الفهرس 
Cervical InsufficiencyOnly 14 pages are availabe for public view
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Abstract
Cervical insufficiency is an obstetrical dilemma often
charactereized by recurrent spontanous mid-trimester pregnancy
loss which is a very painful experience for the couple. Muliple
risk factors have been identified that include; the typical history of
painless mid-trimester loss , history of prior cervical trauma , a
previous pregnancy whith short cervical length , or a maternal
connective tissue disease or abnormalities, e.g. Ehlers-Danlos
syndrome.
Several nonsurgical have been proposed to treat cervical
insufficiency. Some nonsurgical approaches, including activity
restriction, bed rest, and pelvic rests that have not been proved to
be effective for the treatment of cervical insufficiency and their
use is discouraged. Other treatment modalities include
progesterone and cervical pessary have been proposed as
alternatives for cervical cerclage, however there use is
controversial.
Cervical cerclage is commonly used in the management of
women who are considered to be at high risk of mid-trimester loss
or spontaneous preterm birth. Insertion is determined by
indications such as history of recurrent spontatous mid-trimester
pregnancy loss, cervical shortening seen on transvaginal