<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 38-year-old woman, gravida 4, para 3, at 20 weeks gestation comes to the physician for a prenatal care visit. She used fertility enhancing treatment for her current pregnancy. Her other children were born before 37 weeks gestation. She is 170 cm 5 ft 7 in tall and weighs 82 kg 180 lb; BMI is 28.4 kgm2. Her vital signs are within normal limits. The abdomen is nontender, and no contractions are felt. Ultrasonography shows a cervical length of 22 mm and a fetal heart rate of 140min. Which of the following is the most likely diagnosis?? A: Cephalopelvic disproportion, B: Bicornuate uterus, C: Placental insufficiency, D: Diethylstilbestrol exposure, E: Cervical insufficiency,  <response>: This is a medical case scenario question involving a pregnant 38-year-old woman at 20 weeks gestation who has a history of preterm births and is found to have a short cervical length on ultrasound. The key findings in the stem are:- 38 years old, gravida 4, para 3 - History of preterm delivery before 37 weeks in previous pregnancies- Current pregnancy via fertility treatment - 20 weeks gestation currently- Short cervical length of 22mm on ultrasound The diagnosis that best fits with a history of preterm birth and short cervical length in the current pregnancy is cervical insufficiency. Choices A, B, C, and D can all be ruled out:- Cephalopelvic disproportion refers to mismatch between fetal head size and the mothers pelvic dimensions, not relevant here. - Bicornuate uterus is a uterine anomaly, but would not directly cause preterm birth.- Placental insufficiency can lead to preterm birth but there is no evidence of this in the stem. - Diethylstilbestrol DES exposure would have occurred in the patients own gestation, not related to her current cervical issues.E: Cervical insufficiency 