Obstetrics Gabbe Chapter 28: Cervical Insufficiency

Front 1

Cervicalinsufficiency is primarily a _______ diagnosis characterized byrecurrent painless dilatation and spontaneous midtrimester loss.

Back 1

clinical

Front 2

Cervicalinsufficiency is ________ a distinct and well-defined clinical entity,but only one component of the larger and more complex spontaneouspreterm birth syndrome.

Back 2

rarely

Front 3

Currentevidence suggests that cervical competence functions along acontinuum, influenced by both endogenous and exogenous factors, suchas ______________ and _________________

Back 3

uterine contractions, decidual/membrane activation.

Front 4

Thetraditional nomenclature of cerclage type as prophylactic,therapeutic, and emergent should be replaced by ________-indicated, _______-indicated, and _________________–indicated cerclage.

Back 4

history, ultrasound, physical examination

Front 5

Thereis no objective ____________________________ test for cervicalinsufficiency.

Back 5

preconceptional diagnostic

Front 6

_________________________ for patients with a clinical history of cervicalinsufficiency remains a reasonable approach.

Back 6

History-indicated cerclage

Front 7

Cervicalultrasound for cervical insufficiency performs ______________________ in low-risk women, but it has been proven to be a clinicallyuseful screening and diagnostic tool in selected high-riskpopulations such as those with a prior sPTB who may have a treatablecomponentofcervical insufficiency.

Back 7

poorly as a screening test

Front 8

Inthe vast majority of women with prior sPTBs, and even those withnonclassic clinical histories of cervical insufficiency, serialsonographic evaluations of the cervix may be _____________________ to history-indicated cerclage.

Back 8

an acceptable alternative approach

Front 9

Physicalexamination–indicated cerclage may be beneficial in reducing PTB ina subgroup of patients without markers of ____________.

Back 9

infection

Front 10

Abdominalcerclage may be considered for those rare patients with a history of ___________________.

Back 10

failed vaginal cerclage

Front 11

Ultrasoundindicated cerclage in twin gestation should not be performed becauseof the increase risk for _______________ with this intervention.

Back 11

preterm delivery

Front 12

Thereis a need for randomized studies to evaluate alternative treatmentsfor cervical insufficiency such as _______________ therapy, and vaginalpessary.

Back 12

pharmacologic