Overview
Painless cervical dilatation in pregnancy is a sign of cervical insufficiency, a condition where the cervix opens prematurely without contractions. This can lead to preterm birth.Diagnosis
Painless cervical dilatation in singleton pregnancies is the primary presentation 1.Management
Emergency cerclage is an intervention for painless cervical dilatation 1.
Expectant management is an alternative to cerclage 1.Special Populations
Pregnancy
Emergency cerclage in pregnant women with painless cervical dilatation appears to decrease preterm births before 28 and 32 weeks of gestation 1.
Cerclage may prolong pregnancy and decrease neonatal deaths and fetal losses 1.
Cerclage does not appear to increase the risk of chorioamnionitis or premature rupture of membranes 1.Key Recommendations
Emergency cerclage is recommended for pregnant women presenting with painless cervical dilatation, as it decreases preterm birth and prolongs pregnancy 1. (Evidence: Moderate)
Expectant management is an alternative to emergency cerclage in cases of painless cervical dilatation 1. (Evidence: Moderate)References
1 Chatzakis C, Efthymiou A, Sotiriadis A, Makrydimas G. Emergency cerclage in singleton pregnancies with painless cervical dilatation: A meta-analysis. Acta obstetricia et gynecologica Scandinavica 2020. link