Ultrasound diagnosis of cervical incompetence with cord prolapse

Abstract

Cervical incompetence is a frequent cause of inevitable miscarriage in the second trimester, and it is often associated with a poor foetal outcome. Dilatation of the cervix was observed in a 31-year-old pregnant woman with previous preterm delivery. She presented with severe pelvic pains, preterm contractions and amniotic fluid discharge. Emergency abdominal sonography revealed polyhydramnios and umbilical cord prolapse. The cervical diameter measured 45 mm and the length measured 19 mm. The internal os was opened and showed conspicuous funneling and protruding foetal leg through the internal os. The foetus was delivered by means of caesarean section and died about 24 hours later. This finding underscores the importance of ultrasonography to obstetricians and neonatologists and also highlights the need for routine obstetrics scan in patients at risk, especially in low-income populations where such a procedure might be deemed as an unnecessary financial burden.