China
Africa
Explore chapters and articles related to this topic
Causes and risk factors
Published in Janetta Bensouilah, Pregnancy Loss, 2021
Also termed cervical insufficiency, cervical incompetence is well recognised as a potential cause of mid-trimester miscarriage, and although some cases involve mechanical weakness, in the majority of cases there is normal cervical anatomy, but evidence of subclinical intrauterine infection. However, whether infection is the result or cause of premature cervical dilation remains unknown.10 In addition to being a congenital problem, cervical incompetence may follow mechanical trauma such as excessive dilation at the time of curettage, cervical biopsy or occasionally a difficult vaginal delivery. Preterm labour (PTL) has been linked to cervical incompetence in single and multiple pregnancies. In the case of the latter, the risk is higher, and as PTL is the major cause of neonatal death in multiple pregnancies, cervical screening is useful for identifying those at risk, although there is uncertainty as to whether the standard treatment of inserting a stitch (cerclage) improves pregnancy outcome.12,13
DRCOG MCQs for Circuit A Questions
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Causes of preterm labour include: Chorio-amnionitis.Polyhydramnios.Cervical incompetence.Peritonitis.Pyelonephritis.
Endocrine Regulation of Cervical Functions During Pregnancy and Labor
Published in Gabor Huszar, The Physiology and Biochemistry of the Uterus in Pregnancy and Labor, 2020
Early pregnancy loss in most instances is not related to an abnormality of cervical maturation. The entity of cervical incompetence is the exception to this statement. Cervical incompetence is a failure of the cervix to perform its function as a protective barrier. It is a difficult state to define clinically and probably has several etiologies. Among these are previous cervical lacerations or trauma, premature induction of parturitional changes of a normal cervix, and an intrinsic defect in cervical composition. All of these could compromise the structural integrity of the cervix leading to premature effacement and dilatation. Cervical cerclage procedures have proven to be a moderately effective therapy, but future therapies may require a more specific appreciation of the abnormality, which is causing cervical incompetence, and may include biochemical manipulation to maintain or reestablish the physical integrity of the cervix as a barrier.
A retrospective cohort study of obstetric complications and birth outcomes in women with polycystic ovarian syndrome
Published in Journal of Obstetrics and Gynaecology, 2022
Qiwei Liu, Jingxue Wang, Qian Xu, Liang Kong, Jinjuan Wang
Chorioamnionitis was defined by 2 or more clinical signs of infection, including maternal pyrexia, tachycardia, uterine tenderness, offensive liquor and foetal tachycardia (Stojanovska et al. 2018). Cervical incompetence was diagnosed based on clinical symptoms and ultrasound results (Wang et al. 2016). The definition of cervical incompetence incorporates both a sonographic cervical length of less than 25 mm and prior spontaneous preterm birth at less than 37 weeks. The traditional management of cervical incompetence is application of transvaginal cervical cerclage. Non-invasive management options also exist, including progesterone therapy and cervical pessary, which may be effective management options. The diagnosis of preterm birth is defined as <37 weeks of gestation (Leonard et al. 2015).
Clinical factors associated with pregnancy outcome in women with recurrent pregnancy loss
Published in Gynecological Endocrinology, 2019
Maho Miyaji, Masashi Deguchi, Kenji Tanimura, Yuki Sasagawa, Mayumi Morizane, Yasuhiko Ebina, Hideto Yamada
Table 2 shows clinical factors and pregnancy outcome of women with RPL. Twenty-one women with uterine abnormalities included six with septate uterus, two with arcuate uterus, one with bicornuate uterus, one with unicornuate uterus, seven with adenomyosis and/or myoma uteri, and four with cervical incompetence. Six women with uterine abnormalities underwent a surgical operation prior to the conception. Four women with septate uterus underwent hysteroscopic metroplasty, one woman with myoma underwent hysteroscopic myomectomy, and one woman with myoma underwent hysteroscopic and abdominal myomectomy. Two women with cervical incompetence underwent cervical cerclage early in pregnancy. Twenty-one women with thyroid dysfunction included 10 with hypothyroidism and 11 with hyperthyroidism.
Comparing pregnancy, childbirth, and neonatal outcomes in women with different phenotypes of polycystic ovary syndrome and healthy women: a prospective cohort study
Published in Gynecological Endocrinology, 2020
Fatemeh Foroozanfard, Zatollah Asemi, Fatemeh Bazarganipour, Seyed Abdolvahab Taghavi, Helen Allan, Shahintaj Aramesh
Evaluation of cervical incompetence: transvaginal ultrasound from 16–24 weeks’ gestation was performed by a gynecologist. The mean cervical length from 16–24 weeks of pregnancy is 25 mm. Cervical length <25 mm does not indicate cervical incompetence but it is a risk factor for adverse pregnancy outcomes. Cervical incompetence indicates preterm delivery due to passive dilation of the uterine cervix. Cervical length <25 mm is an indication for cerclage placement in a population of pregnant women with a history of preterm delivery. In this study, we considered cervical length <25 mm as cervical incompetence and cervical length >25 mm as not having cervical incompetence [20].