🌸 Second Trimester Miscarriage & Cervical Incompetence

Losing a pregnancy in the second trimester is heartbreaking and often unexpected.  

One of the leading causes is Cervical Incompetence – when the cervix opens too early, painlessly, and without contractions, leading to pregnancy loss.

🔍 Causes & Risk Factors  

•  Previous cervical surgery (cone biopsy, LEEP).  
•  Cervical trauma during labor or delivery.  
•  Congenital cervical weakness.  
•  Multiple gestation (twins or more).  
•  Uterine anomalies.

🩺 Diagnosis  

•  History of 2nd trimester losses or preterm births.  
•  Ultrasound: cervical length <25mm before 24 weeks is concerning.  
•  Speculum exam if membranes are visible at the os.

🧵 Management (Guideline-Based)  

 Cervical Cerclage:  

•   History-indicated: for women with ≥2 previous second trimester losses.  
•   Ultrasound-indicated: for cervical length <25mm before 24 weeks (ACOG, RCOG).  
•   Rescue cerclage: when cervix is already dilating with intact membranes.  
•   Progesterone supplementation: helps reduce the risk of preterm birth in high-risk women.  
•  Close monitoring: regular scans to assess cervical length and fetal well-being.  
•  Lifestyle advice: rest, avoid unnecessary pelvic procedures, manage infections promptly.

✨ Key Message for Mothers  

Cervical incompetence can be silent, but it’s not hopeless. With early diagnosis, timely intervention, and supportive care, many mothers can carry their pregnancies safely. 💕  

Every loss is painful, but every effort brings hope.