Incompetencia Cervical
Femenina 28 años de edad ,gestante con embarazo de 17,3 semanas por fetometria. Presenta dolores pelvicos sin sangrados. Antecedente de aborto previo a la misma fecha del actual embarazo. El examen sonografico de embarazo vía abdominal muestra embarazo de aprox: 17,3 semanas con actividad cardiaca y motriz normales.La placenta se aprecia en insercion baja, previa,marginal.El cuello uterino se aprecia con gran apertura del canal cervical en toda su extensión por lo cual se sospecha incompetencia cervical tanto en el anterior embarazo como en el actual. Ante esto, se le propone a la paciente la realización de una cervicometria, vía transvaginal. En principio la paciente rehúsa el procedimiento ya que tuvo un trauma previo con su primer embarazo donde se le realizo una exploración manual,digital, de una forma brusca por lo cual ella piensa que fue la causa real de la perdida en su embarazo anterior. A pesar de que el marido, presente durante el examen, acepto el procedimiento, la paciente no lo acepto hasta que su ginecóloga lo autorizó vía teléfono. Se procedió al examen el cual mostró un cuello uterino acortado, con el fenómeno del embudo o funneling en el os interno y una apertura de todo el canal cervical.Durante un pequeño momento del examen se aprecio que una extremidad superior del producto la introdujo al través del orificio interno.Lamentablemente se produjo lo que ya se veia como inevitable,la paciente perdió su embarazo.
28-year-old female, pregnant with a 17.3-week pregnancy due to fetometry. She has pelvic pain without bleeding. History of abortion prior to the same date as the current pregnancy. The abdominal sonographic examination of pregnancy shows a pregnancy of approx: 17.3 weeks with normal cardiac and motor activity.The placenta is seen in low, anterior, marginal insertion.The cervix is seen with a large opening of the cervical canal in its entirety for which cervical incompetence is suspected in both the previous and current pregnancy. Given this, the patient is proposed to perform a cervicometry, transvaginally. In principle, the patient refuses the procedure since she had a previous trauma with her first pregnancy where a manual, digital examination was carried out, in an abrupt way, for which she thinks that it was the real cause of the loss in her previous pregnancy. Although the husband, present during the examination, accepted the procedure, the patient did not accept it until her gynecologist authorized it by phone. The examination was carried out which showed a shortened cervix, with the phenomenon of the funnel or funneling in the internal os and an opening of the entire cervical canal.During a short moment of the examination, it was appreciated that an upper extremity of the product introduced it through the internal orifice. Unfortunately, what was already seen as inevitable occurred, the patient lost her pregnancy.
Cervical Incompetence
28-year-old female, pregnant with a 17.3-week pregnancy due to fetometry. She has pelvic pain without bleeding. History of abortion prior to the same date as the current pregnancy. The abdominal sonographic examination of pregnancy shows a pregnancy of approx: 17.3 weeks with normal cardiac and motor activity.The placenta is seen in low, anterior, marginal insertion.The cervix is seen with a large opening of the cervical canal in its entirety for which cervical incompetence is suspected in both the previous and current pregnancy. Given this, the patient is proposed to perform a cervicometry, transvaginally. In principle, the patient refuses the procedure since she had a previous trauma with her first pregnancy where a manual, digital examination was carried out, in an abrupt way, for which she thinks that it was the real cause of the loss in her previous pregnancy. Although the husband, present during the examination, accepted the procedure, the patient did not accept it until her gynecologist authorized it by phone. The examination was carried out which showed a shortened cervix, with the phenomenon of the funnel or funneling in the internal os and an opening of the entire cervical canal.During a short moment of the examination, it was appreciated that an upper extremity of the product introduced it through the internal orifice. Unfortunately, what was already seen as inevitable occurred, the patient lost her pregnancy.
