DISEASE SCANNER

Global Incurable Diseases Tracker

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Gynecologic Condition

Cervical Incompetence

HIGH SEVERITY

Painless cervical dilation and effacement leading to second-trimester pregnancy loss or preterm birth. The cervix is unable to retain the pregnancy until term.

Global Affected

120.0K

Countries

15

Symptoms

Usually asymptomatic until late
Mild pelvic pressure
Vaginal discharge changes
Painless cervical dilation
Preterm premature rupture of membranes
Second-trimester pregnancy loss

Treatment Options

Transvaginal cerclage (McDonald or Shirodkar)
Transabdominal cerclage
Vaginal progesterone
Cervical pessary (Arabin)
Bed rest (limited evidence)
Emergency rescue cerclage

Risk Factors

1Prior cervical surgery (LEEP, cone biopsy)
2History of second-trimester loss
3Multiple D&C procedures
4DES exposure in utero
5Uterine anomalies
6Multiple gestation
7Cervical trauma

Diagnostic Methods

  • 1Transvaginal ultrasound (cervical length)
  • 2Physical examination of cervix
  • 3Review of obstetric history
  • 4Fetal fibronectin testing
  • 5Serial cervical length measurements

Prognosis

Good with cerclage placement. Cerclage reduces preterm birth by 30-40% in high-risk women. 85-90% pregnancy success rate with history-indicated cerclage. Emergency cerclage has 50-60% success rate. Progesterone provides additional benefit. Early detection and intervention critical. Most women carry to 34+ weeks with proper management.

Prevention

  • Cervical length screening in high-risk pregnancies
  • Progesterone for short cervix
  • Preconception counseling
  • Avoiding unnecessary cervical procedures

Research Status

Cerclage (cervical stitch) placement, progesterone supplementation, cervical pessary, and activity restriction. Emergency cerclage for acute cervical changes. Preconception counseling for high-risk women.

Affected Countries

United StatesUnited KingdomCanadaAustraliaGermanyFranceItalySpainJapanBrazilMexicoIndiaChinaNigeriaSouth Africa

Sources

  • https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2014/02/cervical-insufficiency
  • https://www.smfm.org/publications/smfm-consult-series-52-cerclage
  • https://www.ncbi.nlm.nih.gov/books/NBK532856

Medical Disclaimer

This information is for educational purposes only. Always consult healthcare professionals for medical advice, diagnosis, and treatment.