Emergency Cervical cerclage Does the gestational age make a difference?

To investigate the effectiveness of emergency cervical cerclage in prolongation of pregnancy and its effect on pregnancy outcome in patients with cervical incompetence. A retrospective review of patients who had an emergency cervical cerclage performed for cervical incompetence during the period from July 1995 to June 2002 was carried out in Abha General Hospital, Abha, Kingdom of Saudi Arabia. Twenty patients between 16 and 26 weeks of gestation with 1] cervical effacement, 2] cervical dilatation of The mean duration of cerclage in situ was 68.5 days. The mean gestation at delivery was 30.5 weeks and the mean birth weight was 1844 grams. The duration of cerclage in situ was significantly longer when the procedure was performed at or before 22 weeks of gestation with a p value of <0.02 [Mann-Whitney U test], but the difference in the gestation at delivery and birth weight was not significant. There was also a significant negative correlation between the gestation at cerclage and the duration of cerclage in situ [Spearman's correlation coefficient rs = -0.56, p<0.05]. Emergency cervical cerclage in early second trimester effectively prolonged pregnancy compared to emergency cerclage performed in late second trimester

Splenic artery aneurysm rupture during pregnancy

Splenic aneurysm rupture during pregnancy is an uncommon, obstetric acute emergency which requires prompt communication between the obstetrician and the surgeon. Our case illustrates the importance of suspecting the condition early, and prompt surgery in order to salvage the mother and the fetus. The obstetrician should entertain strongly the diagnosis of ruptured aneurysm of the splenic artery in a pregnant woman who complains of pain in the left upper quadrant, especially in the third trimester irrespective of her clinical status. We did not suspect the condition early enough and as a result could not salvage the fetus. The maternal and fetal survival depends on the awareness of this rare condition and immediate surgery to deliver the fetus and arrest hemorrhage

Heterotopic pregnancy follwing spontaneous conception: successful pregnancy outcome

Heterotopic pregnancy, although rare, is increasing in incidence as a result of the increase in the availability of assisted reproductive methods. It is even rarer for heterotopic pregnancy to follow spontaneous conception. This case is presented to alert the practicing obstetrician to this condition when a patient presents with abdominal pain in early pregnancy. As in our patient, transabdominal ultrasound that confirmed intrauterine pregnancy did not exclude heterotopic pregnancy. It is recommended that a transvaginal ultrasonography be performed in all of these cases to diagnose or exclude the condition. This will prevent the patient from prolonged agonizing pain as a result of difficulty in arriving at a diagnosis and possibly wrong surgery if the diagnosis was missed