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A 30-year-old G6P2A4L1 is referred by her primary care provider to your high-risk obstetrics clinic for preconception counseling after a pregnancy loss at 21+4 weeks’ gestation last year, shortly after incidental transvaginal cervical shortening was noted at second-trimester fetal morphology survey. After an uncomplicated first pregnancy and term delivery, she experienced four consecutive first-trimester losses for which comprehensive investigations were unremarkable.
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