PREMATURE CERVICAL DILATION

Question 1

Cervix that dilates prematurely and therefore cannot hold a fetus until term

Previously termed an incompetent cervix

Answer 1

Premature Cervical dilation

Question 2

Risk Factors:

Answer 2

~ Increased maternal age
~ Congenital structural defects
~ Trauma to the cervix, such as might have occured with a cone biopsy or repeated D & Cs

Question 3

Causes:

Answer 3

•Previous surgery on the cervix

•Damage during a difficult birth

•Congenital cervical or uterine anomalies

•Previous trauma to the cervix

•Infection

•Increased uterine volume

Question 4

Signs and Symptoms:

Answer 4

•painless dilatation

•Presence of show

•increased pelvic pressure

•followed by rupture of the membranes & discharge of the amniotic fluid

•Uterine contractions

Question 5

Assessment:

Answer 5

positive history of
repeated, relatively
painless spontaneous
second trimester
abortions

•Serial pelvic exam
and ultrasound

Question 6

•As soon as a sonogram confirms that the
fetus of a second pregnancy is healthy, at
approximately weeks 12 to 14, purse-string
sutures are placed in the cervix by the
vaginal route under regional anesthesia

•McDonald or a Shirodkar –Barter technique

Answer 6

Cervical Cerclage

Question 7

A women would not be eligible for a cerclage if:

Answer 7

✅ There is increased irritation of the cervix
✅ The cervix has dilated 4cm
✅ membranes have ruptured

Question 8

🧾Nursing Management:

Answer 8

✅ Reporting painless bleeding

✅ Encourage strict bedrest

✅ Sexual relations can be resumed in most instances after this rest period

✅ After cerclage surgery, remain on bed rest (Tredelenburg) for a few days

Question 9

Nursing Management part 2

Answer 9

✅ The amniotic membranes may rupture when the cerclage is placed

✅The uterus may become irritated, starting labor

✅The placenta or uterus may become infected

✅ The cervix may be damaged if contractions tear the cerclage out