The role of isthmic-cervical insufficiency in miscarriage

Abstract

Cervical insufficiency (CI) is one of the main pathological conditions that leads to pregnancy loss, in particular, recurrence miscarriages and premature births, which account for up to 5 % of all obstetric cases. Recurrence pregnancy losses caused by CI lead to serious psychological trauma for both the woman and her family members, as well as significant economic losses for the society. However, many women in some regions of the world still do not know about this pathology, and clinicians do not always diagnose this condition in time.At the same time, etiology of CI remains uncertain, and there are still ambiguous points regarding the diagnosis of this pathology and its treatment. The diagnosis of CI should be established by analyzing the medical history, clinical manifestations and results of ultrasound examination. Treatment of CI mainly includes surgical and conservative methods. Surgical treatment is performed with cervical cerclage, while conservative techniques mainly include the use of vaginal progesterone and insertion of various types cervical pessaries. This article summarizes the potential risk factors associated with cervical insufficiency that are of great attention and may be useful for future researches. Also, the review of the literature considers modern methods of diagnosis and treatment of CI to understand this pathology of the cervix better. From a modern standpoint, a consensus and problematic issues are presented in accordance with the recently updated recommendations, which are of practical importance, and are also important for further deeper research on this topical issue of modern obstetrics.