Two 2nd trimester pregnancy loss.. Clincal criteria fullfilled...then why not go for direct cervical cerclage...?

Two 2nd trimester pregnancy loss…

Clincal criteria fullfilled…then why not go for direct cervical cerclage…?

What if the Abortions were not due to Cervical Incompetence and we do a cerclage where its not needed?

We will do more harm than good to the patient.

So check for the Cervical length ,if <2.5 cm do the prophylactic cerclage.

means…always do usg… Before cerclage.

(Clinical criteria does not matter).

the patient is just 9 weeks.

I agree she has fulfilled the criteria.

But my " Next Step" would be USG and not directly Cerclage to look for any bulging membranes, PROM/ preterm labour as such.

If my USG findings are consistent , I will go with a Prophylactic Cerclage at 12-14 weeks

if clinical criteria is fulfilled and USG is showing >2.5cm cervical length still we do cervical cerclage in 2nd trimester . Cervical cerclage is done in 2nd trimester for the same reason you mentioned .

if, in question 14 weeks pregancy, clinical criteria fulfilled… Direct cerclage…no need usg.

In question 9 wks… Thats why… Usg…?

If any gravid pt Fulfills this history : atleast 2 painless preg loss in 2nd trimester : even if USG says cervical length is >2.5cm : we will do CERCLAGE ( but we will only do it in 2nd trimester )

If there’s any uncertainty in clinical history : we will do USG and then plan for CERCLAGE of length <2.5cm

I don’t think that answer here should be USG . Because USG to check cervical dilatation IS DONE IN 2nd Trimester and she is 9week pog only .

If in option it would have just mentioned USG : it would be correct answer as we routinely do 1st trim USG . But here it’s saying USG to check for cervical dilatation which is done in 2nd trim .

So I think ans should be : bed rest and recall after 3-4 weeks