Document Detail


A new technique using a rubber balloon in emergency second trimester cerclage for fetal membrane prolapse.
MedLine Citation:
PMID:  19012689     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: Prolongation of pregnancy in cases of fetal membrane prolapse into the vagina during the second trimester is difficult using conservative therapy. After pushing the membranes back into the cervix, emergency cervical cerclage may be advantageous in improving the neonatal outcome. We have been managing membrane repositioning and emergency cervical cerclage with a technique using a rubber balloon device (known as a 'mini metreu' in Japan), and we examined the efficacy of this technique in five cases. METHODS: Our management was as follows: initially, the full bladder technique was attempted under general anesthesia. If this was not effective, amnioreduction was performed by transabdominal amniocentesis. After the membrane repositioning using a mini metreu, double suture cervical cerclage (McDonald method + Shirodkar method) was performed. RESULTS: The diameter of the bulging prolapsed membranes ranged from 30-84 mm, with a mean of 52 mm. Cerclage was successfully performed in all of the five cases. Prolongation of the pregnancy period was from 22-107 days (average; 77.6 +/- 28.9 days). In cases 1-4, healthy newborns were delivered, but in case 5 sudden intrauterine fetal death due to umbilical cord complications occurred at 24 weeks of gestation. CONCLUSION: It appears that long-term prolongation of pregnancy is possible, when performing membrane repositioning using the mini metreu and emergency cervical cerclage for fetal membrane prolapse into the vagina.
Authors:
Makoto Kanai; Takashi Ashida; Satoshi Ohira; Ryosuke Osada; Ikuo Konishi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The journal of obstetrics and gynaecology research     Volume:  34     ISSN:  1341-8076     ISO Abbreviation:  J. Obstet. Gynaecol. Res.     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-17     Completed Date:  2009-02-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9612761     Medline TA:  J Obstet Gynaecol Res     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  935-40     Citation Subset:  IM    
Affiliation:
Department of Family and Child Nursing, and Midwifery, Shinshu University School of Health Sciences, Matsumoto, Nagano, Japan. makotok@shinshu-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Cerclage, Cervical / methods*
Extraembryonic Membranes / pathology*,  surgery
Female
Humans
Infant, Newborn
Pregnancy
Pregnancy Trimester, Second
Prolapse
Uterine Cervical Diseases / pathology,  surgery*

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