Cervical incompetence: A reappraisal of an obstetric controversy
Date
2002
Authors
Althuisius, S.
Dekker, G.
van Geijn, H.
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Journal article
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Obstetrical and Gynecological Survey, 2002; 57(6):377-387
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Sietske M. Althuisius, Gustaaf A. Dekker, and Herman P. van Geijn
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Abstract
Cervical incompetence is not a categoric but rather a continuous variable, meaning that there are various degrees in the competency of the cervix. Furthermore, a certain degree of competency of the cervix can be expressed differently in subsequent pregnancies. Women with risk factors for cervical incompetence in their gynecological/obstetric history should be followed by transvaginal ultrasonography. History alone is not an indication for a prophylactic cerclage. Although transvaginal ultrasonography identifies women at high risk of preterm delivery, it does not discriminate between different underlying pathologies. Short cervical length alone is not an indication for a therapeutic cerclage. Serial transvaginal ultrasonographic measurements of cervical length in women with risk factors can identify those women truly at high risk of preterm delivery. A transvaginal cervical cerclage with bed rest reduces preterm delivery and improves perinatal outcome in women with a short cervical length and risk factors for cervical incompetence.
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© 2002 Lippincott Williams & Wilkins, Inc.