Miscarriage Research Today is a free monthly online journal that collates and summarizes the latest research about Miscarriage, including details on signs, symptoms, recurrent, pregnancy.

Controversies regarding cervical incompetence, short cervix, and the need for cerclage.

Althuisius S, Dekker G

Department of Obstetrics and Gynecology, Free University Hospital, De Boelelaan 1117, 1007 MB, Amsterdam, The Netherlands.

Cervical incompetence (CI) is not an all or nothing phenomenon but a continuous variable. CI and preterm labor are not distinct entities but rather part of a spectrum leading to preterm delivery. Cervical length (CL) is an independent variable in the prediction of preterm delivery, to which it is inversely related. Application of a primary transvaginal cervical cerclage appears to be an unnecessary intervention in about 50% of women presenting with a history suggesting cervical incompetence. A better alternative for women with a history of or risk factors for CI is transvaginal ultrasonographic follow-up of CL. To facilitate the comparison of studies of CI, the authors suggest a nomenclature reflecting the different stages of prevention: primary, secondary, and tertiary transvaginal cervical cerclage.

Published 2 November 2004 in Clin Perinatol, 31(4): 695-720, v-vi.
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