ABSTRACT
Objective To investigate the clinical effect of McDonald cervical cerclage and the affecting factors. Methods Between January 2002 to December 2013 in Peking University First Hospital we performed McDonald cervical cerclage for 116 single pregnant women. They were defined as the successful group who deliveried the live babies after 28 weeks after the cerclage and the failure group who deliveried in the second trimester. According to the surgical indications they were divided into preventive cerclage group and therapeutic cerclage group. Then we analyzed the curative effect and the affecting factors in the groups. Results (1) In the 116 cases, 12 cases (10.3%) failed, and 104 cases (89.7%) succeeded. In the successful group, 37 cases (35.6%,37/104) deliveried pretermly and 67 cases (64.4%) deliveried termly. And there were 56 cases of vaginal delivery (53.8%), and 48 cases (46.2%) of cesarean section. (2) Among the 116 cases, 48 cases (41.4%) were included in prophylactic cerclage group, the gestational age was (16.3± 2.2) weeks, 68 (58.6%) cases were included in therapeutic group, the gestational age was (24.0±2.2) weeks. The operation time was (22±9) minutes in preventive group and (24±13) minutes in therapeutic group,there was no statistical difference between the two groups (P>0.05). Live-birth rate between preventive cerclage group and therapeutic cerclage group was no statistically significant difference (P>0.05). The term birth rate (72.9%, 35/48) in preventive group was higher than that in therapeutic group (47.1%, 32/68), the difference was statistically significant (P0.05). (4) There were 68 cases in the therapeutic group, 7 cases failed, and 61 cases succeeded;the preoperative cervical os in failure group [ (21 ± 20) mm] was wider than that in successful group [(14±5) mm], the difference was statistically significant (P0.05). Conclusions The McDonald cervical cerclage for cervical incompetence is a simple, safe and high successful rate of intervention measures. The term labor rate of prophylactic cervical cerclage was higher than that of the therapeutic cerclage. Older maternal age and preoperative invasive procedure may be the risk factors for cerclage. The infection may play an important factor leading to the failure of McDonald cervical cerclage.
ABSTRACT
Objective To observe the changes of cervix in women between 16 and 35 weeks of gestation using transvaginal ultrasound and to determine the value of the cervix length in predicting preterm delivery among the women with threatened preterm labor Methods Transvaginal sonography were performed in 154 normal single nulliparous pregnant women between 16 and 35 weeks of gestation and 58 women with threatened preterm labor but without premature rupture of membrane Results (1) There is no definitely change in either cervical length or internal diameter of cervix among the pregnant women over the studied period There was also no funneling to be observed The mean cervical length is (36?5) mm,and the mean cervical internal diameter is (4?1) mm (2) Eleven preterm deliveries occured among the 58 pregnancy women with threatened preterm labor The cervical length by sonography of 11 preterm deliveries was (18?6) mm,and was significant shorter than the women without preterm deliveries whose mean cervical length was (32?6) mm ( P
ABSTRACT
ObjectiveTo discuss the value of interrupted circular suture in hemostasis of placenta previa during cesarean section. Methods We summarized 54 caesarean section patients with placenta previa. Results The hemostasis was succeeded in all of the 9 patients and uterus was retained without postpartum complications. The duration of operation was obviously shorter than that of hysterectomy( P＜0.05). Bleeding and blood transfusion were less than that of hysterectomy, but without statistical difference (P＞0.05). ConclusionInterrupted circular suture is one of the efficient methods in controlling postpartum bleeding during caesarean section with placenta previa.
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Objective To determine the incidence of pregnancy complicated with heart disease and assess the current obstetric management principles of pregnancy complicated with heart disease. Methods 428 cases of pregnancy complicated with heart disease were reviewed.54 cases were sur- gically corrected heart disease.Results:The incidence of pregnancy complicated with heart dis- ease,during January,1973 to December,1982 and January,1983 to December,1992,were 1.2% (254/21 221) and 0.9% (174/18 726)respectively.The ratio of rheumatic heart disease and congenital heart disease were 4:1 and 1:2 in two periods.There were 37 cases of heart failure and 4 cases of ma- ternal deaths occured.No heart failure and maternal death occured in cases with surgically corrected heart disease.In the two periods,the cesarean section rate were 16.9%(43/254),and 33.3% (58/74) ,P
ABSTRACT
Objective To determine the predictive value of fetal fibronectin (fFN) alone or combined with cervical length (CD for preterm birth in pregnant women with preterm labor. Methods Pregnant women were collected from three hospitals. fFN level in discharges from the posterior fornix and the CL under vaginal ultrasound scan were measured for all subjects who presented with preterm labor between 24-34+6 gestational weeks with intact membranes, cervical dilation