Society and culture
General
Pedophilia is one of the most stigmatized mental disorders. One study reported high levels of anger, fear and social rejection towards pedophiles who have not committed a crime. The authors suggested such attitudes could negatively impact child sexual abuse prevention by reducing pedophiles mental stability and discouraging them from seeking help. According to sociologists Melanie-Angela Neuilly and Kristen Zgoba, social concern over pedophilia intensified greatly in the 1990s, coinciding with several sensational sex crimes (but a general decline in child sexual abuse rates). They found that the word pedophile appeared only rarely in The New York Times and Le Monde before 1996, with zero mentions in 1991.Social attitudes towards child sexual abuse are extremely negative, with some surveys ranking it as morally worse than murder. Early research showed that there was a great deal of misunderstanding and unrealistic perceptions in the general public about child sexual abuse and pedophiles. However, a 2004 study concluded that the public was well-informed on some aspects of these subjects. Misuse of medical terminology
The words pedophile and pedophilia are commonly used informally to describe an adults sexual interest in pubescent or post-pubescent persons under the age of consent. The terms hebephilia or ephebophilia may be more accurate in these cases.Another common usage of pedophilia is to refer to the act of sexual abuse itself, rather than the medical meaning, which is a preference for prepubescents on the part of the older individual (see above for an explanation of the distinction).
Risk factors
Risk factors for premature birth or stillbirth due to cervical weakness include:
diagnosis of cervical weakness in a previous pregnancy
previous preterm premature rupture of membranes
history of conization (cervical biopsy)
diethylstilbestrol exposure, which can cause anatomical defects, and
uterine anomaliesRepeated procedures (such as mechanical dilation, especially during late pregnancy) appear to create a risk. Additionally, any significant trauma to the cervix can weaken the tissues involved. Diagnosis
Diagnosis of cervical weakness can be challenging and is based on a history of painless cervical dilation usually after the first trimester without contractions or labor and in the absence of other clear pathology. In addition to history, some providers use assessment of cervical length in second trimester to identify cervical shortening using ultrasound. However, short cervical length has actually been shown to be a marker of preterm birth rather than cervical weakness. Other diagnostic tests that have been suggested which have not been validated include hysterosalpingography and radiographic imaging of balloon traction on the cervix, assessment of the patulous cervix with Hegar or Pratt dilators, the use of a balloon elastance test, and use of graduated cervical dilators to calculate a cervical resistance index.Normally, the cervix should be at least 30 mm in length. Cervical weakness is variably defined. However, a common definition is a cervical length of less than 25 mm at or before 24 weeks of gestational age.