Snapshot 29-year-old, G7P0A3, is in her thirteenth week of pregnancy. She has lost three consecutive normally formed fetuses before 20 weeks gestation, and she has had three spontaneous first trimester abortions. Her mother took diethylstilbestrol (DES) while she was in utero. Introduction Cervix that is too weak to stay closed during a pregnancy Resulting in a preterm birth and possibly the loss of the baby Risk factors include repeated cervical dilations and/or cervical excisional procedures Presentation Symptoms/Physical exam painless dilation of cervix delivery of fetus between 18 and 32 weeks of gestation Shortened cervix is defined as less than the 10th percentile (2.5 cm at 23-28 weeks) Evaluation Transvaginal Ultrasonography Routine cervical length screening is recommended for all women without a history of prior preterm birth Ultrasound should be performed between 16 and 24 weeks for the most accurate and predictive measurement Women with prior cervical excisional procedures or cervical dilations do not require additional screening on top of the one-time cervical length measurement Treatment Surgical cerlage procedure to suture cervix closed until labor or rupture of membranes