Cervical Insufficiency

Cervical Insufficiency: Surgical Therapy

Operatively, a distinction is made between prophylactic (= primary) and therapeutic (= secondary) operations. They are performed in the form of cerclage (cervical encircling) or total closure of the cervix. Definition of prophylactic/primary surgery for cervical insufficiency (preferably cerclage/cervical wrap): Patients with: Congenital disorders: Malformations of the Müllerian ducts ( e.g., uterine malformations). Deficiency of: … Cervical Insufficiency: Surgical Therapy

Cervical Insufficiency: Prevention

Intravaginal progesterone application (progesterone administration, inserted into the vagina) In a high-risk population (postpreterm delivery status, cervical length before 24 weeks’ gestation <25 mm), once-daily application of progesterone gel 90 mg or progesterone capsules 200 mg may result in a significant reduction in preterm delivery.

Cervical Insufficiency: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate cervical insufficiency (cervical weakness): Pathognomonic (indicative of a disease) Speculum setting (speculum: medical examination instrument used to examine the vagina, cervix): Prolapse (prolapse) of the amniotic sac. Ultrasound (vaginal/through the vagina): in the course of pregnancy, increasing shortening of the cervix (cervical length) and the opening of the … Cervical Insufficiency: Symptoms, Complaints, Signs

Cervical Insufficiency: Causes

Pathogenesis (development of disease) Cervical maturation (maturation of the uterus) is a very complex, active chemical process and a process that is still not fully understood. It is independent of uterine contractions or labor. Simplistically, it resembles a bacterial or abacterial inflammatory reaction (granulocyte and macrophage proliferation/granulocytes belong to the white blood cell group; macrophages … Cervical Insufficiency: Causes

Cervical Insufficiency: Therapy

General measures Bed rest and physical rest: there are no studies on prophylaxis or therapy regarding physical rest and bed rest from the point of view of cervical insufficiency. Exceptions are the opened cervix or prolapse (prolapse) of the amniotic sac. Both situations lead to hospital admission, extensive bed rest and, if possible, early surgical … Cervical Insufficiency: Therapy

Cervical Insufficiency: Medical History

Medical history (history of illness) represents an important component in the diagnosis of cervical insufficiency (cervical weakness). Family history To date, the only known genetic familial cause is Ehlers-Danlos syndrome. It is a very rare, heterogeneous group of congenital disorders of collagen synthesis. Organs with connective tissue-rich structures, for example, also the cervix uteri (cervix) … Cervical Insufficiency: Medical History

Cervical Insufficiency: Or something else? Differential Diagnosis

Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93). Irritable bowel syndrome (irritable colon). Musculoskeletal system and connective tissue (M00-M99). Soft tissue disease, unspecified: Pelvic region and thigh [pelvis, femur, buttocks, hip, hip joint, sacroiliac joint/ISG; sacroiliac joint]. Low back pain, incl.: Lumbar pain, lumbago (lumbago), overload in the sacral region. Myalgia (muscle pain): pelvic … Cervical Insufficiency: Or something else? Differential Diagnosis

Cervical Insufficiency: Complications

The following are the most important conditions that may be contributed to by cervical insufficiency (cervical weakness) or by prophylactic (e.g., cerclage/cervical wrap) and therapeutic (e.g., cerclage, bed rest, especially tocolysis/inhibition of labor) measures, as well as by premature delivery: Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Patent ductus arteriosus (synonyms: Called ductus arteriosus botalli, … Cervical Insufficiency: Complications

Cervical Insufficiency: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin and mucous membranes Abdominal wall and inguinal region (groin area). Auscultation (listening) of the heart. Auscultation of the lungs Gynecological-obstetrical examination. Inspection Vulva (external, primary female sex organs) … Cervical Insufficiency: Examination

Cervical Insufficiency: Test and Diagnosis

Laboratory parameters of the 1st order – obligatory laboratory tests. There are no specific laboratory tests that must be performed as part of the diagnosis of cervical insufficiency. The only concern is to rule out infections. The following tests should be performed to rule out vaginal inflammation: Bacteriological smear if colpitis (vaginitis)/cervicitis (cervicitis) is suspected. … Cervical Insufficiency: Test and Diagnosis

Cervical Insufficiency: Diagnostic Tests

Mandatory medical device diagnostics. Vaginal sonographic measurement (vaginal ultrasonography; ultrasound procedure in which the ultrasound probe is inserted vaginally) of cervical length (cervix length). Vaginal palpation in to assess the cervix is a subjective, difficult to reproduce examination with many sources of error. It is possible to partially assess the position, consistency, width of the … Cervical Insufficiency: Diagnostic Tests