cervical incompetence


cervical incompetence

Incompetent cervical os Gynecology A condition characterized by dilation and effacement of uterine cervix in later pregnancy which may be associated with spontaneous abortion and prematurity Frequency 1-2% of all pregnancies; causes 20-25% of 2nd trimester abortions Clinical Vaginal bleeding or spotting; sensation of lower abdominal weightRisk factors Prior cervical surgery or previous difficult vaginal delivery, cervical malformation, DES exposure, multigestation Management Cerclage. See Cerclage.

cervical incompetence

Structural inability of the cervical os to remain closed and support a growing fetus. This problem has commonly been associated with recurrent spontaneous second-trimester abortions. A higher incidence of this structural abnormality is noted after cervical trauma, e.g., previous vaginal or cesarean births, cervical laceration, conization of the cervix. It also has been reported among daughters whose mothers were treated with diethylstilbestrol (DES) during their pregnancies. Traditionally, cerclage has been used for treatment even though controlled trials of its effectiveness have not been uniformly successful. See: cerclage; Shirodkar operationSee also: incompetence

cervical incompetence

The inability of the inner opening of the neck of the womb to remain properly closed. This is a cause of repeated, painless, spontaneous abortions around the fourth or fifth month of pregnancy and affects about one pregnancy in 100. This can be prevented with a temporary encircling stitch (a Shirodkar suture), but the difficulty is to know which women are likely to be affected. Women with a history of mid-term miscarriage are obvious candidates for cerclage. The procedure can be done as an emergency if threatened miscarriage is detected in time.