A 40 year old G2P1 woman with 18 weeks of amenorrhea comes with a dilated cervix. The cervical length is 15 mm. In spite of explaining the risks, she insisted on cerclage. Which of the following is a contraindication for cervical cerclage?
A 40 year old G2P1 woman with 18 weeks of amenorrhea comes with a dilated cervix. The cervical length is 15 mm. In spite of explaining the risks, she insisted on cerclage. Which of the following is a contraindication for cervical cerclage?
- Ruptured membranes
- Prolapse of membranes into the vagina
- Fetal fibronectin positive
Advanced maternal age
The Correct Option is B
Solution and Explanation
In the context of obstetrics and gynecology, a cervical cerclage is a procedure where stitches are used to close the cervix during pregnancy to prevent preterm birth or miscarriage. This procedure is typically considered for women who have a history of cervical insufficiency.
When evaluating a candidate for this procedure, it is crucial to identify any contraindications that would make the procedure unsafe or inappropriate. Listed are the options given:
- Ruptured membranes
- Prolapse of membranes into the vagina
- Fetal fibronectin positive
- Advanced maternal age
Among these, the prolapse of membranes into the vagina is the correct answer, as it is a contraindication for cervical cerclage. This condition signifies that the membranes are bulging through the cervix, increasing the risk of rupture during the procedure.
Other options are considered as follows:
- Ruptured membranes: This is also generally considered a contraindication as it indicates a high risk of infection and other complications.
- Fetal fibronectin positive: While it indicates a higher risk of preterm labor, it is not an absolute contraindication for cervical cerclage but rather a marker to guide clinical decisions.
- Advanced maternal age: Though it may be associated with other pregnancy risks, it is not a contraindication for cervical cerclage.
Therefore, the most direct contraindication for proceeding with a cervical cerclage in this scenario is the prolapse of membranes into the vagina.
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