| Pregnancy outcome after placement of 'rescue' Shirodkar cerclage. | |
| | |
MedLine Citation:
|
PMID: 19158805 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: Mid-trimester painless cervical dilation is associated with high rates of perinatal morbidity and mortality. 'Rescue' cerclage is one option in managing these patients. We evaluated pregnancy outcomes of women in whom we placed Shirodkar cerclage. STUDY DESIGN: We analyzed the pregnancy outcome of a retrospective cohort of women carrying singleton pregnancies who experienced late mid-trimester cervical dilation in whom we placed Shirodkar cerclage. Exclusion criteria were uterine contractions, bleeding, premature rupture of membranes and chorioamnionitis. Primary outcomes were gestational age at delivery, maternal, fetal and neonatal outcomes and surgical complications. RESULT: Between January 2003 and December 2005, 68 patients met our inclusion criteria. The average maternal age was 26.4+/-8.3 years and the mean gestational age at the time of surgery was 19.6+/-3.2 weeks. Seven women opted for expectant management and 5 more were followed up by their referring physicians; the 12 of them were used as a comparison group. Fifty-six women underwent placement of Shirodkar cerclage. We were unable to place a cerclage in three women (5.1%) and all three delivered before 23 weeks. Of the 56 women who had cerclage, 14 (23.7%) delivered at term, 20 (33.9%) delivered between 34 and 36.9 weeks, 13 (22%) between 30 and 33.9 weeks, 6 (10.2%) between 24 and 29.9 weeks and 3 (5.1%) before 24 weeks. Median time from diagnosis to delivery was longer in the cerclage group (9.1 weeks) than in the comparison group (3.3 weeks P<0.01). CONCLUSION: When pregnancies are complicated by late mid-trimester cervical dilation, placement of Shirodkar cerclage in appropriately selected patients has the potential to be a beneficial therapeutic option. |
| | |
Authors:
|
G Ventolini; T J Genrich; J Roth; R Neiger |
Related Documents
:
|
6368815 - Cervical cerclage. a review of 74 cases. 11776685 - Changes in light-induced fluorescence of cervical collagen in guinea pigs during gestat... 8616965 - The diagnosis of preterm labor and the prediction of preterm delivery. 10203305 - Pregnancy outcome after laser vaporization of the cervix. 11281465 - Biochemical markers of maternal bone turnover are elevated in pre-eclampsia. 17981685 - Role of progesterone and progestin therapy in threatened abortion and preterm labour. |
Publication Detail:
|
Type: Comparative Study; Journal Article Date: 2009-01-22 |
Journal Detail:
|
Title: Journal of perinatology : official journal of the California Perinatal Association Volume: 29 ISSN: 1476-5543 ISO Abbreviation: J Perinatol Publication Date: 2009 Apr |
Date Detail:
|
Created Date: 2009-03-27 Completed Date: 2009-07-30 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8501884 Medline TA: J Perinatol Country: United States |
Other Details:
|
Languages: eng Pagination: 276-9 Citation Subset: IM |
Affiliation:
|
Department of Obstetrics and Gynecology, Wright State University Boonshoft School of Medicine, Dayton, OH 45409, USA. gary.ventolini@wright.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Adult Bed Rest Cerclage, Cervical / methods* Cohort Studies Combined Modality Therapy Female Fetal Membranes, Premature Rupture / prevention & control Follow-Up Studies Humans Indomethacin / administration & dosage Infant, Newborn Labor Stage, First Obstetric Labor, Premature / prevention & control* Pregnancy Pregnancy Outcome Pregnancy Trimester, Second Retrospective Studies Tocolytic Agents / administration & dosage Young Adult |
| Chemical | |
Reg. No./Substance:
|
0/Tocolytic Agents; 53-86-1/Indomethacin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Erythrocyte sodium/potassium ATPase activity in severe preeclampsia.
Next Document: Neonatal cerebral oximetry monitoring during ECMO cannulation.