O34.3

Clinical Causes: Congenital abnormalities affecting cervical structure Previous cervical surgeries or procedures Hormonal factors affecting cervical tissue Infections leading to cervical tissue damage Trauma or injury to the cervix during delivery or other procedures Multiple pregnancies (e.g., twins or more) increasing cervical strain Connective tissue disorders that weaken the cervical tissue

Key Symptoms: Typically, cervical incompetence does not cause noticeable symptoms before complications arise Pelvic pressure or heaviness Vaginal discharge that increases in amount or change in character Sensation of pelvic or lower back pressure In some cases, mild cramping In the event of preterm labor or miscarriage, symptoms may include abdominal cramps, bleeding, or fluid leakage

Diagnosis Path: Pelvic examination to assess cervical length and condition Transvaginal ultrasound to measure cervical length and detect dilation History of previous pregnancy losses or preterm births due to cervical issues Monitoring cervical length during pregnancy, especially in women with risk factors Other imaging or tests as necessary to evaluate cervical tissue integrity

Treatment Protocols: Cerclage: a surgical procedure where a suture is placed around the cervix to reinforce its structure. Common types include: Shirodkar cerclage: performed higher up within the cervix, often used in cases with significant cervical shortening or history of preterm birth McDonald cerclage: a simpler, widely used technique involving a purse-string suture around the cervix Timing of cerclage placement typically occurs between 12 to 14 weeks of pregnancy but depends on individual risk factors Medication such as progesterone supplements may also be prescribed to support pregnancy Close monitoring of cervical length throughout pregnancy to assess ongoing risk Lifestyle adjustments, including activity modifications and avoiding strenuous activities