Cervical Insufficiency Differential Diagnoses

Updated: May 23, 2016
  • Author: Errol R Norwitz, MD, PhD, MBA; Chief Editor: Ronald M Ramus, MD  more...
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DDx

Diagnostic Considerations

Preterm birth may result from numerous causes, including spontaneous preterm labor, preterm premature rupture of membranes (PPROM), antepartum hemorrhage, multiple gestation, and indicated preterm delivery for maternal or fetal conditions (eg, hypertensive disorders of pregnancy, fetal growth restriction, nonreassuring fetal heart rate testing). Cervical insufficiency is responsible for only 8-9% of all preterm births, compared with 40-45% with spontaneous preterm labor and 25-30% with PPROM. [18, 19] Clinical and laboratory studies suggest that preterm labor and delivery may result from several pathogenic processes, including premature activation of the fetal hypothalamic-pituitary-adrenal axis, intrauterine infection, decidual inflammation, hemorrhage, and pathological uterine distension.

Differential Diagnoses