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This article is part of the supplement: Proceedings of the First and Second European Workshops on Preterm Labour of the Special Non-Invasive Advances in Fetal and Neonatal Evaluation (SAFE) Network of Excellence

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Clinical aspects of cervical insufficiency

Frederik K Lotgering

Author Affiliations

Department of Obstetrics and Gynecology, 791 Radboud University Nijmegen Medical Centre, PO Box 1901, 6500 HB Nijmegen, the Netherlands

BMC Pregnancy and Childbirth 2007, 7(Suppl 1):S17  doi:10.1186/1471-2393-7-S1-S17

Published: 1 June 2007

Abstract

Fetal loss is a painful experience. A history of second or early third trimester fetal loss, after painless dilatation of the cervix, prolapse or rupture of the membranes, and expulsion of a live fetus despite minimal uterine activity, is characteristic for cervical insufficiency. In such cases the risk of recurrence is high, and a policy of prophylactic cerclage may be safer than one of serial cervical length measurements followed by cerclage, tocolysis and bed rest in case of cervical shortening or dilatation. In low risk cases, however, prophylactic cerclage is not useful. There is a need for more basic knowledge of cervical ripening, objective assessment of cervical visco-elastic properties, and randomized controlled trials of technical aspects of cervical cerclage (e.g. suturing technique).