July 10th, 2020

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Cervical Insufficiency: Are Some Cases Fetal Induced? A Report of 2 Cases
Authors:  Craig V. Towers, M.D.
BACKGROUND: Many causes for cervical insufficiency have been reported, including trauma, infections, irritants, and social factors. This report describes 2 separate cases of pregnancy loss caused by cervical insufficiency that appear to be pregnancy/fetus specific.
CASES: Two unrelated patients had similar histories with 2 midgestation losses from cervical insufficiency that occurred before and after full-term deliveries. Both cases occurred in married, middle class women, and the fathers in each case were unchanged. No known factors associated with cervical insufficiency were present in either patient. The only variable that was different was the specific pregnancy.

CONCLUSION: These 2 cases might suggest that the fetus and/or placenta may have produced some change that provoked painless cervical dilation. Whether this could be genomic, epigenetic, hormonal, metabolomic, or a combination of these factors is unknown, but further research in this area is needed.
Keywords:  abortion, habitual; abortion, recurrent; cerclage; cervical cerclage; cervical incompetence; cervical insufficiency; cervix incompetence; incompetent cervix; miscarriage, recurrent; pregnancy loss; premature cervical dilation; preterm birth; recurrent early pregnancy loss; uterine cervical incompetence
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