Cervical Insufficiency

Cervical insufficiency is the inability of the cervix to retain the fetus in the absence of uterine contractions (ie, painless cervical dilatation) due to a functional or structural cervical defect. Cervical insufficiency may be identified in the second or early third trimester of an ongoing pregnancy, though often, this condition is diagnosed retrospectively. Progressive cervical dilation at these early gestational ages can result in preterm premature rupture of membranes (PPROM), mid-trimester pregnancy loss, or spontaneous preterm birth. Diagnosis can be based on physical exam findings (painless dilation without labor), a history of second-trimester losses or preterm births, or ultrasound evidence of a shortened cervix (<25 mm) before 24 weeks gestation. Risk factors, including prior cervical surgeries or preterm births, should be assessed early in pregnancy. Treatment options include cerclage (suturing the cervix to prevent dilation) and vaginal progesterone. The approach depends on the severity and timing of the diagnosis, with individualized care for high-risk patients. This activity for healthcare professionals is designed to enhance the learner's competence in recognizing cervical insufficiency, performing the recommended evaluation, and implementing an appropriate interprofessional management approach to improve patient outcomes.

Credit & MOC Details

Credit information is provided by the course provider. We recommend confirming credit eligibility with the provider or your licensing board before starting the activity.