A case of recurrent miscarriage
A 30 year old woman booked for antenatal care of a much wanted pregnancy at nine weeks' gestation. She had previously undergone three surgical terminations of pregnancy at 15, 12, and 10 weeks. She was otherwise fit and healthy and the pregnancy was progressing normally. A routine ultrasound scan was done at 19 weeks (figure).
Cervical incompetence is a biological continuum of reproductive performance ranging from cervical incompetence to premature labour.1 Most women with clinically diagnosed cervical incompetence have entirely normal cervical anatomy.2
A change in the morphology of the internal os and length of the cervix in a pregnant woman can be detected on a routine ultrasound scan (shown in the figure) and may predict premature labour.3 A premenstrual hysterosalpingogram, where the uterus and fallopian tubes are visualised by injecting dye via the cervix and then taking a series of x ray pictures, may also detect weakness of the