Skip to main content Accessibility help
×
Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-29T01:58:57.496Z Has data issue: false hasContentIssue false

Chapter 8 - Cervical Insufficiency

from Section 1 - Obstetric Aspects of Antenatal Care

Published online by Cambridge University Press:  23 February 2023

Amira El-Messidi
Affiliation:
McGill University, Montréal
Alan D. Cameron
Affiliation:
University of Glasgow
Get access

Summary

A 30-year-old G6P2A4L1 is referred by her primary care provider to your high-risk obstetrics clinic for preconception counseling after a pregnancy loss at 21+4 weeks’ gestation last year, shortly after incidental transvaginal cervical shortening was noted at second-trimester fetal morphology survey. After an uncomplicated first pregnancy and term delivery, she experienced four consecutive first-trimester losses for which comprehensive investigations were unremarkable.

Type
Chapter
Information
OSCEs in Obstetrics and Maternal-Fetal Medicine
An Evidence-Based Approach
, pp. 96 - 108
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Suggested Readings

ACOG Practice Bulletin No. 142: cerclage for the management of cervical insufficiency. Obstet Gynecol. 2014;123(2 Pt 1):372–379.Google Scholar
(a) Alfirevic, Z, Stampalija, T, Medley, N. Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy. Cochrane Database Syst Rev. 2017;6(6):CD008991.Google ScholarPubMed
Eleje, GU, Eke, AC, Ikechebelu, JI, et al. Cervical stitch (cerclage) in combination with other treatments for preventing spontaneous preterm birth in singleton pregnancies. Cochrane Database Syst Rev. 2020;9(9):CD012871.Google Scholar
Conde-Agudelo, A, Romero, R, Nicolaides, KH. Cervical pessary to prevent preterm birth in asymptomatic high-risk women: a systematic review and meta-analysis. Am J Obstet Gynecol. 2020;223(1):4265.Google Scholar
Gluck, O, Mizrachi, Y, Ginath, S, et al. Obstetrical outcomes of emergency compared with elective cervical cerclage. J Matern Fetal Neonatal Med. 2017;30(14):16501654.CrossRefGoogle ScholarPubMed
Pergialiotis, V, Bellos, I, Antsaklis, A, et al. Presence of amniotic fluid sludge and pregnancy outcomes: a systematic review. Acta Obstet Gynecol Scand. 2020;99(11):14341443.Google Scholar
Preterm Labour and Birth. NICE Guideline NG25, November 20, 2015, last updated August 2, 2019. Available at www.nice.org.uk/guidance/ng25?unlid=9291036072016213201257. Accessed July 10, 2021.Google Scholar
Senarath, S, Ades, A, Nanayakkara, P. Cervical cerclage: a review and rethinking of current practice. Obstet Gynecol Surv. 2020;75(12):757765.Google Scholar
Shennan, A, Chandiramani, M, Bennett, P, et al. MAVRIC: a multicenter randomized controlled trial of transabdominal vs transvaginal cervical cerclage. Am J Obstet Gynecol. 2020;222(3):261.e1261.e9.Google Scholar
(a) Brown, R, Gagnon, R, Delisle, MF. No. 373 – cervical insufficiency and cervical cerclage. J Obstet Gynaecol Can. 2019;41(2):233247.CrossRefGoogle ScholarPubMed
Lim, KI, Butt, K, Nevo, O, et al. Guideline No. 401: sonographic cervical length in singleton pregnancies: techniques and clinical applications. J Obstet Gynaecol Can. 2020;42(11):13941413.Google Scholar
Sperling, JD, Dahlke, JD, Gonzalez, JM. Cerclage use: a review of 3 national guidelines. Obstet Gynecol Surv. 2017;72(4):235241.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×