Cervical Insufficiency

Cervical insufficiency is a condition in which the cervix painlessly dilates during the second or early third trimester due to a functional or structural defect. This condition can potentially lead to preterm premature rupture of membranes (PPROM), second-trimester pregnancy loss, or spontaneous preterm birth. Cervical insufficiency may be identified in the second or early third trimester of an ongoing pregnancy, though often, this condition is diagnosed retrospectively.

These cervical defects, which may be congenital or acquired, cause cervical insufficiency by disrupting normal cervical remodeling during pregnancy, leading to early cervical ripening, preterm birth, or miscarriage. Common risk factors include a history of cervical surgery, miscarriage, or a shortened cervix. Diagnosis is based on physical examination, clinical history, or ultrasonographic findings, and treatment options include cerclage and vaginal progesterone. Management is tailored to individual patient risk.