ABSTRACT
Emergency cerclage was performed on 27 years old patient with membrane prolapse in 21 weeks' gestation. Ultrasonographically guided amniocentesis was performed intraoperatively in order to decrease intraamniotic pressure. Aggressive prophylactic management (wide spectrum antibiotics and tocolysis-nifedipine) resulted in pregnancy prolongation up to 30 week of gestation. At that time healthy premature newborn (1520 g, Apgar score 7 in 1st minute) was delivered by caesarean section. The mother was discharged from the hospital on the 4th postoperative day, whereas the child after 5 weeks weighted 2130 g.
Subject(s)
Amniocentesis , Cerclage, Cervical , Cervix Uteri/surgery , Emergency Treatment , Extraembryonic Membranes/pathology , Fetal Membranes, Premature Rupture/surgery , Adult , Amniocentesis/methods , Anti-Bacterial Agents/therapeutic use , Cerclage, Cervical/methods , Female , Fetal Membranes, Premature Rupture/prevention & control , Gestational Age , Humans , Infant, Newborn , Obstetric Labor, Premature/prevention & control , Pregnancy , Pregnancy Outcome , Prolapse , Time Factors , Treatment OutcomeABSTRACT
We describe two cases treated for cervical incompetence with prolapsed fetal membranes with emergency cerclage. Two methods of membranes reducing were used: transabdominal amniocentesis and bladder overfilling. We recommend these procedures in patients with advanced cervical incompetence when the membrane reduction by Trendelenburg position or pharmacological tocolysis were ineffective.
Subject(s)
Amniocentesis , Cervix Uteri/surgery , Dilatation , Urinary Bladder , Uterine Cervical Incompetence/physiopathology , Uterine Cervical Incompetence/therapy , Administration, Intravesical , Adult , Extraembryonic Membranes/pathology , Female , Fetal Membranes, Premature Rupture/prevention & control , Gestational Age , Humans , Obstetric Labor, Premature/prevention & control , Pregnancy , Pregnancy Outcome , Treatment Outcome , Uterine Cervical Incompetence/surgeryABSTRACT
A retrospective analysis of 400 twin and 14 triplet pregnancies at the Department of Obstetrics and Perinatology, University School of Medicine in Lublin, from January 1, 1989 to June 30, 1999 was undertaken. A number increase of multiply pregnancies was observed--from 124 in the period 1989-1992 to 181 in the period 1996-1999. A percentage increase of cesarean sections was observed--from 52.42% to 77.34% respectively. The most frequent indications for the cesarean sections were non-vertex presentation of the first twin, threatened intrauterine infection and threatened intrauterine asphyxia.
Subject(s)
Pregnancy, Multiple/statistics & numerical data , Adult , Asphyxia Neonatorum/prevention & control , Bacterial Infections/prevention & control , Cesarean Section/statistics & numerical data , Diseases in Twins/prevention & control , Female , Fetal Diseases/prevention & control , Humans , Infant, Newborn , Labor Presentation , Obstetrics and Gynecology Department, Hospital/statistics & numerical data , Poland , Pregnancy , Retrospective Studies , Triplets/statistics & numerical data , Twins/statistics & numerical dataABSTRACT
Between September 1998 and July 1999, 34 patients with twin pregnancy (79.1%) underwent cesarean section with Misgav Ladach method in the Department of Obstetrics and Perinatology of the Medical Academy in Lublin. The aim of this study was to evaluate safety and other advantages of the Misgav Ladach method. Body temperature, usage of antibiotics, analgesics, hematinics, and postoperative complications were evaluated in the postoperative course. No postoperative complications were noted at 32 patients (94.1%). 67.6% of patients did not receive antibiotics. Stitches were removed on the fourth p.o. day at 70.6% of patients. This study highlights the safety of the Misgav Ladach method, and points out some advantages like reduction of postoperative pain, speeded recovery, and no indication for transfusion.
