| Cervical incompetence: the use of selective and emergency cerclage. | |
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MedLine Citation:
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PMID: 11234614 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: This prospective case series was performed in order to assess pregnancy outcome of women with tentative diagnosis of cervical incompetence undergoing selective and emergency cervical cerclage. METHODS: Women recruited in this case series were divided into two groups. The selective group (n = 13) was chosen among pregnant women with a history suggestive of cervical incompetence, but no clinical evidence of threatened miscarriage. The definition of cervical incompetence was dilatation of internal cervical os with shortening of the cervix less than 25 mm and "funnelling" of 25% and more, found on the ultrasound examination of the cervix. The emergency group (n = 12) had clinical symptoms of threatened miscarriage. After exclusion of infection and in the absence of uterine activity they were counseled and offered cerclage. RESULTS: After cervical cerclage all women were treated in the same way as per our clinical protocol and monitored until delivery. The median gestational age at delivery was 36 weeks (19-39) in the selective group and 33 weeks (22-38) in the emergency group. This difference is not statistically significant. There was 1 miscarriage (8%), 5 pre-term deliveries (38%) and 7 term deliveries (54%) in the selective group; and 4 miscarriages (33%), 3 pre-term deliveries (25%) and 5 term deliveries (42%) in the emergency group. Total neonatal survival was 19/20 (95%) if pregnancy exceeded 24 weeks, making perinatal mortality 5%. There was no differences between selective and emergency groups (1 of 12 in selective vs. 0 of 8 in emergency). CONCLUSION: Overall, it can be concluded that both selective and emergency cerclage may have some benefits in patients with cervical incompetence. However, in the absence of a randomized-controlled study, these beneficial effects described cannot be considered as proved. |
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Authors:
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R Matijevic; B Olujic; J Tumbri; A Kurjak |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of perinatal medicine Volume: 29 ISSN: 0300-5577 ISO Abbreviation: J Perinat Med Publication Date: 2001 |
Date Detail:
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Created Date: 2001-03-07 Completed Date: 2001-05-17 Revised Date: 2005-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0361031 Medline TA: J Perinat Med Country: Germany |
Other Details:
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Languages: eng Pagination: 31-5 Citation Subset: IM |
Affiliation:
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Department of Obstetrics and Gynecology, University of Zagreb, Sveti Duh Hospital, Zagreb, Croatia. ratko.matijevic@zg.tel.hr |
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| MeSH Terms | |
Descriptor/Qualifier:
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Abortion, Spontaneous
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etiology Chorioamnionitis / complications Emergency Treatment* Female Fetal Membranes, Premature Rupture / complications Gestational Age Humans Obstetric Labor, Premature / prevention & control Pregnancy Pregnancy Outcome Prospective Studies Suture Techniques Uterine Cervical Incompetence / surgery*, ultrasonography |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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