McDonald's Cerclage in Cervical Incompetence: A Case Report

Cervical incompetence is a condition where the cervix painlessly dilates in the absence of uterinecontractions, leading to pregnancy loss or preterm birth. This case report presents a 21-year-old pregnantwoman in her second trimester who experienced lower abdominal pain and pelvic pressure. Ultrasoundconfirmed cervical shortening and premature dilation, indicative of cervical incompetence. A McDonaldcervical cerclage was performed under spinal anesthesia to reinforce the cervix and prevent furtherdilation. Preoperative care included antibiotics, progesterone supplementation, and gastrointestinalprotection, while postoperative management focused on infection prevention, pain control, and pregnancymaintenance. The patient had an uneventful recovery, was discharged with appropriate medications, andwas advised on strict antenatal follow-up. Serial ultrasounds were planned to monitor cervical length andfetal well-being, with cerclage removal scheduled at 36-37 weeks or earlier if labor occurred. This casehighlights the significance of early diagnosis, timely intervention, and careful monitoring in managingcervical insufficiency to improve pregnancy outcomes.