Cervical Insufficiency May Be Aggravated by Glucose Intolerance: A Case Report

 Cervical insufficiency occurs in the second trimester. Herein, we report a successful term pregnancy in a woman with glucose intolerance and a history of cervical insufficiency after two consecutive preterm deliveries in the second trimester.

 We present a 35-year-old woman, G3P2L0, with a history of two preterm deliveries in the second trimester. In the second pregnancy, vaginal cerclage at the 18th gestational week did not prevent premature delivery. Following two pregnancies with borderline fasting blood sugar (FBS) results, we decided to further evaluate the gestational diabetes mellitus (GDM) state with a two-hour postprandial (2 hpp) glucose test and glucose tolerance test (GTT). By impaired 2 hpp and GTT results, an insulin regimen was started with subsequent vaginal cerclage in the third pregnancy. She delivered a healthy 2,750-g girl at 38 weeks of gestation by tight blood sugar control.

 More attention should be paid to evaluating glucose intolerance in pregnancy, especially in patients with cervical insufficiency. Blood glucose control in these patients can probably improve pregnancy outcomes.