Which of the following is a risk factor for cervical insufficiency?

Choice A rationaleMultiple gestation increases pregnancy risks but is not directly linked to cervical insufficiency, which involves premature cervical dilation leading to preterm birth or loss without uterine contractions.Choice B rationaleAdvanced maternal age presents various pregnancy risks, including chromosomal abnormalities and hypertension, but is not a primary risk factor for cervical insufficiency, which involves cervical structural issues.Choice C rationaleA history of preterm labor involves previous early deliveries but does not specifically indicate cervical insufficiency, which is characterized by painless cervical dilation and effacement in the second trimester.Choice D rationaleCervical surgery, such as conization or LEEP, can weaken the cervical structure, increasing the risk of cervical insufficiency by reducing the cervix’s ability to remain closed during pregnancy.