Painless early pregnancy dilation
Etiology
- Trauma from rapid forceful cervical dilation associated with 2nd trimester abortion
- Cervical laceration from rapid delivery
- Injury from deep cervical cone
- Congenital weakness from DES exposure
Diagnosis:
- History of 2 or more unexplained second trimester pregnancy losses.
- Benefit of cerclage is unclear
Management:
- Elective cerclage at 13-16 weeks gestation
- Emergency or Urgent cerclage
- Cerclage removal at 36-37 weeks