通常第一次發生子宮頸閉鎖不全時，都是沒有徵兆的說來就來，卻又預後很差，讓人惋惜。因此如何預防「子宮頸閉鎖不全」再次發生，最好的方式就是在下一胎懷孕三個月後先進行子宮頸環紮術，以加強子宮頸承受懷孕與日俱增的重壓，並且應多休息少提重物，如此才能再次擁有健康的小孩。•Obstetrical history-based diagnosis of cervical insufficiency – We make an obstetrical history-based diagnosis of cervical insufficiency in women with a classic history of ≥2 consecutive prior second-trimester pregnancy losses/extremely preterm births (ie, <28 weeks) associated with no or minimal mild symptoms. The presence of risk factors for structural cervical weakness support the diagnosis. Most of these cases are pregnancy losses before 24 weeks. (See 'Obstetrical history-based diagnosis' above.)
•Ultrasound-based diagnosis of cervical insufficiency – In asymptomatic women with a past history of one second trimester pregnancy loss/extremelypreterm birth (ie, <28 weeks) associated with no or minimal mild symptoms (see 'Symptoms' above) and those in whom a history-based diagnosis is uncertain, we perform serial TVU examinations and make a diagnosis of cervical insufficiency when cervical length is ≤25 mm before 24 weeks. In these women, the author begins TVU measurement of cervical length at around 14 weeks, with repeat screening every two weeks until 24 weeks as long as cervical length is ≥30 mm. If cervical length is 26 to 29 mm, he repeats screening weekly as long as the length remains in this range. TVU screening is discontinued at 24 weeks of gestation, as cerclage is rarely performed after this time. The presence of risk factors for structural cervical insufficiency supports the diagnosis. (See 'Ultrasound-based diagnosis' above.)
Amniotic fluid index — The amniotic fluid index (AFI) is calculated by dividing the uterus into four quadrants using the linea nigra for the right and left divisions and the umbilicus for the upper and lower quadrants. The maximal vertical amniotic fluid pocket diameter in each quadrant not containing cord or fetal extremities (on gray-scale examination) is measured in centimeters; the sum of these measurements is the AFI. A 2014 consensus panel at a fetal imaging workshop suggested the following interpretation of AFI [10]:
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