Question

A 29-year-old G3P0 woman presents for prenatal care at eight weeks gestation. Her two prior pregnancies ended in spontaneous losses at 19 and 18 weeks, respectively. Records corroborate the patient’s history of an uncomplicated gestation until the evening of the losses, which is when she experienced a pink-tinged discharge that prompted her to call her obstetrician. In both cases, the obstetrician noted that her cervix had dilated completely with the amnionic sac bulging into the vagina to the level of the introitus. The patient was afebrile without other complaints, and there was no uterine tenderness on exam. She spontaneously delivered the fetus and placenta in both cases. A sonohysterogram confirmed normal uterine anatomy several weeks later. What is the most appropriate next step in the management of this patient?

Answer 1

Hi !

Placement of a cervical cerclage at 14 weeks.