She came in with the complaints of amenorrhea and she had had three episodes of recurrent pregnancy loss

Emobileclinic Patient’s corner

Emobileclinic Specialist

She came in with the complaints of amenorrhea and she had had three episodes of recurrent pregnancy loss. She was 14 weeks amenorrhoeic and had pregnancy symptoms. She came for antenatal booking in view of her previous problems. Her pregnancy was at 20 weeks, the second and third were at 18 weeks each.

The first one was an induced abortion terminated by dilatation and curettage in a private hospital. There was no immediate post-abortal complications but she resumed menstruation 8 weeks after the procedure. The last two were characterized by painless drainage of liquor and subsequent expulsion of products of conception with minimal pain. They were not preceded by any febrile illness or trauma. She had no other complaints and present pregnancy had been uneventful. She attained menarche at 14 years and menstruates for 5 days in a regular 28-30 day cycle. She was the only wife of her husband, who was a civil servant. She was a trader and she neither smoked cigarette nor drank alcohol.

There was no family history of twinning .
After all examination which includes past medical history, breast,cardiovascular system, etc her vaginal examination shows vulva and vagina were normal, but the cervix was soft,posterior and 2cm long. It admitted a tip of finger. The uterus was 14 weeks size. The adnexae were free. On the speculum, the cervix was normal looking. There was no bulging foetal membrane through the cervical Os. The cervical Os was closed.

Diagnosis
Intrauterine pregnancy with suspected cervical incompetence
The patient was counselled based on the clinical findings and the need for Cervical cerclage was discussed with the patient and her husband in view of her previous pregnancy loses.

What is cervical incompetence?