Multiple choice

A gravida3, with a history of 2 previous 2nd trimester abortions presents at 22 weeks of gestation with funneling of the cervix. Most appropriate management would be

  1. administer dinoprostone and bed rest

  2. administer mifipristone and bed rest

  3. apply Fothergill's stitch

  4. apply McDonald's stitch
Reveal answer Fill a bubble to check yourself
D Correct answer
Explanation

Cervical insufficiency is diagnosed by painless cervical dilation in the second trimester, often with funnelling. McDonald's stitch (a simple cervical cerclage) is appropriate at 22 weeks. Fothergill's stitch is for later pregnancy stages or prolapse. Mifepristone is for abortion, dinoprostone for induction.

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