus in the absence of uterine contractions (ie, painless cervical dilatation) due to a functional or structural cervical defect. […] Diagnosis can be based on physical exam findings (painless dilation without labor), a history of second-trimester losses or preterm births, or ultrasound evidence of a shortened cervix (25 mm) before 24 weeks gestation. […] Diagnosis is based on physical examination, clinical history, or ultrasonographic findings, and treatment options include cerclage and vaginal progesterone. […] The diagnosis of cervical insufficiency is typically made in one of the following scenarios: […] Exam-based diagnosis: Painless dilation in the second or early third trimester in the absence of contractions or other clear pathologies such as bleeding, PPROM, infection, or placental abruption.

• #8 Cervical incompetence – Miracle Babies

  https://www.miraclebabies.org.au/content/cervical-incompetence/gm41js

  The diagnosis and management of cervical incompetence is usually managed by an obstetrician. […] The diagnosis of incompetent cervix is usually made in three different settings: Women who present with a sudden onset of symptoms and signs of cervical insufficiency. […] Women who present with a history of second-trimester losses consistent with the diagnosis of cervical incompetence (history-based). […] Women with endovaginal ultrasound findings consistent with cervical incompetence (ultrasound diagnosis).

• #9 Cervical Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525954/

  Cervical insufficiency is the inability of the cervix to retain the fetus in the absence of uterine contractions (ie, painless cervical dilatation) due to a functional or structural cervical defect. […] Diagnosis can be based on physical exam findings (painless dilation without labor), a history of second-trimester losses or preterm births, or ultrasound evidence of a shortened cervix (25 mm) before 24 weeks gestation. […] Diagnosis is based on physical examination, clinical history, or ultrasonographic findings, and treatment options include cerclage and vaginal progesterone. […] The diagnosis of cervical insufficiency is typically made in one of the following scenarios: […] Exam-based diagnosis: Painless dilation in the second or early third trimester in the absence of contractions or other clear pathologies such as bleeding, PPROM, infection, or placental abruption.

• #10 Cervical Insufficiency: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1979914-overview

  Cervical insufficiency (cervical incompetence) is defined by the American College of Obstetricians and Gynecologists (ACOG) as the inability of the uterine cervix to retain a pregnancy in the second trimester, in the absence of uterine contractions. It typically presents as acute, painless dilatation of the cervix, which can lead to a midtrimester pregnancy loss. In women with this history, the risk of recurrence in a subsequent pregnancy is less than 30%. […] The diagnosis of cervical insufficiency is primarily based on a history of a previous midtrimester pregnancy loss, which can present with the following: Painless cervical dilatation and bulging fetal membranes upon presentation in the second trimester of pregnancy. […] In women without a history of pregnancy loss, the diagnosis of cervical insufficiency is based on a combination of the following: Clinical presentation, Physical examination, Ultrasonographic findings.

• #11 Cervical Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525954/

  History-based diagnosis: Patients with a clinical history consistent with cervical insufficiency, which includes a history of at least 1 to 3 consecutive second-trimester losses or early preterm births related to painless cervical dilation (definitions vary slightly by organization) and patients with a history of a prior exam-indicated cerclage. […] Ultrasound-based diagnosis: Patients with a history of at least 1 preterm birth or second-trimester loss AND a shortened cervical length before 24 weeks EGA in the current pregnancy. […] Cervical insufficiency is a well-recognized cause of second-trimester fetal loss and early preterm birth, and the diagnosis is often made retrospectively. […] Screening is typically performed via transvaginal sonography every 1 to 2 weeks between 16 and 24 weeks gestation.

• #12 Incompetent Cervix: symptoms – The fertility center mexico

  https://thefertilitycentermexico.com/en/blog/incompetent-cervix-symptoms-diagnosis-and-treatment/

  Incompetent cervix treatments range from non-invasive to invasive. Your specialist will determine what options are best for you. Together, you will create a treatment plan that will work best for you. […] Diagnosing an incompetent cervix only happens during pregnancy. It is essential in your initial intake to share with your obstetrician your complete medical history. They will need to know if you have had any procedures involving your cervix, if you have lost a pregnancy in the second trimester, or if you delivered a baby before the 42nd week. There is no specific test for cervical insufficiency, but your doctor can do an MRI or ultrasound to determine a congenital issue with your cervix. […] Diagnosing an incompetent cervix starts with a pelvic exam. Your doctor will check to see if the wall of the amniotic sac surrounding the fetus has prolapsed (fallen into your cervical canal or vagina.) This is known as prolapsed fetal membranes. When this happens, your cervix is beginning to open.

• #13 Cervical Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525954/

  History-based diagnosis: Patients with a clinical history consistent with cervical insufficiency, which includes a history of at least 1 to 3 consecutive second-trimester losses or early preterm births related to painless cervical dilation (definitions vary slightly by organization) and patients with a history of a prior exam-indicated cerclage. […] Ultrasound-based diagnosis: Patients with a history of at least 1 preterm birth or second-trimester loss AND a shortened cervical length before 24 weeks EGA in the current pregnancy. […] Cervical insufficiency is a well-recognized cause of second-trimester fetal loss and early preterm birth, and the diagnosis is often made retrospectively. […] Screening is typically performed via transvaginal sonography every 1 to 2 weeks between 16 and 24 weeks gestation.

• #14 Cervical Incompetence Imaging: Practice Essentials, Magnetic Resonance Imaging, Ultrasonography

  https://emedicine.medscape.com/article/402598-overview

  The diagnosis is usually based on the patient’s history and findings from physical examination, with the aid of ultrasonography. […] In patients at risk for pregnancy loss, placement of cervical cerclages in response to ultrasound-detected shortening of the endocervical canal is an acceptable alternative to elective cerclage. […] The Society for Maternal-Fetal Medicine recommends that routine transvaginal cervical length screening be performed for women with singleton pregnancy and history of prior spontaneous preterm birth and that routine transvaginal cervical length screening not be performed for women with cervical cerclage, multiple gestation, preterm premature rupture of membranes, or placenta previa. […] Ultrasonographic features of cervical incompetence may be summarized as follows: Cervical effacement, dilatation, or shortening in the absence of labor in the second trimester; Funneling of the cervix with changes in the forms of T, Y, V, or U; Shortened cervical length in association with a gaping internal os; Membranes protruding into the endocervical canal; Fetal parts in the cervix or vagina.

• #15 Incompetent Cervix: Symptoms, Causes, Diagnosis & Treatment | Women’s Health Partners

  https://www.toplinemd.com/myobgynoffice/incompetent-cervix-symptoms-causes-diagnosis-treatment/

  Cervical insufficiency, or incompetent cervix diagnosis, is a condition that arises from the cervical tissue being weak and causing a premature birth of the baby or a loss of pregnancy. […] When you are diagnosed with cervical insufficiency, the cervix becomes too soft too soon and begins to open causing premature births. […] Since this condition is not easily discovered, a doctor usually has to perform a pelvic exam and an ultrasound to establish an incompetent cervix diagnosis. A test called transvaginal ultrasound is primarily used in these cases, which helps the doctor measure the length and opening of the cervix by using a wand inserted into the vagina. […] Although it is not easy to diagnose and there are really not many ways of treating cervical insufficiency, we want to note that the success rate of the cerclage treatment is over 90%. One in every 100 pregnant women is diagnosed with this condition.

• #16 Incompetent Cervix: Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17912-incompetent-cervix

  Incompetent cervix occurs when your cervix opens, weakens or shortens too early in pregnancy. Its also known as cervical insufficiency. It can cause problems including miscarriage (loss of the pregnancy) and premature birth (being born before 37 weeks of pregnancy). […] If youre at risk for an incompetent cervix or your cervix shows signs of opening too soon, your pregnancy care provider may recommend preventative treatment to avoid pregnancy complications. […] Your provider diagnoses incompetent cervix with a pelvic exam and an imaging test called a transvaginal ultrasound (ultrasound using a wand inserted in the vagina). This test allows your provider to measure the length and opening of your cervix. […] The goal of treating incompetent cervix is to help you stay pregnant as long as possible. Because its hard to diagnose, knowing the risk factors are extremely important. Your provider will decide which treatment is best for you based on your condition and medical history.

• #17 Incompetent Cervix: symptoms – The fertility center mexico

  https://thefertilitycentermexico.com/en/blog/incompetent-cervix-symptoms-diagnosis-and-treatment/

  Incompetent cervix treatments range from non-invasive to invasive. Your specialist will determine what options are best for you. Together, you will create a treatment plan that will work best for you. […] Diagnosing an incompetent cervix only happens during pregnancy. It is essential in your initial intake to share with your obstetrician your complete medical history. They will need to know if you have had any procedures involving your cervix, if you have lost a pregnancy in the second trimester, or if you delivered a baby before the 42nd week. There is no specific test for cervical insufficiency, but your doctor can do an MRI or ultrasound to determine a congenital issue with your cervix. […] Diagnosing an incompetent cervix starts with a pelvic exam. Your doctor will check to see if the wall of the amniotic sac surrounding the fetus has prolapsed (fallen into your cervical canal or vagina.) This is known as prolapsed fetal membranes. When this happens, your cervix is beginning to open.

• #18 Signs and Symptoms of Incompetent Cervix | ABC Law Centers: Birth Injury Lawyers

  https://www.abclawcenters.com/practice-areas/premature-birth-and-prevention/incompetent-cervix/

  During the second or third trimester, a pelvic exam can reveal signs of incompetent cervix. Changes to the cervix like early dilation, shortening, and thinning of the cervix would indicate a weak cervix. […] The physician should order serial transvaginal ultrasound studies (TVS) for anyone with risk factors for cervical incompetence. Transvaginal ultrasounds can help monitor the cervical length and determine if the cervix is shortening or opening.

• #19 Cervical Incompetence Imaging: Practice Essentials, Magnetic Resonance Imaging, Ultrasonography

  https://emedicine.medscape.com/article/402598-overview

  The diagnosis is usually based on the patient’s history and findings from physical examination, with the aid of ultrasonography. […] In patients at risk for pregnancy loss, placement of cervical cerclages in response to ultrasound-detected shortening of the endocervical canal is an acceptable alternative to elective cerclage. […] The Society for Maternal-Fetal Medicine recommends that routine transvaginal cervical length screening be performed for women with singleton pregnancy and history of prior spontaneous preterm birth and that routine transvaginal cervical length screening not be performed for women with cervical cerclage, multiple gestation, preterm premature rupture of membranes, or placenta previa. […] Ultrasonographic features of cervical incompetence may be summarized as follows: Cervical effacement, dilatation, or shortening in the absence of labor in the second trimester; Funneling of the cervix with changes in the forms of T, Y, V, or U; Shortened cervical length in association with a gaping internal os; Membranes protruding into the endocervical canal; Fetal parts in the cervix or vagina.

• #20 Incompetent Cervix: Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17912-incompetent-cervix

  Incompetent cervix occurs when your cervix opens, weakens or shortens too early in pregnancy. Its also known as cervical insufficiency. It can cause problems including miscarriage (loss of the pregnancy) and premature birth (being born before 37 weeks of pregnancy). […] If youre at risk for an incompetent cervix or your cervix shows signs of opening too soon, your pregnancy care provider may recommend preventative treatment to avoid pregnancy complications. […] Your provider diagnoses incompetent cervix with a pelvic exam and an imaging test called a transvaginal ultrasound (ultrasound using a wand inserted in the vagina). This test allows your provider to measure the length and opening of your cervix. […] The goal of treating incompetent cervix is to help you stay pregnant as long as possible. Because its hard to diagnose, knowing the risk factors are extremely important. Your provider will decide which treatment is best for you based on your condition and medical history.

• #21 Incompetent Cervix: symptoms – The fertility center mexico

  https://thefertilitycentermexico.com/en/blog/incompetent-cervix-symptoms-diagnosis-and-treatment/

  Your doctor will do an amniocentesis. During the amniocentesis, a needle will be inserted through the abdomen into the uterus to retrieve a sample of the amniotic fluid. Once the fluid is removed, it can be tested for infection. The doctor will also do a transvaginal ultrasound to get a good image of your cervix. The use of a transducer, which resembles a wand or thick round stick, is inserted into your vagina. It bounces sound off your cervix, creating a picture on the monitor, allowing the doctor to see how long your cervix is and if there is any prolapsed tissue.

• #22 Incompetent Cervix: What Causes It, and How It’s Treated

  https://www.webmd.com/women/what-is-incompetent-cervix

  An incompetent cervix is a condition where your cervix opens too early during pregnancy. It’s also called cervical insufficiency. This can cause you to have a miscarriage or to give birth too early. If your doctor knows you have an incompetent cervix, it can be treated early in your pregnancy. […] It can be difficult to diagnose an incompetent cervix. There are no tests that can diagnose it before pregnancy. Some tests, such as magnetic resonance imaging (MRI) or ultrasound, can be used to diagnose an abnormality that can cause an incompetent cervix before you get pregnant. […] Your doctor may diagnose you with an incompetent cervix if you have a history of delivering during your second trimester, or if your cervix opens and thins before you’re 24 weeks pregnant. […] Some tests your doctor may do to help diagnose an incompetent cervix include: Transvaginal ultrasound. Your health care provider may use this test to see if your membranes are protruding from your cervix. […] Your doctor may do an amniocentesis to see if you have an infection. […] Your health care provider may do a pelvic exam to see if your membranes are protruding from your cervix. If so, you may have an incompetent cervix.

• #23 Cervical incompetence | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/cervical-incompetence?lang=us

  Cervical incompetence refers to a painless spontaneous dilatation of the cervix and is a common cause of second trimester pregnancy failure. […] Typically cervical incompetence manifests in the second trimester. Patients at high risk for preterm delivery include those with: idiopathic (most common), uterine anomalies, exposure to diethylstilbestrol (DES), previous cervical trauma or surgery, previous recurrent spontaneous or therapeutic abortion, previous premature delivery, multifetal pregnancy, connective tissue disorder (Ehlers-Danlos syndrome). […] Clinical tests include fetal fibronectin (fFN) test on vaginal mucus: needs to be done before trans-vaginal scanning is attempted. […] Transvaginal scanning is required. The opening of the cervical os at rest or in response to fundal pressure is considered an early feature of cervical incompetence.

• #24 Cervical Insufficiency: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1979914-overview

  Although the diagnosis of cervical insufficiency may be based on a history of midtrimester pregnancy loss, the following measures may also be useful: Ultrasonographic transvaginal measurement of cervical length Cervical length has a strong inverse correlation with the risk of spontaneous preterm birth, particularly in women with a history of preterm delivery. […] Fetal fibronectin (fFN) testing Studies have demonstrated the utility of fFN testing in addition to cervical length assessment, with a significant improvement in the prediction of preterm delivery in women with a positive fFN and a cervical length of less than 30 mm. […] According to a practice bulletin from the ACOG concerning the management of cervical insufficiency, cervical cerclage, in which a stitch is placed at the cervicovaginal junction, may benefit women with a history of cervical insufficiency or painless cervical dilatation in the second trimester on physical examination.

• #25 Cervical Insufficiency: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1979914-overview

  Cervical insufficiency (cervical incompetence) is defined by the American College of Obstetricians and Gynecologists (ACOG) as the inability of the uterine cervix to retain a pregnancy in the second trimester, in the absence of uterine contractions. It typically presents as acute, painless dilatation of the cervix, which can lead to a midtrimester pregnancy loss. In women with this history, the risk of recurrence in a subsequent pregnancy is less than 30%. […] The diagnosis of cervical insufficiency is primarily based on a history of a previous midtrimester pregnancy loss, which can present with the following: Painless cervical dilatation and bulging fetal membranes upon presentation in the second trimester of pregnancy. […] In women without a history of pregnancy loss, the diagnosis of cervical insufficiency is based on a combination of the following: Clinical presentation, Physical examination, Ultrasonographic findings.

• #26 Cervical Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525954/

  Cervical insufficiency is the inability of the cervix to retain the fetus in the absence of uterine contractions (ie, painless cervical dilatation) due to a functional or structural cervical defect. […] Diagnosis can be based on physical exam findings (painless dilation without labor), a history of second-trimester losses or preterm births, or ultrasound evidence of a shortened cervix (25 mm) before 24 weeks gestation. […] Diagnosis is based on physical examination, clinical history, or ultrasonographic findings, and treatment options include cerclage and vaginal progesterone. […] The diagnosis of cervical insufficiency is typically made in one of the following scenarios: […] Exam-based diagnosis: Painless dilation in the second or early third trimester in the absence of contractions or other clear pathologies such as bleeding, PPROM, infection, or placental abruption.

• #27 ACOG Releases Bulletin on Managing Cervical Insufficiency | AAFP

  https://www.aafp.org/pubs/afp/issues/2004/0115/p436.html

  In the past, patient selection for elective cerclage has been based on congenital or acquired visible defects in the ectocervix or classic features of cervical incompetence, which include history of two or more second-trimester pregnancy losses (excluding those resulting from preterm labor or abruption); history of losing each pregnancy at an earlier gestational age; history of painless cervical dilation of up to 4 to 6 cm; absence of clinical findings consistent with placental abruption; and history of cervical trauma caused by cone biopsy, intrapartum cervical lacerations, and excessive, forced cervical dilation during pregnancy termination. […] Based on limited clinical information, elective cerclage for historical factors generally should be confined to patients with three or more otherwise unexplained second-trimester pregnancy losses or preterm deliveries.

• #28 Cervical insufficiency – UpToDate

  https://www.uptodate.com/contents/cervical-insufficiency

  Cervical insufficiency refers to painless cervical dilation that leads to second-trimester fetal expulsion (miscarriage or preterm birth). […] Although the diagnosis may be suspected in the first pregnancy in which it occurs, the diagnosis is confirmed when it recurs in consecutive pregnancies. […] The American College of Obstetricians and Gynecologists’ definition of cervical insufficiency is „the inability of the uterine cervix to retain a pregnancy in the second trimester in the absence of clinical contractions, labor, or both”. […] This topic will review issues related to diagnosis and management of patients with cervical insufficiency. […] Structural cervical weakness is the likely cause of cervical insufficiency. […] The weakness may be secondary to prior cervical trauma (eg, rapid mechanical cervical dilation, childbirth) […] decidual inflammation/infection, bleeding at the interface of the decidua and placenta, or uterine overdistension, which initiates biochemical changes that lead to premature cervical shortening.

• #29 Cervical Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525954/

  Cervical insufficiency is the inability of the cervix to retain the fetus in the absence of uterine contractions (ie, painless cervical dilatation) due to a functional or structural cervical defect. […] Diagnosis can be based on physical exam findings (painless dilation without labor), a history of second-trimester losses or preterm births, or ultrasound evidence of a shortened cervix (25 mm) before 24 weeks gestation. […] Diagnosis is based on physical examination, clinical history, or ultrasonographic findings, and treatment options include cerclage and vaginal progesterone. […] The diagnosis of cervical insufficiency is typically made in one of the following scenarios: […] Exam-based diagnosis: Painless dilation in the second or early third trimester in the absence of contractions or other clear pathologies such as bleeding, PPROM, infection, or placental abruption.

• #30 Cervical Incompetence

  https://www.birthinjuryhelpcenter.org/birth-injuries/prenatal-problems/cervical-incompetence/

  American College of Obstetrics and Gynecologys (ACOG) defines an incompetent cervix as a painless dilation and delivery in the second trimester of pregnancy. […] The most accurate sign of incompetent cervix is a painless cervical dilation and bulging fetal membranes during the second trimester of pregnancy. […] The is no definitive test for cervical incompetency. It is a clinical diagnosis based pattern of facts. Generally, incompetent cervix is not routinely checked for and is not diagnosed until after the second or third trimester, usually after a miscarriage has occurred. […] Physicians will use an ultrasound to check for any potential indicators for cervical incompetency. […] An incompetent cervix may pose grave risk for your pregnancy, especially during the second trimester. The most serious consequences of cervical insufficiency are premature birth and sudden pregnancy loss.

• #31 Cervical Incompetence Imaging: Practice Essentials, Magnetic Resonance Imaging, Ultrasonography

  https://emedicine.medscape.com/article/402598-overview

  The diagnosis is usually based on the patient’s history and findings from physical examination, with the aid of ultrasonography. […] In patients at risk for pregnancy loss, placement of cervical cerclages in response to ultrasound-detected shortening of the endocervical canal is an acceptable alternative to elective cerclage. […] The Society for Maternal-Fetal Medicine recommends that routine transvaginal cervical length screening be performed for women with singleton pregnancy and history of prior spontaneous preterm birth and that routine transvaginal cervical length screening not be performed for women with cervical cerclage, multiple gestation, preterm premature rupture of membranes, or placenta previa. […] Ultrasonographic features of cervical incompetence may be summarized as follows: Cervical effacement, dilatation, or shortening in the absence of labor in the second trimester; Funneling of the cervix with changes in the forms of T, Y, V, or U; Shortened cervical length in association with a gaping internal os; Membranes protruding into the endocervical canal; Fetal parts in the cervix or vagina.

• #32 Cervical incompetence | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/cervical-incompetence?lang=us

  Cervical incompetence is variably defined, however, a cervical length of 25 mm at or before 24 weeks is often used. […] The presence of cervical funneling is also an important finding. Greater than 50% funneling before 25 weeks is associated with an 80% risk of preterm delivery. […] A meta-analysis suggests that cerclage is effective in reducing preterm births by 26% in singleton pregnancies.

• #33 Cervical weakness – Wikipedia

  https://en.wikipedia.org/wiki/Cervical_weakness

  Cervical weakness, also called cervical incompetence or cervical insufficiency, is a medical condition of pregnancy in which the cervix begins to dilate (widen) and efface (thin) before the pregnancy has reached term. […] Diagnosis of cervical weakness can be challenging and is based on a history of painless cervical dilation usually after the first trimester without contractions or labor and in the absence of other clear pathology. […] In addition to history, some providers use assessment of cervical length in second trimester to identify cervical shortening using ultrasound. […] However, short cervical length has actually been shown to be a marker of preterm birth rather than cervical weakness. […] Cervical weakness is variably defined. However, a common definition is a cervical length of less than 25 mm at or before 24 weeks of gestational age. […] The risk of preterm birth is inversely proportional to cervical length.

• #34 Cervical incompetence | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/cervical-incompetence?lang=us

  Cervical incompetence is variably defined, however, a cervical length of 25 mm at or before 24 weeks is often used. […] The presence of cervical funneling is also an important finding. Greater than 50% funneling before 25 weeks is associated with an 80% risk of preterm delivery. […] A meta-analysis suggests that cerclage is effective in reducing preterm births by 26% in singleton pregnancies.

• #35 ACOG Releases Bulletin on Managing Cervical Insufficiency | AAFP

  https://www.aafp.org/pubs/afp/issues/2004/0115/p436.html

  Identification of a short cervix at or after 20 weeks of gestation should prompt assessment of the fetus for anomalies, uterine activity to rule out preterm labor, and maternal factors to rule out chorioamnionitis. […] Cerclage in the treatment of women with cervical insufficiency after determining fetal viability has not been adequately assessed. […] The evidence-based risk-benefit ratio does not support first-trimester cerclage, even with transabdominal procedures. […] Suture displacement, rupture of membranes, and chorioamnionitis are the most common complications associated with cerclage placement, and incidence varies widely in relation to the timing and indications for the cerclage. […] Urgent and emergency cerclages are associated with a higher incidence of morbidity as a result of cervical shortening and exposure of the fetal membranes to the vaginal ecosystem.

• #36 Cervical insufficiency – UpToDate

  https://www.uptodate.com/contents/cervical-insufficiency

  Cervical insufficiency refers to painless cervical dilation that leads to second-trimester fetal expulsion (miscarriage or preterm birth). […] Although the diagnosis may be suspected in the first pregnancy in which it occurs, the diagnosis is confirmed when it recurs in consecutive pregnancies. […] The American College of Obstetricians and Gynecologists’ definition of cervical insufficiency is „the inability of the uterine cervix to retain a pregnancy in the second trimester in the absence of clinical contractions, labor, or both”. […] This topic will review issues related to diagnosis and management of patients with cervical insufficiency. […] Structural cervical weakness is the likely cause of cervical insufficiency. […] The weakness may be secondary to prior cervical trauma (eg, rapid mechanical cervical dilation, childbirth) […] decidual inflammation/infection, bleeding at the interface of the decidua and placenta, or uterine overdistension, which initiates biochemical changes that lead to premature cervical shortening.

• #37 ACOG Releases Bulletin on Managing Cervical Insufficiency | AAFP

  https://www.aafp.org/pubs/afp/issues/2004/0115/p436.html

  Identification of a short cervix at or after 20 weeks of gestation should prompt assessment of the fetus for anomalies, uterine activity to rule out preterm labor, and maternal factors to rule out chorioamnionitis. […] Cerclage in the treatment of women with cervical insufficiency after determining fetal viability has not been adequately assessed. […] The evidence-based risk-benefit ratio does not support first-trimester cerclage, even with transabdominal procedures. […] Suture displacement, rupture of membranes, and chorioamnionitis are the most common complications associated with cerclage placement, and incidence varies widely in relation to the timing and indications for the cerclage. […] Urgent and emergency cerclages are associated with a higher incidence of morbidity as a result of cervical shortening and exposure of the fetal membranes to the vaginal ecosystem.

• #38 Cervical Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525954/

  History-based diagnosis: Patients with a clinical history consistent with cervical insufficiency, which includes a history of at least 1 to 3 consecutive second-trimester losses or early preterm births related to painless cervical dilation (definitions vary slightly by organization) and patients with a history of a prior exam-indicated cerclage. […] Ultrasound-based diagnosis: Patients with a history of at least 1 preterm birth or second-trimester loss AND a shortened cervical length before 24 weeks EGA in the current pregnancy. […] Cervical insufficiency is a well-recognized cause of second-trimester fetal loss and early preterm birth, and the diagnosis is often made retrospectively. […] Screening is typically performed via transvaginal sonography every 1 to 2 weeks between 16 and 24 weeks gestation.

• #39 Short cervix: Diagnosis and treatment

  https://www.medicalnewstoday.com/articles/short-cervix

  Having a short cervix can complicate labor and delivery. If a doctor recognizes someone has a short cervix early on, it can make treatment easier and more effective. […] If a pregnant woman’s cervix is short, it may lead to cervical insufficiency. Cervical insufficiency refers to the cervix dilating too soon. This can increase the risk of pregnancy loss, preterm labor and delivery, and other complications. […] Doctors define preterm labor as cervical changes that happen before 37 weeks of pregnancy. Preterm labor is a risk factor for numerous complications, including stillbirth, low birth weight, bleeding in the brain, and long-term disabilities. […] The Society for Maternal-Fetal Medicine recommend routine cervical length screening for pregnant women with a history of preterm labor or delivery.

• #40 Cervical Incompetence Imaging: Practice Essentials, Magnetic Resonance Imaging, Ultrasonography

  https://emedicine.medscape.com/article/402598-overview

  The diagnosis is usually based on the patient’s history and findings from physical examination, with the aid of ultrasonography. […] In patients at risk for pregnancy loss, placement of cervical cerclages in response to ultrasound-detected shortening of the endocervical canal is an acceptable alternative to elective cerclage. […] The Society for Maternal-Fetal Medicine recommends that routine transvaginal cervical length screening be performed for women with singleton pregnancy and history of prior spontaneous preterm birth and that routine transvaginal cervical length screening not be performed for women with cervical cerclage, multiple gestation, preterm premature rupture of membranes, or placenta previa. […] Ultrasonographic features of cervical incompetence may be summarized as follows: Cervical effacement, dilatation, or shortening in the absence of labor in the second trimester; Funneling of the cervix with changes in the forms of T, Y, V, or U; Shortened cervical length in association with a gaping internal os; Membranes protruding into the endocervical canal; Fetal parts in the cervix or vagina.

• #41 Short cervix: Diagnosis and treatment

  https://www.medicalnewstoday.com/articles/short-cervix

  Having a short cervix can complicate labor and delivery. If a doctor recognizes someone has a short cervix early on, it can make treatment easier and more effective. […] If a pregnant woman’s cervix is short, it may lead to cervical insufficiency. Cervical insufficiency refers to the cervix dilating too soon. This can increase the risk of pregnancy loss, preterm labor and delivery, and other complications. […] Doctors define preterm labor as cervical changes that happen before 37 weeks of pregnancy. Preterm labor is a risk factor for numerous complications, including stillbirth, low birth weight, bleeding in the brain, and long-term disabilities. […] The Society for Maternal-Fetal Medicine recommend routine cervical length screening for pregnant women with a history of preterm labor or delivery.

• #42 Cervical Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525954/

  History-based diagnosis: Patients with a clinical history consistent with cervical insufficiency, which includes a history of at least 1 to 3 consecutive second-trimester losses or early preterm births related to painless cervical dilation (definitions vary slightly by organization) and patients with a history of a prior exam-indicated cerclage. […] Ultrasound-based diagnosis: Patients with a history of at least 1 preterm birth or second-trimester loss AND a shortened cervical length before 24 weeks EGA in the current pregnancy. […] Cervical insufficiency is a well-recognized cause of second-trimester fetal loss and early preterm birth, and the diagnosis is often made retrospectively. […] Screening is typically performed via transvaginal sonography every 1 to 2 weeks between 16 and 24 weeks gestation.

• #43 Management of Incompetent Cervix | Maternal Fetal Associates of the Mid-Atlantic

  https://mfama.com/project/management-of-incompetent-cervix/

  Most cases can be identified early with the liberal use of vaginal ultrasound in women who are at risk. Contemporary research recommends screening for cervical weakness in all pregnant women with risk factors and some data suggests routine universal screening at the time of the 20 week ultrasound. […] Sonographic evaluation by a Maternal Fetal Medicine Specialist is essential to prevent misdiagnosis and unnecessary treatment. Ultrasound for cervical evaluation in women at risk of Incompetent Cervix starts around 16 weeks and continues every two weeks until about 24 weeks.

• #44 Cervical Incompetence | Cervical Shortening in Pregnancy | Alana Healthcare

  https://www.alanahealthcare.com.au/services/obstetrics/cervical-incompetence/

  Cervical incompetence is an uncommon condition where, during pregnancy, the cervix shortens or opens before it is time to do so. […] Diagnosis is usually only made once a pregnancy has occurred and there has been an early delivery resulting in a miscarriage or premature baby. […] When the problem of vaginal shortening or incompetence is suspected, it may be diagnosed with an internal ultrasound scan through the vagina (transvaginal ultrasound). If the cervix length measures 25 mm or less, then it is considered to be short. […] High risk women are those with a history of a previous painless miscarriage between 12-24 weeks; a premature delivery thought to be due to cervical incompetence; surgery to the cervix. […] Women without any risk factors for cervical incompetence or short cervix are recommended to have a transvaginal ultrasound to measure the length of the cervix at 18-20 weeks gestation.

• #45 Management of Incompetent Cervix | Maternal Fetal Associates of the Mid-Atlantic

  https://mfama.com/project/management-of-incompetent-cervix/

  Most cases can be identified early with the liberal use of vaginal ultrasound in women who are at risk. Contemporary research recommends screening for cervical weakness in all pregnant women with risk factors and some data suggests routine universal screening at the time of the 20 week ultrasound. […] Sonographic evaluation by a Maternal Fetal Medicine Specialist is essential to prevent misdiagnosis and unnecessary treatment. Ultrasound for cervical evaluation in women at risk of Incompetent Cervix starts around 16 weeks and continues every two weeks until about 24 weeks.

• #46 Cervical Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525954/

  A shortened cervix is typically defined as a cervical length of less than 25 mm in patients undergoing serial screening ultrasounds. […] Before placing a cerclage, an obstetric ultrasound should be performed to ensure fetal viability, confirm the gestational age and cervical length, and exclude clinically relevant structural anomalies. […] The primary treatment options for cervical insufficiency include cerclage placement and vaginal progesterone. […] A cerclage is a nonresorbable suture placed around the cervix to improve mechanical strength and prevent premature dilation. […] Cervical insufficiency complicates up to 1% of pregnancies in the general population. […] Adverse outcomes associated with cervical insufficiency are primarily related to the effects of preterm birth.

• #47 Short cervix: Diagnosis and treatment

  https://www.medicalnewstoday.com/articles/short-cervix

  If a clinician thinks that a woman may have a short cervix, they may begin checking the length via transvaginal ultrasound between weeks 16 and 20. […] If the cervix is less than 25 mm long (about 1 inch), doctors generally consider it to be short. […] For some women, a doctor may recommend a cerclage. This is a stitch in the cervix that reinforces it, reducing the risk of pregnancy loss or preterm labor. […] A 2017 review of 15 studies concluded that while cerclage reduces the risk of preterm birth in women at high risk it is still unclear whether other options may be more effective, particularly vaginal progesterone. […] According to a 2013 study, vaginal progesterone reduces the risk of delivering before 33 weeks by 44%. […] Most women do not know the length of their cervixes. It may be a good idea for women with a history of preterm labor, cervical injury, or late pregnancy loss to have the length checked. […] Pregnant women with short cervixes should seek medical attention if they have symptoms of labor, such as contractions. […] Treatment for a short cervix is most effective if it begins before 24 weeks of pregnancy.

• #48 Cervical weakness – Wikipedia

  https://en.wikipedia.org/wiki/Cervical_weakness

  Cervical weakness, also called cervical incompetence or cervical insufficiency, is a medical condition of pregnancy in which the cervix begins to dilate (widen) and efface (thin) before the pregnancy has reached term. […] Diagnosis of cervical weakness can be challenging and is based on a history of painless cervical dilation usually after the first trimester without contractions or labor and in the absence of other clear pathology. […] In addition to history, some providers use assessment of cervical length in second trimester to identify cervical shortening using ultrasound. […] However, short cervical length has actually been shown to be a marker of preterm birth rather than cervical weakness. […] Cervical weakness is variably defined. However, a common definition is a cervical length of less than 25 mm at or before 24 weeks of gestational age. […] The risk of preterm birth is inversely proportional to cervical length.

• #49 ACOG Releases Bulletin on Managing Cervical Insufficiency | AAFP

  https://www.aafp.org/pubs/afp/issues/2004/0115/p436.html

  Urgent, or therapeutic, cerclage often is recommended for women who have ultrasonographic changes consistent with a short cervix or evidence of funneling. […] The decision to proceed with cerclage should be made with caution. […] In patients with a history of fewer than three second-trimester pregnancy losses, urgent cerclage is not supported by evidence-based studies, and further transvaginal ultrasound surveillance may be the more judicious approach. […] Cervical change noted before fetal viability is a better indication for cerclage than if it is identified after fetal viability has been achieved. […] Emergency cerclage may be considered in women if clinical chorioamnionitis or signs of labor are not present. […] If transvaginal ultrasonography before 16 to 20 weeks of gestation identifies a short cervix, the examination should be repeated because of the inability to adequately distinguish the cervix from the lower uterine segment in early pregnancy.

• #50 Incompetent Cervix: Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17912-incompetent-cervix

  Incompetent cervix occurs when your cervix opens, weakens or shortens too early in pregnancy. Its also known as cervical insufficiency. It can cause problems including miscarriage (loss of the pregnancy) and premature birth (being born before 37 weeks of pregnancy). […] If youre at risk for an incompetent cervix or your cervix shows signs of opening too soon, your pregnancy care provider may recommend preventative treatment to avoid pregnancy complications. […] Your provider diagnoses incompetent cervix with a pelvic exam and an imaging test called a transvaginal ultrasound (ultrasound using a wand inserted in the vagina). This test allows your provider to measure the length and opening of your cervix. […] The goal of treating incompetent cervix is to help you stay pregnant as long as possible. Because its hard to diagnose, knowing the risk factors are extremely important. Your provider will decide which treatment is best for you based on your condition and medical history.

• #51 Cervical Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525954/

  A shortened cervix is typically defined as a cervical length of less than 25 mm in patients undergoing serial screening ultrasounds. […] Before placing a cerclage, an obstetric ultrasound should be performed to ensure fetal viability, confirm the gestational age and cervical length, and exclude clinically relevant structural anomalies. […] The primary treatment options for cervical insufficiency include cerclage placement and vaginal progesterone. […] A cerclage is a nonresorbable suture placed around the cervix to improve mechanical strength and prevent premature dilation. […] Cervical insufficiency complicates up to 1% of pregnancies in the general population. […] Adverse outcomes associated with cervical insufficiency are primarily related to the effects of preterm birth.

• #52 Cervical Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525954/

  A shortened cervix is typically defined as a cervical length of less than 25 mm in patients undergoing serial screening ultrasounds. […] Before placing a cerclage, an obstetric ultrasound should be performed to ensure fetal viability, confirm the gestational age and cervical length, and exclude clinically relevant structural anomalies. […] The primary treatment options for cervical insufficiency include cerclage placement and vaginal progesterone. […] A cerclage is a nonresorbable suture placed around the cervix to improve mechanical strength and prevent premature dilation. […] Cervical insufficiency complicates up to 1% of pregnancies in the general population. […] Adverse outcomes associated with cervical insufficiency are primarily related to the effects of preterm birth.

• #53 Cervical Insufficiency: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1979914-overview

  Cervical cerclage is the mainstay of surgical treatment for cervical insufficiency and is reasonable in the following situations: History of second trimester pregnancy loss with painless cervical dilatation, Prior cerclage placement for cervical insufficiency, History of spontaneous preterm birth (prior to 34 weeks gestation) and a short cervical length (ie, 25 mm) prior to 24 weeks gestation, Painless cervical dilatation on physical examination in the second trimester. […] The ACOG does not recommend cerclage placement for women with a short cervix who do not have a history of preterm delivery, as it has not been shown to be beneficial in this population. […] Cervical insufficiency may occur as a result of a functional defect in the cervix, which can be due to an anatomic abnormality (congenital Mllerian anomalies), in utero exposure to diethylstilbestrol (DES), or collagen disorders (Ehlers-Danlos syndrome).

• #54 Cervical Insufficiency: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1979914-overview

  Cervical cerclage is the mainstay of surgical treatment for cervical insufficiency and is reasonable in the following situations: History of second trimester pregnancy loss with painless cervical dilatation, Prior cerclage placement for cervical insufficiency, History of spontaneous preterm birth (prior to 34 weeks gestation) and a short cervical length (ie, 25 mm) prior to 24 weeks gestation, Painless cervical dilatation on physical examination in the second trimester. […] The ACOG does not recommend cerclage placement for women with a short cervix who do not have a history of preterm delivery, as it has not been shown to be beneficial in this population. […] Cervical insufficiency may occur as a result of a functional defect in the cervix, which can be due to an anatomic abnormality (congenital Mllerian anomalies), in utero exposure to diethylstilbestrol (DES), or collagen disorders (Ehlers-Danlos syndrome).

• #55 ACOG Releases Bulletin on Managing Cervical Insufficiency | AAFP

  https://www.aafp.org/pubs/afp/issues/2004/0115/p436.html

  In the past, patient selection for elective cerclage has been based on congenital or acquired visible defects in the ectocervix or classic features of cervical incompetence, which include history of two or more second-trimester pregnancy losses (excluding those resulting from preterm labor or abruption); history of losing each pregnancy at an earlier gestational age; history of painless cervical dilation of up to 4 to 6 cm; absence of clinical findings consistent with placental abruption; and history of cervical trauma caused by cone biopsy, intrapartum cervical lacerations, and excessive, forced cervical dilation during pregnancy termination. […] Based on limited clinical information, elective cerclage for historical factors generally should be confined to patients with three or more otherwise unexplained second-trimester pregnancy losses or preterm deliveries.

• #56 Cervical Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525954/

  A shortened cervix is typically defined as a cervical length of less than 25 mm in patients undergoing serial screening ultrasounds. […] Before placing a cerclage, an obstetric ultrasound should be performed to ensure fetal viability, confirm the gestational age and cervical length, and exclude clinically relevant structural anomalies. […] The primary treatment options for cervical insufficiency include cerclage placement and vaginal progesterone. […] A cerclage is a nonresorbable suture placed around the cervix to improve mechanical strength and prevent premature dilation. […] Cervical insufficiency complicates up to 1% of pregnancies in the general population. […] Adverse outcomes associated with cervical insufficiency are primarily related to the effects of preterm birth.

• #57 Cervical incompetence | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/cervical-incompetence?lang=us

  Cervical incompetence is variably defined, however, a cervical length of 25 mm at or before 24 weeks is often used. […] The presence of cervical funneling is also an important finding. Greater than 50% funneling before 25 weeks is associated with an 80% risk of preterm delivery. […] A meta-analysis suggests that cerclage is effective in reducing preterm births by 26% in singleton pregnancies.

• #58 Incompetent Cervix: Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17912-incompetent-cervix

  Incompetent cervix can cause complications, including miscarriage and premature birth. […] Cerclage treatment for incompetent cervix is successful in nearly 90% of cases. […] An incompetent cervix (or cervical insufficiency) is when your cervix shortens, weakens or opens too soon during pregnancy. This can cause miscarriage or premature birth. Its hard to detect incompetent cervix unless you have a history of miscarriage or other risk factors. Be sure to discuss your complete medical history with your provider as well as any pregnancy symptoms you have. Knowing this information can help your provider determine if youre at risk for cervical insufficiency. In most cases, this condition is treatable with a procedure called a cerclage.

• #59 Incompetent Cervix: Symptoms, Causes, Diagnosis & Treatment | Women’s Health Partners

  https://www.toplinemd.com/myobgynoffice/incompetent-cervix-symptoms-causes-diagnosis-treatment/

  Cervical insufficiency, or incompetent cervix diagnosis, is a condition that arises from the cervical tissue being weak and causing a premature birth of the baby or a loss of pregnancy. […] When you are diagnosed with cervical insufficiency, the cervix becomes too soft too soon and begins to open causing premature births. […] Since this condition is not easily discovered, a doctor usually has to perform a pelvic exam and an ultrasound to establish an incompetent cervix diagnosis. A test called transvaginal ultrasound is primarily used in these cases, which helps the doctor measure the length and opening of the cervix by using a wand inserted into the vagina. […] Although it is not easy to diagnose and there are really not many ways of treating cervical insufficiency, we want to note that the success rate of the cerclage treatment is over 90%. One in every 100 pregnant women is diagnosed with this condition.

• #60 Short cervix: Diagnosis and treatment

  https://www.medicalnewstoday.com/articles/short-cervix

  If a clinician thinks that a woman may have a short cervix, they may begin checking the length via transvaginal ultrasound between weeks 16 and 20. […] If the cervix is less than 25 mm long (about 1 inch), doctors generally consider it to be short. […] For some women, a doctor may recommend a cerclage. This is a stitch in the cervix that reinforces it, reducing the risk of pregnancy loss or preterm labor. […] A 2017 review of 15 studies concluded that while cerclage reduces the risk of preterm birth in women at high risk it is still unclear whether other options may be more effective, particularly vaginal progesterone. […] According to a 2013 study, vaginal progesterone reduces the risk of delivering before 33 weeks by 44%. […] Most women do not know the length of their cervixes. It may be a good idea for women with a history of preterm labor, cervical injury, or late pregnancy loss to have the length checked. […] Pregnant women with short cervixes should seek medical attention if they have symptoms of labor, such as contractions. […] Treatment for a short cervix is most effective if it begins before 24 weeks of pregnancy.

• #61 Weak cervix (cervical incompetence): symptoms, causes and treatment | Tommy’sCloseleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowCloseReconfirm cookies choice

  https://www.tommys.org/pregnancy-information/pregnancy-complications/cervical-incompetence

  Treatment with vaginal progesterone involves putting a progesterone medication into your vagina, usually up until 34 weeks of pregnancy. […] Putting a stitch into your cervix (a cervical stitch or cerclage) can help keep it closed and reduce your risk of having a miscarriage or preterm birth, though it does not always work. […] If your cervix has started to open, and you are between 16 and 28 weeks pregnant, you may be offered a cervical stitch as an emergency procedure to try to delay your baby’s birth. […] There may be reasons why a stitch isn’t a good option for you, because it may have risks for you and/or wouldn’t help your baby. […] If scans show you have a short cervix, but you are pregnant with 1 baby and don’t have any other risk factors for preterm birth, a stitch isn’t recommended.

• #62 Short cervix before 24 weeks: Screening and management in singleton pregnancies – UpToDate

  https://www.uptodate.com/contents/short-cervix-before-24-weeks-screening-and-management-in-singleton-pregnancies/print

  Prelabor preterm cervical shortening, particularly before 24 weeks of gestation, is associated with an increased risk for spontaneous preterm birth, which is a major cause of neonatal morbidity and mortality. […] Detection of a short cervix in the second trimester is useful because providing vaginal progesterone supplementation and/or performing a cerclage may prolong the gestation compared with expectant management. […] Before 24 weeks, the diagnosis of a short cervix is based on transvaginal ultrasound cervical length (TVU CL) ≤25 mm (the 2nd to 3rd centile at this gestational age), regardless of the patient’s obstetric history. This is an appropriate diagnostic threshold because meta-analyses of randomized trials of therapeutic interventions (vaginal progesterone, cerclage) initiated at this threshold in patients with singleton pregnancies report a 30 to 40 percent reduction in preterm birth compared with no intervention.

• #63 Treating Short Cervix (and Cervical Insufficiency) in Pregnancy

  https://www.healthline.com/health/pregnancy/short-cervix

  The main cause of a short cervix is cervical insufficiency, also called incompetent cervix. […] If youre considered at higher risk for a short cervix due to previous preterm labor or birth, history of miscarriage, or family members with a short cervix your doctor will do a transvaginal ultrasound to measure your cervix. […] If your cervix measures less than 25 mm at this stage, your doctor will diagnose you with a short cervix. […] If youve had issues with a short cervix in the past, if your cervix measures less than 25 mm, or if you have cervical incompetence, your doctor may recommend getting a cerclage early in the second trimester to prevent miscarriage and keep baby nice and secure. […] Your doctor may prescribe progesterone as an injection or vaginal suppository. […] An Arabin pessary is considered a newer alternative to cerclage and progesterone. […] These symptoms may also prompt your doctor to check for a short cervix.

• #64 Weak cervix (cervical incompetence): symptoms, causes and treatment | Tommy’sCloseleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowCloseReconfirm cookies choice

  https://www.tommys.org/pregnancy-information/pregnancy-complications/cervical-incompetence

  Treatment with vaginal progesterone involves putting a progesterone medication into your vagina, usually up until 34 weeks of pregnancy. […] Putting a stitch into your cervix (a cervical stitch or cerclage) can help keep it closed and reduce your risk of having a miscarriage or preterm birth, though it does not always work. […] If your cervix has started to open, and you are between 16 and 28 weeks pregnant, you may be offered a cervical stitch as an emergency procedure to try to delay your baby’s birth. […] There may be reasons why a stitch isn’t a good option for you, because it may have risks for you and/or wouldn’t help your baby. […] If scans show you have a short cervix, but you are pregnant with 1 baby and don’t have any other risk factors for preterm birth, a stitch isn’t recommended.

• #65 ACOG Releases Bulletin on Managing Cervical Insufficiency | AAFP

  https://www.aafp.org/pubs/afp/issues/2004/0115/p436.html

  Urgent, or therapeutic, cerclage often is recommended for women who have ultrasonographic changes consistent with a short cervix or evidence of funneling. […] The decision to proceed with cerclage should be made with caution. […] In patients with a history of fewer than three second-trimester pregnancy losses, urgent cerclage is not supported by evidence-based studies, and further transvaginal ultrasound surveillance may be the more judicious approach. […] Cervical change noted before fetal viability is a better indication for cerclage than if it is identified after fetal viability has been achieved. […] Emergency cerclage may be considered in women if clinical chorioamnionitis or signs of labor are not present. […] If transvaginal ultrasonography before 16 to 20 weeks of gestation identifies a short cervix, the examination should be repeated because of the inability to adequately distinguish the cervix from the lower uterine segment in early pregnancy.

• #66 The shortened cervix in pregnancy: Investigation and current management recommendations for primary caregivers

  https://www1.racgp.org.au/ajgp/2019/march/the-shortened-cervix-in-pregnancy

  Cervical cerclage involves a procedure that uses a non-absorbable suture to mechanically support the cervix. […] Rescue cerclage is considered in the setting of a woman presenting with pre-viability cervical dilation or if, during ultrasound surveillance, a cervix continues to shorten despite progesterone.

• #67 Cervical Insufficiency: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1979914-overview

  Cervical cerclage is the mainstay of surgical treatment for cervical insufficiency and is reasonable in the following situations: History of second trimester pregnancy loss with painless cervical dilatation, Prior cerclage placement for cervical insufficiency, History of spontaneous preterm birth (prior to 34 weeks gestation) and a short cervical length (ie, 25 mm) prior to 24 weeks gestation, Painless cervical dilatation on physical examination in the second trimester. […] The ACOG does not recommend cerclage placement for women with a short cervix who do not have a history of preterm delivery, as it has not been shown to be beneficial in this population. […] Cervical insufficiency may occur as a result of a functional defect in the cervix, which can be due to an anatomic abnormality (congenital Mllerian anomalies), in utero exposure to diethylstilbestrol (DES), or collagen disorders (Ehlers-Danlos syndrome).

• #68

  https://step2.medbullets.com/obstetrics/120368/cervical-insufficiency

  cervical insufficiency is the inability of the cervix to retain a pregnancy in the second trimester, in the absence of uterine contractions […] routine cervical length screening is recommended for all women without a history of prior preterm birth […] should be performed between 16- 24 weeks for the most accurate and predictive measurement […] women with prior cervical excisional procedures or cervical dilations do not require additional screening following the first cervical length measurement […] positive fetal fibronectin may predict a higher risk of preterm delivery […] women with a prior spontaneous preterm birth should be offered progesterone supplementation starting at 16-24 weeks of gestation and continuing up to 36 weeks of gestation […] cervical cerlage […] placement of sutures to improve the tensile strength of the cervix […] NOT recommended in women with multiple gestations and a short cervix.

• #69 Weak cervix (cervical incompetence): symptoms, causes and treatment | Tommy’sCloseleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowCloseReconfirm cookies choice

  https://www.tommys.org/pregnancy-information/pregnancy-complications/cervical-incompetence

  Treatment with vaginal progesterone involves putting a progesterone medication into your vagina, usually up until 34 weeks of pregnancy. […] Putting a stitch into your cervix (a cervical stitch or cerclage) can help keep it closed and reduce your risk of having a miscarriage or preterm birth, though it does not always work. […] If your cervix has started to open, and you are between 16 and 28 weeks pregnant, you may be offered a cervical stitch as an emergency procedure to try to delay your baby’s birth. […] There may be reasons why a stitch isn’t a good option for you, because it may have risks for you and/or wouldn’t help your baby. […] If scans show you have a short cervix, but you are pregnant with 1 baby and don’t have any other risk factors for preterm birth, a stitch isn’t recommended.

• #70 Diagnosis and Management of Short Cervix – The ObG Project

  https://www.obgproject.com/2024/10/28/diagnosis-and-management-of-short-cervix/

  Diagnosis of Short Cervix […] Singleton pregnancy without a prior PTB history: Midtrimester length ≤25 mm […] Apply diagnosis only if there is no cervical dilation […] The majority of deliveries <34 weeks do not have a history of preterm birth (PTB) [...] Cervical lengths should be performed transvaginally [...] For twin gestations with a shortened cervical length [...] Routine use of pessaries, progesterone, or cerclage is not recommended [...] 17-hydroxyprogesterone caproate (17-OHPC) should not be used to treat shortened cervical length

• #71

  https://step2.medbullets.com/obstetrics/120368/cervical-insufficiency

  cervical insufficiency is the inability of the cervix to retain a pregnancy in the second trimester, in the absence of uterine contractions […] routine cervical length screening is recommended for all women without a history of prior preterm birth […] should be performed between 16- 24 weeks for the most accurate and predictive measurement […] women with prior cervical excisional procedures or cervical dilations do not require additional screening following the first cervical length measurement […] positive fetal fibronectin may predict a higher risk of preterm delivery […] women with a prior spontaneous preterm birth should be offered progesterone supplementation starting at 16-24 weeks of gestation and continuing up to 36 weeks of gestation […] cervical cerlage […] placement of sutures to improve the tensile strength of the cervix […] NOT recommended in women with multiple gestations and a short cervix.

• #72 Ultrasound Criteria for the Diagnosis of Incompetent Cervix

  https://www.fetalultrasound.com/online/text/33-039.htm

  Ultrasound Criteria for the Diagnosis of Incompetent Cervix […] Cervical incompetence […] Cervical Length […] 3 cm […] Cervical Width […] 2 cm in second trimester. […] Cervical Canal Width […] 8 mm […] Cervical funneling […] 25-50% or 50% […] Bulging of Membranes into cervical canal […] Present […] Twin pregnancy: Membranes of both twins in incompetent cervix. […] Sonographic detection of cervical incompetence.

• #73 Diagnosis and treatment of cervical incompetence combined with intrauterine adhesions

  https://atm.amegroups.org/article/view/36488/html

  Cervical incompetence (CI) with concomitant intrauterine adhesions (IUAs) is a common clinical phenomenon among CI patients. But there are neither published reports regarding the difference in diagnosis and treatment of such patients compared to those with CI only, nor any report about their prognosis. This study aimed to preliminary the alteration in diagnostic and curative aspects of these patients, so as to provide a certain reference for the clinical management of such conditions. […] If a patient has a history of typical painless cervical dilation during the second trimester, and a No. 7 Hegar dilator can pass through the internal cervical os without resistance during the nonpregnancy period, the diagnosis of CI can be confirmed. […] The diagnosis of CI combined with IUAs should be carried out with diligence as the inability or difficulty in introducing the Hegar dilator may lead to missed diagnosis, creation of false passage and even cause uterine perforation.

• #74 Diagnosis and treatment of cervical incompetence combined with intrauterine adhesions

  https://atm.amegroups.org/article/view/36488/html

  Therefore, for patients with CI, complicated with moderate to severe IUAs, especially of the cervix and lower uterine segment, it is recommended to insert the cervical dilator again after the uterine cavity morphology returns to normal or 3 months after the initial HA; as it is more safe and reliable postoperatively and it effectively avoids missed diagnosis. […] In summary, patients with CI complicated with IUAs of the cervix or lower uterine segment, it is necessary to separate the adhesion first and then evaluate the cervix with the No. 7 Hegar dilator to confirm the diagnosis. However, when the cervix is too loose, laparoscopic cervical cerclage is exceptionally carried out first and then IUAs is treated. Patients with CI complicated with moderate to severe IUAs who underwent pre-pregnancy laparoscopic cervical cerclage had a relatively good prognosis.

• #75 Cervical Incompetence Imaging: Practice Essentials, Magnetic Resonance Imaging, Ultrasonography

  https://emedicine.medscape.com/article/402598-overview

  MRI findings of a cervix shorter than 3.1 mm, an internal cervical os wider than 4.2 mm, and abnormal signal intensity in the cervical stroma were highly suggestive of incompetent cervix. However, with the advent of high-resolution ultrasonography, MRI is not likely to be used clinically in the diagnosis of cervical incompetence, as it offers no major advantage over ultrasonography.

• #76 Cervical Incompetence Imaging: Practice Essentials, Magnetic Resonance Imaging, Ultrasonography

  https://emedicine.medscape.com/article/402598-overview

  MRI findings of a cervix shorter than 3.1 mm, an internal cervical os wider than 4.2 mm, and abnormal signal intensity in the cervical stroma were highly suggestive of incompetent cervix. However, with the advent of high-resolution ultrasonography, MRI is not likely to be used clinically in the diagnosis of cervical incompetence, as it offers no major advantage over ultrasonography.

• #77 How MRI imaging for an ovarian cyst led to diagnosis of short cervix | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-025-07297-6

  Short cervical length is a marker for preterm birth, which is responsible for significant perinatal morbidity and mortality. Preterm birth risk increases with shorter cervical length and an unmeasurable cervical length increased the risk of early preterm birth. […] While transvaginal ultrasound is the principal modality for assessing cervical length, MRI has been evaluated in diagnosis of short cervix. […] These case reports support the importance of MRI in the diagnosis of cervical incompetence in certain cases. […] When MRI is performed for another indication in pregnancy, the cervix should be evaluated to assess for incidental finding of short cervix to allow for early intervention.

• #78 Incompetent cervix | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20373818/

  Sometimes the cervix opens and thins early, putting a pregnancy at risk. Learn more about this hard-to-diagnose condition. […] An incompetent cervix can be a hard problem to diagnose and treat. If your cervix begins to open early, or if you’ve had cervical insufficiency in the past, you might benefit from treatment. […] An incompetent cervix can be found only during pregnancy. It can be a difficult diagnosis to make, especially during a first pregnancy. […] Your doctor might diagnose an incompetent cervix if you have: A history of painless widening of the cervix, known as dilation, and second trimester delivery during a past pregnancy. […] Diagnosis of an incompetent cervix during the second trimester also may include: An ultrasound exam. […] There are no reliable tests that can be done before pregnancy to predict if you’ll have an incompetent cervix.

• #79 Incompetent Cervix: What Causes It, and How It’s Treated

  https://www.webmd.com/women/what-is-incompetent-cervix

  An incompetent cervix is a condition where your cervix opens too early during pregnancy. It’s also called cervical insufficiency. This can cause you to have a miscarriage or to give birth too early. If your doctor knows you have an incompetent cervix, it can be treated early in your pregnancy. […] It can be difficult to diagnose an incompetent cervix. There are no tests that can diagnose it before pregnancy. Some tests, such as magnetic resonance imaging (MRI) or ultrasound, can be used to diagnose an abnormality that can cause an incompetent cervix before you get pregnant. […] Your doctor may diagnose you with an incompetent cervix if you have a history of delivering during your second trimester, or if your cervix opens and thins before you’re 24 weeks pregnant. […] Some tests your doctor may do to help diagnose an incompetent cervix include: Transvaginal ultrasound. Your health care provider may use this test to see if your membranes are protruding from your cervix. […] Your doctor may do an amniocentesis to see if you have an infection. […] Your health care provider may do a pelvic exam to see if your membranes are protruding from your cervix. If so, you may have an incompetent cervix.

• #80 Diagnosis and treatment of cervical incompetence combined with intrauterine adhesions

  https://atm.amegroups.org/article/view/36488/html

  Cervical incompetence (CI) with concomitant intrauterine adhesions (IUAs) is a common clinical phenomenon among CI patients. But there are neither published reports regarding the difference in diagnosis and treatment of such patients compared to those with CI only, nor any report about their prognosis. This study aimed to preliminary the alteration in diagnostic and curative aspects of these patients, so as to provide a certain reference for the clinical management of such conditions. […] If a patient has a history of typical painless cervical dilation during the second trimester, and a No. 7 Hegar dilator can pass through the internal cervical os without resistance during the nonpregnancy period, the diagnosis of CI can be confirmed. […] The diagnosis of CI combined with IUAs should be carried out with diligence as the inability or difficulty in introducing the Hegar dilator may lead to missed diagnosis, creation of false passage and even cause uterine perforation.

• #81 Incompetent Cervix: Symptoms, Risk Factors and Treatment

  https://www.prepladder.com/neet-pg-study-material/obstetrics-and-gynaecology/incompetent-cervix-symptoms-risk-factors-diagnosis-treatment-prevention-and-complications

  An incompetent cervix diagnosed in the second trimester may also include: An ultrasonic analysis: During this test, a thin, wand-like instrument called a transducer is put into your vagina. […] There is no reliable test to find out if you will have an incompetent cervix before getting pregnant. MRIs and ultrasounds, on the other hand, may be able to detect uterine congenital abnormalities that may result in an incompetent cervix during pregnancy.

• #82 Diagnosis and treatment of cervical incompetence combined with intrauterine adhesions

  https://atm.amegroups.org/article/view/36488/html

  Therefore, for patients with CI, complicated with moderate to severe IUAs, especially of the cervix and lower uterine segment, it is recommended to insert the cervical dilator again after the uterine cavity morphology returns to normal or 3 months after the initial HA; as it is more safe and reliable postoperatively and it effectively avoids missed diagnosis. […] In summary, patients with CI complicated with IUAs of the cervix or lower uterine segment, it is necessary to separate the adhesion first and then evaluate the cervix with the No. 7 Hegar dilator to confirm the diagnosis. However, when the cervix is too loose, laparoscopic cervical cerclage is exceptionally carried out first and then IUAs is treated. Patients with CI complicated with moderate to severe IUAs who underwent pre-pregnancy laparoscopic cervical cerclage had a relatively good prognosis.

• #83 Incompetent cervix: pathogenesis, diagnosis and treatment – PubMed

  https://pubmed.ncbi.nlm.nih.gov/1876871/

  The incompetent cervix is a diagnostic dilemma. There are no well-defined or strict criteria to diagnose cervical incompetence, and therefore the indications for treatment are not always clear. […] The methods that would allow making an unequivocal and objective diagnosis of incompetent cervix are not yet available. Until we reach this goal, the subject of cervical incompetence and effectiveness of its treatment will remain challenging and elusive.

• #84 Incompetent Cervix: Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17912-incompetent-cervix

  Incompetent cervix occurs when your cervix opens, weakens or shortens too early in pregnancy. Its also known as cervical insufficiency. It can cause problems including miscarriage (loss of the pregnancy) and premature birth (being born before 37 weeks of pregnancy). […] If youre at risk for an incompetent cervix or your cervix shows signs of opening too soon, your pregnancy care provider may recommend preventative treatment to avoid pregnancy complications. […] Your provider diagnoses incompetent cervix with a pelvic exam and an imaging test called a transvaginal ultrasound (ultrasound using a wand inserted in the vagina). This test allows your provider to measure the length and opening of your cervix. […] The goal of treating incompetent cervix is to help you stay pregnant as long as possible. Because its hard to diagnose, knowing the risk factors are extremely important. Your provider will decide which treatment is best for you based on your condition and medical history.

• #85 Incompetent Cervix: Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17912-incompetent-cervix

  Incompetent cervix occurs when your cervix opens, weakens or shortens too early in pregnancy. Its also known as cervical insufficiency. It can cause problems including miscarriage (loss of the pregnancy) and premature birth (being born before 37 weeks of pregnancy). […] If youre at risk for an incompetent cervix or your cervix shows signs of opening too soon, your pregnancy care provider may recommend preventative treatment to avoid pregnancy complications. […] Your provider diagnoses incompetent cervix with a pelvic exam and an imaging test called a transvaginal ultrasound (ultrasound using a wand inserted in the vagina). This test allows your provider to measure the length and opening of your cervix. […] The goal of treating incompetent cervix is to help you stay pregnant as long as possible. Because its hard to diagnose, knowing the risk factors are extremely important. Your provider will decide which treatment is best for you based on your condition and medical history.

• #86 Cervical Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525954/

  Cervical insufficiency is the inability of the cervix to retain the fetus in the absence of uterine contractions (ie, painless cervical dilatation) due to a functional or structural cervical defect. […] Diagnosis can be based on physical exam findings (painless dilation without labor), a history of second-trimester losses or preterm births, or ultrasound evidence of a shortened cervix (25 mm) before 24 weeks gestation. […] Diagnosis is based on physical examination, clinical history, or ultrasonographic findings, and treatment options include cerclage and vaginal progesterone. […] The diagnosis of cervical insufficiency is typically made in one of the following scenarios: […] Exam-based diagnosis: Painless dilation in the second or early third trimester in the absence of contractions or other clear pathologies such as bleeding, PPROM, infection, or placental abruption.

• #87 Incompetent Cervix: Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17912-incompetent-cervix

  Incompetent cervix occurs when your cervix opens, weakens or shortens too early in pregnancy. Its also known as cervical insufficiency. It can cause problems including miscarriage (loss of the pregnancy) and premature birth (being born before 37 weeks of pregnancy). […] If youre at risk for an incompetent cervix or your cervix shows signs of opening too soon, your pregnancy care provider may recommend preventative treatment to avoid pregnancy complications. […] Your provider diagnoses incompetent cervix with a pelvic exam and an imaging test called a transvaginal ultrasound (ultrasound using a wand inserted in the vagina). This test allows your provider to measure the length and opening of your cervix. […] The goal of treating incompetent cervix is to help you stay pregnant as long as possible. Because its hard to diagnose, knowing the risk factors are extremely important. Your provider will decide which treatment is best for you based on your condition and medical history.

• #88 Incompetent Cervix: Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17912-incompetent-cervix

  Incompetent cervix can cause complications, including miscarriage and premature birth. […] Cerclage treatment for incompetent cervix is successful in nearly 90% of cases. […] An incompetent cervix (or cervical insufficiency) is when your cervix shortens, weakens or opens too soon during pregnancy. This can cause miscarriage or premature birth. Its hard to detect incompetent cervix unless you have a history of miscarriage or other risk factors. Be sure to discuss your complete medical history with your provider as well as any pregnancy symptoms you have. Knowing this information can help your provider determine if youre at risk for cervical insufficiency. In most cases, this condition is treatable with a procedure called a cerclage.

• #89 Cervical Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK525954/

  A shortened cervix is typically defined as a cervical length of less than 25 mm in patients undergoing serial screening ultrasounds. […] Before placing a cerclage, an obstetric ultrasound should be performed to ensure fetal viability, confirm the gestational age and cervical length, and exclude clinically relevant structural anomalies. […] The primary treatment options for cervical insufficiency include cerclage placement and vaginal progesterone. […] A cerclage is a nonresorbable suture placed around the cervix to improve mechanical strength and prevent premature dilation. […] Cervical insufficiency complicates up to 1% of pregnancies in the general population. […] Adverse outcomes associated with cervical insufficiency are primarily related to the effects of preterm birth.

• #90 Incompetent Cervix

  https://www.contemporaryobgyn.net/view/incompetent-cervix

  Incompetent cervix is diagnosed in I in 2000 pregnancies, and has been determined as the cause of approximately 15% of all recurrent pregnancy loss. […] The diagnosis can be made either by poor obstetric history or by examination. In the absence of poor obstetric history, the classic presentation of incompetent cervix is rapid and painless second trimester loss. However, the more common presentation of this condition is pregnancy loss accompanied by some degree of symptoms. Vaginal spotting, vaginal discharge, and pelvic pressure are the symptoms described most often by these patients. […] Recent advances in medicine have resulted in the early diagnosis of incompetent cervix with transvaginal ultrasonography. Asymptomatic cases can now be diagnosed earlier than before, prior to advanced cervical dilatation, funneling of the lower uterine segment, or prolapsing of fetal membranes into the vagina. […] Today’s ultrasound technology has greatly improved the diagnostic ability of obstetricians in determining incompetent cervix, with early diagnosis offering more treatment options.

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