RESUMO
Cervical incompetence is one of the main contributors to repeated pregnancy loss and preterm delivery. Typically it results in progressive cervical dilatation, leading to a painless second or early third trimester abortion. Emergency cerclage can be used in the setting of advanced cervical incompetence, even when fetal membranes bulge through the dilated cervix. To facilitate the procedure, various techniques have been developed to replace the fetal membranes into the uterine cavity. We performed six successful cases of emergency cerclage combined with amnioreduction in advanced incompetent internal os of cervix (IIOC). Interval from emergency cerclage to delivery was 8.1 +/- 2.4 weeks (range 4-10 weeks) and we delivered viable fetuses in all but one. Hereby we report our experiences with a brief review of literature.
Assuntos
Feminino , Humanos , Gravidez , Colo do Útero , Emergências , Membranas Extraembrionárias , Feto , Primeira Fase do Trabalho de Parto , Terceiro Trimestre da GravidezRESUMO
OBJECTIVE: The aim of this study is to improve the pregnancy outcome and evaluate the prognostic factor after McDonald operation of IIOC patients. METHODS: From January 1, 1995 to December 31, 1999, 230 cases of IIOC were admitted and treated with McDonald operation at department of Obstetrics and Gynecology, Medical college of Catholic university. Among these patients, 187 cases were analyzed. We classified the above patients into 4 groups by gestational weeks of the operation (1st group before 14weeks, 2nd group 14+1-16weeks, 3rd group 16+1-18weeks, 4th group after 18weeks), and we analyzed the mean age of the patients, parity, indications, operation time, delivery methods and fetal survival rate on each groups. RESULTS: The fetal survival rate was 76.08%,and duration of pregnancy was 21.65weeks+/-6.39 in the 1st group, 78.5%, 19.24weeks+/-6.367 in the 2nd group, 88.2%,18.25weeks+/-5.15 in the 3rd group, 75.67%, 12.12weeks+/-7.19 in the 4th group. The 3rd group shows higher fetal survival rate with significantly. CONCLUSION: We can have higher fetal survival rate and prolongation of duration of pregnancy in the IIOC patients when we do the McDonald operation in the 16+1-18th gestation weeks.
Assuntos
Feminino , Humanos , Gravidez , Colo do Útero , Ginecologia , Obstetrícia , Paridade , Resultado da Gravidez , Taxa de SobrevidaRESUMO
OBJECTIVE: The aim of this study is to improve the pregnancy outcome and evaluate the prognostic factor after McDonald operation of IIOC patients. METHODS: From January 1, 1995 to December 31, 1999, 230 cases of IIOC were admitted and treated with McDonald operation at department of Obstetrics and Gynecology, Medical college of Catholic university. Among these patients, 187 cases were analyzed. We classified the above patients into 4 groups by gestational weeks of the operation (1st group before 14weeks, 2nd group 14+1-16weeks, 3rd group 16+1-18weeks, 4th group after 18weeks), and we analyzed the mean age of the patients, parity, indications, operation time, delivery methods and fetal survival rate on each groups. RESULTS: The fetal survival rate was 76.08%,and duration of pregnancy was 21.65weeks+/-6.39 in the 1st group, 78.5%, 19.24weeks+/-6.367 in the 2nd group, 88.2%,18.25weeks+/-5.15 in the 3rd group, 75.67%, 12.12weeks+/-7.19 in the 4th group. The 3rd group shows higher fetal survival rate with significantly. CONCLUSION: We can have higher fetal survival rate and prolongation of duration of pregnancy in the IIOC patients when we do the McDonald operation in the 16+1-18th gestation weeks.
Assuntos
Feminino , Humanos , Gravidez , Colo do Útero , Ginecologia , Obstetrícia , Paridade , Resultado da Gravidez , Taxa de SobrevidaRESUMO
OBJECTIVE: Our purpose was to review the clinical use of transabdominal cervicoishmic cerclage to determine whether it is a valid alternative to transvaginal cerclage. Study design : A retrospective review was carried out of transabdominal cerclage patients at our hospital from Jan. 1999 to May. 2001. Analysis of the clinical use of transabdominal rather than the vaginal approach in some IIOC patients was performed and fetal outcomes was evaluated. RESULTS: Fifteen patients underwent transabdominal cerclages. The primary indication for transabdominal cervicoisthmic cerclage was failed transvaginal cerclage in 9 patients and anatomic unsuitability for transvaginal cerclage in 6 patients. Follow-up was conducted for all except one patient. All patients were successfully delivered of live babies by Cesarean section. Complications including blood loss requiring transfusion did not occur. However one baby died at postpartal 1 day because of congenital Tetralogy of Fallot. CONCLUSION: All patients had histories compatible with incompetent cervix requiring cerclage, and none were suitable candidates for vaginal cerclage. Our results and review of the literature confirm that Transabdominal cervicoisthmic cerclage has an important role to play for carefully selected patients.
Assuntos
Feminino , Humanos , Gravidez , Cesárea , Seguimentos , Estudos Retrospectivos , Tetralogia de Fallot , Incompetência do Colo do ÚteroRESUMO
Emergency cerclage commonly known as that performed in the setting of advanced cervical dilatation with bulging membranes and associated with significantly increased failure rates. We experienced a successful emergency cerclage for advanced incompetent internal os of cervix ( IIOC ). Pregnancy was prolonged and we delivered viable fetus. Hereby we report this case with the brief review of literature.