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Rescue cerclage

Siddhidatri Mishra, Rashmi Bagga, Jasvinder Kalra, Vanita Jain, Sourabh Dutta
Women (n = 300) at 'low risk' for a preterm birth (PTB), a singleton pregnancy and for a 16-24 week period of gestation (POG) were randomised to undergo cervical length (CL) measurement by transvaginal sonography (TVS) or not. The aim was to see if routine CL measurement and treatment of a short CL reduced the PTB rate. 'Low risk' was defined by an absence of a prior abortion or PTB of a singleton infant (>16 to <37 weeks) due to a spontaneous preterm labour (PTL) or a preterm pre-labour rupture of membranes (pPROM)...
March 14, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Cristina Mitric, Vincent Ponette
BACKGROUND: In twin pregnancies, elective cerclage placement based on obstetrical history or ultrasound findings has been shown to be ineffective and even harmful. There are currently no guidelines for the use of rescue cervical cerclage in twin pregnancies. CASE: The current report presents the case of a 33-year-old patient with monochorionic diamniotic twins (MCDA) found to have dilated cervix at 3.5cm with exposed membranes upon physical examination at 19 weeks and 3 days...
April 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Yu Yang Feng, Alexander Jarde, Ye Rin Seo, Anne Powell, Nwachukwu Nwebube, Sarah D McDonald
OBJECTIVE: This study sought to determine the proportions of women at risk of preterm birth who received progesterone, elective and rescue cerclage, or pessary to prevent preterm birth, by using medical records. The authors also sought to determine whether these proportions differed among primary-, secondary-, and tertiary-level centres. METHODS: The authors conducted a retrospective cohort study and extracted data from consecutive medical charts of women with an estimated date of confinement over 3 months in primary-, secondary-, and tertiary-level centres in Southern Ontario...
May 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Jennifer Deanna, Omar Abuzied, Fahmi Islam, Ivana Vettriano, Frederico Rocha, Mostafa Abuzeid
Introduction: It is well known that cervical incompetence and associated preterm birth confers greater morbidity and mortality on birth outcomes, with an additional increased risk of cervical incompetence in higher order gestations. While the pathophysiology of cervical incompetence has yet to be elucidated, research has identified risk factors and assessed outcomes of numerous interventions. Cervical cerclage has been shown, in certain situations involving singleton pregnancies, to improve outcomes...
June 2017: Facts, Views & Vision in ObGyn
Nimrah Abbasi, Jon Barrett, Nir Melamed
OBJECTIVE: Our aim was to compare perinatal outcomes in twin pregnancies complicated by premature asymptomatic cervical dilatation treated with rescue cerclage and expectant management. METHODS: A retrospective cohort study was conducted at a single tertiary referral center between 2003 and 2014 and included all women with twins found to have a dilated cervix with intact membranes before 25-week gestation. Pregnancy outcomes were compared between women with rescue cerclage and those managed expectantly...
July 4, 2017: Journal of Maternal-fetal & Neonatal Medicine
Shota Kanbayashi, Yukiyasu Sato, Atsuko Taga, Yumiko Satake, Ikuko Emoto, Shunsuke Maruyama, Tomoko Kim
PURPOSE: This retrospective case-control study is aimed to extract predictors of preterm delivery after rescue cerclage. MATERIALS AND METHODS: We collected the data from all the pregnant women who underwent rescue cerclage before 26+0 gestational weeks at our facility between July 2006 and July 2016. These women were divided into "delivery at <34 weeks" group (n = 12) and "delivery at ≥34 weeks" group (n = 12). Multiple factors that had been detected at the time of cerclage were compared between these two groups...
May 2018: Journal of Maternal-fetal & Neonatal Medicine
Mehmet Bayrak, Ahmet Gul, Gokhan Goynumer
A cross-sectional study was conducted to evaluate the efficacy of rescue cerclage in patients with a dilated cervix and prolapsed foetal membranes. Thirty-five patients presenting with cervical dilatation and prolapsed foetal membranes were included in the study. A McDonald cerclage was placed in 27 patients. The duration of pregnancy prolongation and the number of deliveries after 28 weeks were evaluated. The median prolongation of pregnancy after cerclage placement differed significantly between the cerclage and bed-rest groups (64 days versus 13...
May 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Loïc Sentilhes, Marie-Victoire Sénat, Pierre-Yves Ancel, Elie Azria, Guillaume Benoist, Julie Blanc, Gilles Brabant, Florence Bretelle, Stéphanie Brun, Muriel Doret, Chantal Ducroux-Schouwey, Anne Evrard, Gilles Kayem, Emeline Maisonneuve, Louis Marcellin, Stéphane Marret, Nicolas Mottet, Sabine Paysant, Didier Riethmuller, Patrick Rozenberg, Thomas Schmitz, Héloïse Torchin, Bruno Langer
In France, 60,000 neonates are born preterm every year (7.4%), half of them after the spontaneous onset of labor. Among preventable risk factors of spontaneous prematurity, only cessation of smoking is associated with decreased prematurity (level of evidence [LE]1). It is therefore recommended (Grade A). Routine screening and treatment of vaginal bacteriosis is not recommended in the general population (Grade A). The only population for which vaginal progesterone is recommended is that comprising asymptomatic women with singleton pregnancies, no history of preterm delivery, and a short cervix at 16-24 weeks of gestation (Grade B)...
March 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Lisa Story, Andrew Shennan
OBJECTIVE: Treatment modalities to reduce the incidence of preterm birth are currently limited. Cerclage, is a common and established intervention in most obstetrics units worldwide, however, many questions regarding its efficacy, with respect to pregnancy outcomes remain unanswered. This study aims to investigate whether an antenatal placed cerclage affects the subsequent mode of delivery in women at high risk of preterm birth who labour. STUDY DESIGN: A retrospective case controlled study was performed at St Thomas's Hospital London...
March 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
L Sentilhes, M-V Sénat, P-Y Ancel, E Azria, G Benoist, J Blanc, G Brabant, F Bretelle, S Brun, M Doret, C Ducroux-Schouwey, A Evrard, G Kayem, E Maisonneuve, L Marcellin, S Marret, N Mottet, S Paysant, D Riethmuller, P Rozenberg, T Schmitz, H Torchin, B Langer
OBJECTIVES: To determine the measures to prevent spontaneous preterm birth (excluding preterm premature rupture of membranes)and its consequences. MATERIALS AND METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. RESULTS: In France, premature birth concerns 60,000 neonates every year (7.4 %), half of them are delivered after spontaneous onset of labor...
December 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Akiko Ito, Yoshiaki Maseki, Sayako Ikeda, Atsuko Tezuka, Momoko Kuribayashi, Madoka Furuhashi
OBJECTIVE: To elucidate the factors that contribute to prolonged pregnancy and promote neonate survival in women with bulging fetal membranes. METHODS: A database was reviewed to identify women with singleton pregnancies who underwent amniocentesis on admission to determine amniotic fluid neutrophil elastase levels before 26 + 0 weeks gestation between July 2001 and January 2015. Following delivery, the placentas of these patients were examined for histologic chorioamnionitis...
September 30, 2016: Journal of Maternal-fetal & Neonatal Medicine
Elham M Jalal, Felipe Moretti, Andree Gruslin
BACKGROUND: Non-elective cervical cerclages are associated with significant perinatal complications. There is scant available information about what the predictors of these outcomes are, thus making counselling difficult. OBJECTIVE: To identify which factors predict delivery at or beyond 28, 34, and 37 weeks' gestation in women with emergency/rescue cervical cerclage. METHODS: We conducted a retrospective cohort study of nonelective cerclages over 10 years in our centre...
March 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
E Nohuz, J-L Pouly, M Albaut, E Boulay, D Lemery, D Gallot, F Vendittelli
No abstract text is available yet for this article.
October 2015: Gynécologie, Obstétrique & Fertilité
Shirlene Sim, Fabricio Da Silva Costa, Edward Araujo Júnior, Penelope M Sheehan
OBJECTIVE: To determine the predictive value of various cervical length measurements postcerclage for the outcome of preterm birth following both elective and rescue cerclage. MATERIALS AND METHODS: Over a five-year period, we identified 59 women who had a transvaginal cerclage inserted followed by serial cervical length measurement. Of these, 18 were elective cerclages placed at 14 weeks of gestation on the basis of a history of cervical insufficiency and 41 were rescue cerclages performed at gestations ranging from 17 to 23 weeks following a diagnosis of shortened cervix on ultrasound...
August 2015: Australian & New Zealand Journal of Obstetrics & Gynaecology
Lucia L K Chan, T W Leung, T K Lo, W L Lau, W C Leung
OBJECTIVES: To review and compare pregnancy outcomes of patients undergoing history-indicated, ultrasound-indicated, or rescue cerclage. DESIGN: Case series with internal comparison. SETTING: A regional obstetric unit in Hong Kong. PATIENTS: Women undergoing cervical cerclage at Kwong Wah Hospital between 1 January 2001 and 31 December 2011. INTERVENTIONS: Cervical cerclage. MAIN OUTCOME MEASURES: Pregnancy outcomes including miscarriage, gestational age at delivery, birth weight, and duration of pregnancy prolongation...
August 2015: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
Ahmed Ragab, Yasser Mesbah
PURPOSE: To measure the outcome of emergency cervical cerclage (ECC) combined with progesterone vs. progesterone alone in pregnancy prolongation for preterm labor at 24-28 weeks. METHODS: One hundred patients in early labor were allocated randomly into two equal groups. Group A were treated by ECC and progesterone, and group B were on the same progesterone dose only treatment. RESULTS: No significant differences were observed in both groups as regard demographic data, fetal gestational age or cervical state on admission...
December 2015: Archives of Gynecology and Obstetrics
Vicente Jose Diago Almela, Alicia Martinez-Varea, Alfredo Perales-Puchalt, Ricardo Alonso-Diaz, Alfredo Perales
OBJECTIVE: To determine if absence of sub-clinical intra-amniotic inflammation improves the prognosis of rescue cerclage in cases of bulging membranes. METHODS: Cohort study with all women with bulging membranes admitted into our hospital between 2009 and 2013. Patients underwent amniocentesis to quantify amniotic glucose, leukocytes, IL-6 and leukocyte esterase levels and for microbiological culture. All patients without intra-amniotic inflammation or sub-clinical chorioamnionitis were proposed a physical examination-indicated cervical cerclage...
September 2015: Journal of Maternal-fetal & Neonatal Medicine
Ea Bonney, V Collins, E Gees, M Mweemba, Nab Simpson
INTRODUCTION: Around 11,000 infants are born < 33 weeks gestation annually in the UK. Cervical weakness is associated with midtrimester birth, and placement of a reinforcing suture is a strategy used to preserve or restore both cervical strength and length. McDonald's approach encircles the vaginal portion of the cervix, the Shirodkar procedure uses colpotomies to place the suture higher up, at the level of the internal os. We examined the efficacy of this approach in our practice...
June 2014: Archives of Disease in Childhood. Fetal and Neonatal Edition
J Carter, S Gibson, N Hezelgrave, Ah Shennan
UNLABELLED: : Preterm birth (PTB) or mid-trimester loss is rare following term pregnancy. Caesarean section carried out at full dilatation (FDCS) is associated with increased clinical challenges(1). The integrity of the cervix may be affected by the uterine incision performed late in labour(2), however, there are few reports of clinical outcome following this scenario. We report ten cases of women with a previous history of mid-trimester loss or early birth that was preceded by a full term FDCS...
June 2014: Archives of Disease in Childhood. Fetal and Neonatal Edition
G Burul, Cp James, F Forya, D Casagrandi, A Tetteh, B Al-Fahdi, G Fox, D Warner, A Kenyon, Al David
BACKGROUND: Evidence suggests that cervical cerclage should be offered to women after three or more previous preterm births (PTB) or second-trimester losses. Ultrasound-indicated cerclage reduces the rate of recurrent PTB in women with previous PTB or late miscarriage and a shortening cervix before 24 weeks. Patient selection is therefore critical for this intervention. AIM: To assess the impact of a specialist antenatal service for women at risk of PTB on patient selection for cervical cerclage, cerclage rates and pregnancy outcome after surgery...
June 2014: Archives of Disease in Childhood. Fetal and Neonatal Edition
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