Evaluation of the Cervix
The diagnosis of cervical incompetence is generally based on a prior history of late abortions or preterm deliveries. In the absence of such antecedents or in primigravidae, about the only way to diagnose cervical incompetence in the past was by vaginal examination. However, this examination provides no objective information on cervical shortening. Only about half the true cervical length is accessible to the palpating finger, and the interpretation of possible cervical shortening is highly subjective. Moreover, dilatation of the cervical canal is detectable by palpation only if it extends to the external os. Thus, palpation can detect an incompetent cervix only at a relatively late stage, and treatment is correspondingly delayed.
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