[What should you tell a patient with a history of cervical incompetence in the first trimester?].
Data is now more than ever available to inform couples at risk of second trimester miscarriage or preterm delivery. We are able to give customized information according to the obstetrical history and to the evolution of the cervix during the second trimester although the level of scientific evidence is limited or poor. Elective cerclage can be proposed to patients with a history of at least 3 second trimester miscarriages or preterm deliveries. There is no clear consensus on which patients could benefit from therapeutic cerclage. Indications would have to be motivated by a short cervix on ultrasound measurements and the cerclage performed before 24 weeks of gestation.
Nizard
J
J
Service de Gynécologie-Obstétrique et Biologie de la Reproduction, Centre Hospitalier Poissy-Saint-Germain-en-Laye, 10, rue du Champ-Gaillard, 78300 Poissy, France. jnizard@gmail.com
D001510:Bed Rest; D023802:Cerclage, Cervical / Q000379:methods*; D005260:Female; D006801:Humans; D007752:Obstetric Labor, Premature / Q000209:etiology / Q000517:prevention & control*; D011247:Pregnancy; D011256:Pregnancy Outcome; D018570:Risk Assessment; D013536:Suture Techniques; D002581:Uterine Cervical Incompetence / Q000601:surgery*