Document Detail

The value of transvaginal ultrasonography in diagnosis and management of cervical incompetence.
MedLine Citation:
PMID:  11838756     Owner:  NLM     Status:  MEDLINE    
To determine the value of transvaginal sonography in women with a previous history of second trimester miscarriage due to cervical incompetence, 55 patients were subjected to either elective cervical cerclage or follow-up (every second patient) with weekly evaluations of the cervix by transvaginal ultrasonography. Emergency cerclage was applied when significant cervical changes were noted. All patients were evaluated with cervical cultures and ultrasound. Women with infection, fibroids, uterine malformations and multiple pregnancies were excluded from the study. The study population was divided in two groups. In group I (n=27) elective cerclage was applied during the 14th week. Women in group II (n=28) were subjected to serial weekly evaluations of the cervix by transvaginal ultrasonograms. In 18 cases emergency cerclage was applied due to significant cervical changes. In group I, labor started before the 33rd week in two cases (7.4%), between 33 and 37 weeks in nine (33.3%) and after the 37th week in 16 cases (59.2%). Out of the 18 patients in group II who had cervical cerclage after ultrasonographic evaluation, four (22.2%) delivered before the 33rd week, three (16.6%) between 33 and 37 weeks and 11 (61.1%) after the 37th week. No statistical difference was noted between the two groups referring to pregnancy outcome (p<0.1). We concluded that ultrasound-guided management despite cervical shortening, does not result in unfavorable pregnancy outcome. A significant number of patients can avoid the operation.
D Kassanos; E Salamalekis; N Vitoratos; N Panayotopoulos; C Loghis; C Creatsas
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Clinical and experimental obstetrics & gynecology     Volume:  28     ISSN:  0390-6663     ISO Abbreviation:  Clin Exp Obstet Gynecol     Publication Date:  2001  
Date Detail:
Created Date:  2002-02-12     Completed Date:  2002-07-30     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  7802110     Medline TA:  Clin Exp Obstet Gynecol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  266-8     Citation Subset:  IM    
2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, University of Athens, Greece.
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MeSH Terms
Cerclage, Cervical*
Pregnancy Outcome
Uterine Cervical Incompetence / surgery*,  ultrasonography*
Vagina / ultrasonography*

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