| Transvaginal sonography and fiberoptic illumination of uterine vessels for abdominal cervicoisthmic cerclage. | |
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MedLine Citation:
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PMID: 14607031 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Transabdominal cervicoisthmic cerclage is a procedure carried out to increase the fetal salvage rates in women who are poor candidates for the more usual procedure of transvaginal cerclage or for those with previously failed vaginal procedures. Although several modifications have been applied to the original procedure in an attempt to reduce the morbidity, bleeding arising from trauma to the uterine vessels during suture placement remains problematic. CASE: Our technique involves transilluminating the uterine vessels during placement of the 5-mm-wide Mersilene (Ethicon Inc., Peterborough, Ontario, Canada) tape suture through an avascular space above the junction of the cervix and the uterine isthmus. This obviates the need to dissect or tunnel into the broad ligament. Simultaneous intraoperative transvaginal ultrasonography is used to enhance high suture placement at the isthmus and monitor the fetoplacental unit. We have used this technique in a series of five women with cervical incompetence for seven pregnancies. All but one procedure resulted in live term births. There were no major complications. CONCLUSION: Simultaneous intraoperative ultrasonography and uterine vessel transillumination simplified suture placement during abdominal cerclage, and reduced the amount of dissection and bleeding. |
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Authors:
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Olufemi Olatunbosun; Roger Turnell; Roger Pierson |
Publication Detail:
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Type: Case Reports; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Obstetrics and gynecology Volume: 102 ISSN: 0029-7844 ISO Abbreviation: Obstet Gynecol Publication Date: 2003 Nov |
Date Detail:
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Created Date: 2003-11-10 Completed Date: 2003-12-23 Revised Date: 2010-09-24 |
Medline Journal Info:
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Nlm Unique ID: 0401101 Medline TA: Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 1130-3 Citation Subset: AIM; IM |
Affiliation:
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Department of Obstetrics, Gynecology & Reproductive Sciences, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. olantunbosun@sask.usask.ca |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Blood Loss, Surgical / prevention & control Cerclage, Cervical / methods* Female Fiber Optic Technology Humans Laparoscopy Monitoring, Intraoperative Pregnancy Suture Techniques Transillumination* Uterus / blood supply*, ultrasonography |
| Grant Support | |
ID/Acronym/Agency:
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11489//Canadian Institutes of Health Research |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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