A gravida 3 female with h/o two prior 2nd trimester abortions associated with h/o painless cervical dilatation, comes to you with Level II USG which shows the below findings. Most appropriate management?
Ans. C. Apply Mc Donald's StitchHistory of prior pregnancy losses in the second trimester with painless cervical dilatation is suggestive of cervical incompetence. The woman has now come in the 2nd trimester again with level II scan showing V shaped tunneling of internal os and the closed cervical length measuring 0.9cm ( as depicted in the figure) which is less than the cutoff of 2.5cm. This case will benefit from placement of cervical cerclage, best achieved by placing a vaginal Mc Donald's cervical cerclage.
Administer progesterone
Apply Fothergill stitch
Apply Mc Donald's Stitch
Wait and watch
Abortion