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The results of cervical cerclage in a single center during a five-year period

Year 2010, , 104 - 107, 01.06.2010
https://doi.org/10.5799/ahinjs.01.2010.02.0021

Abstract

Objectives: The aim of this study was to evaluate the results of the patients who underwent cervical cerclage placement and the contribution of this intervention to the maintenance of pregnancy. Methods: Data of 29 patients who underwent cervical cerclage placement due to cervical insufficiency in Ataturk University Medical Faculty Obstetrics and Gynecology Department Between January 2002 and April 2007 were retrospectively analyzed. The patient\'s age, gestational week, history of abortion, history of previous cervical cerclage, preoperative measurement of cervical length, types of cerclage and delivery weeks were recorded and analysed. Results: The patient\'s ages were between 24 and 43 years. Weeks of gestation were between 12 weeks 2 days and 26 weeks and 1 day. Nineteen patient\'s cervical lengths were less than 20 mm by transvaginal ultrasonography. Eight of patients had funneling sign by transvaginal ultrasonography. Sixteen patients treated with prophylactic cervical cerclage, thirteen women treated with therapeutical cerclage. The cervical lengths of twenty one patients were over 20 mm after the procedure. Five patients reached term. Conclusion: The patient who has risk for cervical insufficiency should be followed with serial ultrasound examination and cervical cerclage should be performed when needed. The prophylactic cerclaje process is still best choice for patients with the history of two or more painless 2nd trimester or early 3rd trimester abortion that typical for cervical incompetence.

References

  • Iams JD, Creasy RK. Preterm Labor and Delivery. In: Creasey RK, Resnick R, Iams JD, eds. Maternal fetal medi- cine: Principles and Practice. 5th ed. Philadelphia: WB Saunders, 2004: 623–62.
  • American College of Obstetricians and Gynecologists Prac- tice Bulletin No.48. Cervival insuuficiency. Obstet Gynecol 2003; 102: 1091–9.
  • Althuisius SM, van Geijn HP. Strategies for prevention-cer- vical cerclage. BJOG. 2005; 112 suppl 1: 51–6.
  • Anthony GS, Calder AA, MacNaughton MC. Cervical resis- tance in patient with previous spontaneous mid-trimester abortion. Br J Obstet Gynaecol. 1982; 89: 1046–9.
  • Shirodkar VN. A new method of operative treatment for ha- bituel abortions in the second trimester of pregnency. Anti- septic 1955; 52: 299–300.
  • Harger JH. Comparison of success and morbidity in cervical cerclage procedures. Obstet Gynecol 1980; 56: 543–8.
  • Barter RH, Riva HL, Parks J, Dusabeck JA. Surgical closure of the incompetent cervix during pregnancy. Am J Obstet Gynecol 1958; 75: 511–21.
  • Easterday CL, Reid DE. The incompetent cervix in repetitive abortion and premature labor. N Engl J Med 1959;260:687– 90.
  • Kiwi R, Neuma MR, Merkatz IR, Selim MA, Lysikiewicz A. Determination of the elastic properties of the cervix. Obstet Gynecol 1988; 71: 568–74.
  • Michaels WH, Thompson HO, Schreiber FR, Berman JM, Ager J, Olson K. Ultrasound surveillance of the cervix dur- ing pregnancy in diethylstilbestrol-exposed offspring. Ob- stet Gynecol 1989; 73: 230–9.
  • Iams JD, Johnson FF, Sonek J, Sachs L, Gebauer C, Samu- els P. Cervical competence as a continuum: A study of ultra- sonographic cervical length and obstetric performance. Am J Obstet Gynecol 1995; 172: 1097–103.
  • Andrews WW, Copper R, Hauth JC, Goldenberg RL, Neely C, Dubard M. Second-trimester cervical ultrasound: Asso- ciation with increased risk for recurrent early spontaneous delivery. Obstet Gynecol 2000; 95: 222-5.
  • Althuisius SM, Dekker GA, van Geijn HP, Hummel P. The effect of therapeutic McDonald cerclage on cervical length assessed by transvaginal ultrasonography. Am J Obstet Gy- necol 1999; 180: 366–9.
  • Iams JD, Goldenberg RL, Meis PJ, Mercer BM et al. The length of the cervix and the risk of spontaneous premature delivery. National Institute of Child Health and Human De- velopment Maternal Fetal Medicine Unit Network. N Engl J Med 1996; 334: 567–72.
  • Newcomer J. Pessaries for the treatment of incompetent cervix and premature delivery. Obstet Gynecol Surv 2000; 55(7): 443–8.
  • Obido AO, Berghella V, To MS, Rust OA, Althuisius SM, Nicolaides KH. Shirodkar versus McDonald cerclage fort the prevention of preterm birth in women with short cervi- cal length. Am J Perinatol 2007, 24: 55–60.
  • Caspi E, Schneider DF, Mor Z, Langer R, Weinraub Z, Buk- ovsky I. Cervical internal os cerclage: Description of a new technique and comparison with Shirodkar operation. Am J Perinatol 1990; 7: 347.
  • Novy MJ, Gupta A, Wothe D, Gupta S, Kennedy KA, Gravetth MG. Cervical cerclage in the second trimester of pregnancy: a historical cohort study. Am J Obstet Gynecol. 2001; 184: 1447–54.
  • Barth WH Jr, Yeomans ER, Hankins GD. Emergent cer- clage. Surg Gynecol Obstet 1990; 170: 323–6.
  • Rust OA, Atlas RO, Reed J, et al. Revisiting the short cer- vix detected by transvaginal ultrasound in the second tri- mester: Why cerclage may not help. Am J Obstet Gynecol 2001;185:1098-112.
  • To MS, Alfirevic Z, Heath VCF, et al. Cervical cerclage for prevention of preterm delivery in women with short cervix: Randomised controlled trial. Lancet 2004;363:1849-52.

Tek merkezde beş yıllık sürede uygulanan servikal serklaj sonuçları

Year 2010, , 104 - 107, 01.06.2010
https://doi.org/10.5799/ahinjs.01.2010.02.0021

Abstract

Amaç: Bu çalışmanın amacı servikal serklaj uygulanan hastaları sonuçlarını ve bu işlemin gebeliğin devamına olan katkısını değerlendirmektir. Yöntemler: Atatürk Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalına Ocak 2002 ile 2007 Nisan tarihleri arasında başvuran ve servikal yetmezlik tanısı ile servikal serklaj uygulanan 29 olgunun verileri geriye dönüşlü olarak incelendi ve sonuçları değerlendirildi. Hastaların yaş, gebelik haftası, abortus veya preterm doğum hikâyesi, servikal serklaj hikâyesi, preoperatif serviksin transvajinal yolla uzunluğunun ölçülmesi, serklaj tipleri ve doğum haftaları kaydedildi ve değerlendirildi. Bulgular: Hastaların yaşları 24-43 arasında değişmekteydi. Gebelik haftaları ise 12 hafta 2 gün ile 26 hafta 1 gün arasında idi. Hastaların 19 (%65.5)\'unda transvajinal ultrasonografik ölçümle serviks uzunluğu 20 mm\'nin altında bulundu. 8 (%27.5) hastada funnelling bulgusu vardı. Toplam 16 hastaya profilaktik serklaj ve diğer 13 (%55.1) hastaya terapotik serklaj uygulandı. Serklaj sonrası 21 (%72.4) hastanın serviks uzunlukları 20 mm\'nin üzerinde ölçüldü. Hastaların beşi terme ulaştı. Sonuç: Servikal yetmezlik için risk faktörü taşıyan hastalara rutin aralıklarla transvajinal ultrasonografi yapılması fetüs için hayat kurtarıcı olabilir. Yine servikal yetmezlik için tipik olan iki veya daha fazla ağrısız olarak 2.trimester düşüğü veya 3.trimester erken doğumu anamnezi veren hastalara profilaktik serklaj uygulamasının iyi bir seçenek olduğunu düşünmekteyiz.

References

  • Iams JD, Creasy RK. Preterm Labor and Delivery. In: Creasey RK, Resnick R, Iams JD, eds. Maternal fetal medi- cine: Principles and Practice. 5th ed. Philadelphia: WB Saunders, 2004: 623–62.
  • American College of Obstetricians and Gynecologists Prac- tice Bulletin No.48. Cervival insuuficiency. Obstet Gynecol 2003; 102: 1091–9.
  • Althuisius SM, van Geijn HP. Strategies for prevention-cer- vical cerclage. BJOG. 2005; 112 suppl 1: 51–6.
  • Anthony GS, Calder AA, MacNaughton MC. Cervical resis- tance in patient with previous spontaneous mid-trimester abortion. Br J Obstet Gynaecol. 1982; 89: 1046–9.
  • Shirodkar VN. A new method of operative treatment for ha- bituel abortions in the second trimester of pregnency. Anti- septic 1955; 52: 299–300.
  • Harger JH. Comparison of success and morbidity in cervical cerclage procedures. Obstet Gynecol 1980; 56: 543–8.
  • Barter RH, Riva HL, Parks J, Dusabeck JA. Surgical closure of the incompetent cervix during pregnancy. Am J Obstet Gynecol 1958; 75: 511–21.
  • Easterday CL, Reid DE. The incompetent cervix in repetitive abortion and premature labor. N Engl J Med 1959;260:687– 90.
  • Kiwi R, Neuma MR, Merkatz IR, Selim MA, Lysikiewicz A. Determination of the elastic properties of the cervix. Obstet Gynecol 1988; 71: 568–74.
  • Michaels WH, Thompson HO, Schreiber FR, Berman JM, Ager J, Olson K. Ultrasound surveillance of the cervix dur- ing pregnancy in diethylstilbestrol-exposed offspring. Ob- stet Gynecol 1989; 73: 230–9.
  • Iams JD, Johnson FF, Sonek J, Sachs L, Gebauer C, Samu- els P. Cervical competence as a continuum: A study of ultra- sonographic cervical length and obstetric performance. Am J Obstet Gynecol 1995; 172: 1097–103.
  • Andrews WW, Copper R, Hauth JC, Goldenberg RL, Neely C, Dubard M. Second-trimester cervical ultrasound: Asso- ciation with increased risk for recurrent early spontaneous delivery. Obstet Gynecol 2000; 95: 222-5.
  • Althuisius SM, Dekker GA, van Geijn HP, Hummel P. The effect of therapeutic McDonald cerclage on cervical length assessed by transvaginal ultrasonography. Am J Obstet Gy- necol 1999; 180: 366–9.
  • Iams JD, Goldenberg RL, Meis PJ, Mercer BM et al. The length of the cervix and the risk of spontaneous premature delivery. National Institute of Child Health and Human De- velopment Maternal Fetal Medicine Unit Network. N Engl J Med 1996; 334: 567–72.
  • Newcomer J. Pessaries for the treatment of incompetent cervix and premature delivery. Obstet Gynecol Surv 2000; 55(7): 443–8.
  • Obido AO, Berghella V, To MS, Rust OA, Althuisius SM, Nicolaides KH. Shirodkar versus McDonald cerclage fort the prevention of preterm birth in women with short cervi- cal length. Am J Perinatol 2007, 24: 55–60.
  • Caspi E, Schneider DF, Mor Z, Langer R, Weinraub Z, Buk- ovsky I. Cervical internal os cerclage: Description of a new technique and comparison with Shirodkar operation. Am J Perinatol 1990; 7: 347.
  • Novy MJ, Gupta A, Wothe D, Gupta S, Kennedy KA, Gravetth MG. Cervical cerclage in the second trimester of pregnancy: a historical cohort study. Am J Obstet Gynecol. 2001; 184: 1447–54.
  • Barth WH Jr, Yeomans ER, Hankins GD. Emergent cer- clage. Surg Gynecol Obstet 1990; 170: 323–6.
  • Rust OA, Atlas RO, Reed J, et al. Revisiting the short cer- vix detected by transvaginal ultrasound in the second tri- mester: Why cerclage may not help. Am J Obstet Gynecol 2001;185:1098-112.
  • To MS, Alfirevic Z, Heath VCF, et al. Cervical cerclage for prevention of preterm delivery in women with short cervix: Randomised controlled trial. Lancet 2004;363:1849-52.
There are 21 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Ünal İsaoğlu This is me

Mehmet Yılmaz This is me

Sedat Kadanalı This is me

Publication Date June 1, 2010
Published in Issue Year 2010

Cite

APA İsaoğlu, Ü., Yılmaz, M., & Kadanalı, S. (2010). Tek merkezde beş yıllık sürede uygulanan servikal serklaj sonuçları. Journal of Clinical and Experimental Investigations, 1(2), 104-107. https://doi.org/10.5799/ahinjs.01.2010.02.0021
AMA İsaoğlu Ü, Yılmaz M, Kadanalı S. Tek merkezde beş yıllık sürede uygulanan servikal serklaj sonuçları. J Clin Exp Invest. June 2010;1(2):104-107. doi:10.5799/ahinjs.01.2010.02.0021
Chicago İsaoğlu, Ünal, Mehmet Yılmaz, and Sedat Kadanalı. “Tek Merkezde Beş yıllık sürede Uygulanan Servikal Serklaj sonuçları”. Journal of Clinical and Experimental Investigations 1, no. 2 (June 2010): 104-7. https://doi.org/10.5799/ahinjs.01.2010.02.0021.
EndNote İsaoğlu Ü, Yılmaz M, Kadanalı S (June 1, 2010) Tek merkezde beş yıllık sürede uygulanan servikal serklaj sonuçları. Journal of Clinical and Experimental Investigations 1 2 104–107.
IEEE Ü. İsaoğlu, M. Yılmaz, and S. Kadanalı, “Tek merkezde beş yıllık sürede uygulanan servikal serklaj sonuçları”, J Clin Exp Invest, vol. 1, no. 2, pp. 104–107, 2010, doi: 10.5799/ahinjs.01.2010.02.0021.
ISNAD İsaoğlu, Ünal et al. “Tek Merkezde Beş yıllık sürede Uygulanan Servikal Serklaj sonuçları”. Journal of Clinical and Experimental Investigations 1/2 (June 2010), 104-107. https://doi.org/10.5799/ahinjs.01.2010.02.0021.
JAMA İsaoğlu Ü, Yılmaz M, Kadanalı S. Tek merkezde beş yıllık sürede uygulanan servikal serklaj sonuçları. J Clin Exp Invest. 2010;1:104–107.
MLA İsaoğlu, Ünal et al. “Tek Merkezde Beş yıllık sürede Uygulanan Servikal Serklaj sonuçları”. Journal of Clinical and Experimental Investigations, vol. 1, no. 2, 2010, pp. 104-7, doi:10.5799/ahinjs.01.2010.02.0021.
Vancouver İsaoğlu Ü, Yılmaz M, Kadanalı S. Tek merkezde beş yıllık sürede uygulanan servikal serklaj sonuçları. J Clin Exp Invest. 2010;1(2):104-7.