Araştırma Makalesi
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Pregnancy Outcomes After Emergency Cerclage For Cervical Insufficiency A Retrospective Study

Yıl 2020, Cilt: 17 Sayı: 4, 580 - 584, 31.12.2020
https://doi.org/10.38136/jgon.738191

Öz

Aim: Evaluation of maternal and fetal outcomes, effectiveness and reliability of the cerclage for the emergently cerclaged cases due to cervical insufficiency
Materials and Methods: Clinical data from live singleton pregnancies who were diagnosed cervical insufficiency were reviewed retrospectively between the Feb 2010-Jan 2019, at Acıbadem University and Mersin University, Department of Obstetrics and Gynecology.
Results: During the study period, total 29 cervical cerclage operation was performed by McDonald technique. Mean maternal age 31.82±4.449 years (21–38), mean gestational age at diagnosis and cerclage placement was 22.17±2.071 weeks (18-28). Take home baby rate was 79.3 % (n=23). Mean time interval between the cerclage and the birth is 9.24±5.723 weeks (0-18), mean pregnancy week during the birth is 31.4±5.02 weeks (23-39) and mean birth weight is 1873±903 g (650-3782). There was no surgical complication reported from the studied population. Thirty percent (9) of the patients were delivered by C-section.
Discussion: Emergency cerclage prolongs the pregnancy duration of the women with cervical insufficiency, and has marked effects on improving the neonatal outcomes. It is thought to be an appropriate choice for the women with cervical dilatation at the earlier pregnancy weeks.

Kaynakça

  • 1. Practice bulletin no. 130: prediction and prevention of preterm birth. Obstet Gynecol, 2012. 120(4): p. 964-73.
  • 2. Matthews TJ;MacDorman MF. Infant mortality statistics from the 2010 period linked birth/infant death data set. Natl Vital Stat Rep 2013;61(8):1-27.
  • 3. Martin JA, Hamilton BE, Osterman MJ, Curtin SC, Matthews TJ. Births: final data for 2013. Natl Vital Stat Rep, 2015. 64(1): p. 1-65 . 4. Stupin JH, David M, Siedentopf JP, Dudenhausen JW. Emergency cerclage versus bed rest for amniotic sac prolapse before 27 gestational weeks. A retrospective, comparative study of 161 women. Eur J Obstet Gynecol Reprod Biol. 2008. 139:32-7. 5. McNamee KM, Dawood F, Farquharson RG. Mid-trimester pregnancy loss. Obstet Gynecol Clin North Am. 2014. 41(1): 87-102.
  • 6. Shirodkar VN: A new method of operative treatment for habitual abortion in the second trimester of pregnancy. Antiseptic, 1955; 52: 299
  • 7. McDonald IA: Suture of the cervix for inevitable miscarriage. J Obstet Gynaecol Br Emp, 1957; 64: 346–50
  • 8. Seravalli V, Potti S, Berghella V: Risk of intrapartum cervical lacerations in women with cerclage. J Matern Fetal Neonatal Med, 2013; 26(3): 294–98
  • 9. ACOG Practice Bulletin No.142: Cerclage for the management of cervical insufficiency. Obstet Gynecol, 2014. 123(2 Pt 1): p. 372-9.
  • 10. Saccone G, Rust O, Althuisius S, Roman A, Berghella V. Cerclage for short cervix on ultrasonography: meta-analysis of trials using individual patient-level data. Obstet Gynecol, 2005. 106(1): p. 181-9
  • 11. Debby A, Sadan O, Glezerman M, Golan A: Favorable outcome following emergency second trimester cerclage. Int J Gynaecol Obstet, 2007; 96(1): 16–19
  • 12. Gundabattula SR, Marakani LR, Dasari S et al: Outcomes of pregnancy in women who had rescue cerclage for cervical insufficiency: a single-center retrospective study. J Obstet Gynaecol Res, 2013; 39(8): 1293–300
  • 13. Cavus Y, Uysal A, Balsak D et al: Emergency cervical cerclage: effect on pregnancy outcome and mode of delivery. J Matern Fetal Neonatal Med, 2014; 27(1): 80–83
  • 14. Keeler SM, Kiefer D, Rochon M et al: A randomized trial of cerclage vs. 17 alpha-hydroxyprogesterone caproate for treatment of short cervix. J Perinat Med, 2009; 37(5): 473–79
  • 15. Treadwell MC, Bronsteen RA, Bottoms SF: Prognostic factors and complication rates for cervical cerclage: a review of 482 cases. Am J Obstet Gynecol, 1991; 165(3): 555–58
  • 16. Lisonkova S, Sabr Y, Joseph KS: Diagnosis of subclinical amniotic fluid infection prior to rescue cerclage using gram stain and glucose tests: an individual patient meta-analysis. J Obstet Gynaecol Can, 2014; 36(2): 116–22
  • 17. American College of Obstetricians and Gynecologists: ACOG Practice Bulletin. Cervical insufficiency. Obstet Gynecol, 2003; 102: 1091–99
  • 18. Abu Hashim H, Al-Inany H, Kilani Z. A review of the contemporary evidence on rescue cervical cerclage. Int J Gynecol Obstet. 2014;124:198–203.
  • 19. Zhu LQ, Chen H, Chen LB, Liu YL, Tian JP, Wang YH, Zhang R, Zhang JP.Effects of emergency cervical cerclage on pregnancy outcome:a retrospective study of 158 cases. Med Sci Monit. 2015 May 15;21:1395-401. doi: 10.12659/MSM.893244.
  • 20. Pang Q, Jia X, Chen L. Perinatal Outcomes After Emergency Cervical Cerclage for Cervical Insufficiency with Prolapsed Membranes. Med Sci Monit. 2019 Jun 6;25:4202-4206
  • 21. Aoki S, Ohnuma E, Kurasawa K et al: Emergency cerclage versus expectant management for prolapsed fetal membranes: a retrospective, comparative study. J Obstet Gynaecol Res, 2014; 40(2): 381–86
  • 22. Abo-Yaqoub S, Mohammed AB, Saleh H: The effect of second trimester emergency cervical cerclage on perinatal outcome. J Matern Fetal Neonatal Med, 2012; 25(9): 1746–49
  • 23. Althuisius SM, Dekker GA, Hummel P, van Geijn HP: Cervical incompetence prevention randomized cerclage trial. Cervical incompetence prevention randomized cerclage trial: emergency cerclage with bed rest versus bed rest alone. Am J Obstet Gynecol, 2003; 189(4): 907–10
  • 24. Wang S, Feng L. A single-center retrospective study of pregnancy outcomes after emergency cerclage for cervical insufficiency. Int J Gynaecol Obstet. 2017 Oct;139(1):9-13. doi: 10.1002/ijgo.12244. Epub 2017 Jul 6.
  • 25. Fortner KB, Fitzpatrick CB, Grotegut CA, et al. Cervical dilation as a predictor of pregnancy outcome following emergency cerclage. J Matern Fetal Neonatal Med. 2012. 25:1884-8.
  • 26. Tezcan B, Hezelgrave N, Shennan A: The role of cervical ultrasound screening in determining the timing of emergency cerclage. J Obstet Gynaecol, 2012; 32(5): 444–46
  • 27. Uzun Cilingir I, Sayin C, Sutcu H, İnan C, Erzincan S, Yener C, Varol F. Does emergency cerclage really works in patients with advanced cervical dilatation? J Gynecol Obstet Hum Reprod. 2019; 48: 387-390
  • 28. Owen J, Hankins G, Iams JD, et al. Multicenter randomized trial of cerclage for preterm birth prevention in high-risk women with shortened midtrimester cervical length. Am J Obstet Gynecol. 2009. 201(4):375.e1-8.
  • 29. Berghella V, Keeler SM, To MS, Althuisius SM, Rust OA. Effectiveness of cerclage according to severity of cervical length shortening: a meta-analysis. Ultrasound Obstet Gynecol. 2010. 35:468-73

Servikal Yetmezlikte Acil Serklaj Sonrası Gebelik Sonuçları Retrospektif Çalışma

Yıl 2020, Cilt: 17 Sayı: 4, 580 - 584, 31.12.2020
https://doi.org/10.38136/jgon.738191

Öz

Amaç : Servikal yetmezlik nedeniyle acil serklaj yapılan hastaların maternal ve fetal sonuçlarını, serklajın etkinliğini ve güvenliğini değerlendirmek amaçlanmaktadır.
Gereç ve yöntem : Şubat 2010-Ocak 2019 tarihleri arasında, Acıbadem Mehmet Ali Aydınlar Üniversitesi ve Mersin Üniversitesi Kadın Hastalıkları ve Doğum kliniğinde servikal yetmezlik nedeniyle acil serklaj uygulanan, canlı tekil gebeliği olan kadınlardan elde edilen veriler retrospektif olarak değerlendirildi.
Bulgular : 29 hastaya McDonald tekniği ile acil serklaj uygulandı. Ortalama anne yaşı 31,82±4,449 yıl (21–38), Serklaj uygulanan hastaların operasyon sırasındaki ortalama gebelik haftası 22,17±2,071 hafta idi (18-28). Canlı gebelik oranı 79,3% (n=23) idi. Serklaj ve doğum arasındaki ortalama aralık 9,24±5,723 hafta (0-18), doğumda ortalama gebelik haftası 31,4±5,02 hafta (23-39) ve doğum ağırlığı 1873±903 g (650-3782) idi. Prosedürle ilgili komplikasyonlar görülmedi. 9 (30%) hasta sezaryen ile doğum yaptı.
Sonuç : Acil servikal serklaj, servikal yetmezliği olan kadınlarda gebelik süresini uzatmakta ve yenidoğan sonuçlarını iyileştirmede etkilidir. Erken gebelik haftalarında servikal dilatasyonu olan kadınlar için uygun bir seçenek olarak düşünülmelidir.

Kaynakça

  • 1. Practice bulletin no. 130: prediction and prevention of preterm birth. Obstet Gynecol, 2012. 120(4): p. 964-73.
  • 2. Matthews TJ;MacDorman MF. Infant mortality statistics from the 2010 period linked birth/infant death data set. Natl Vital Stat Rep 2013;61(8):1-27.
  • 3. Martin JA, Hamilton BE, Osterman MJ, Curtin SC, Matthews TJ. Births: final data for 2013. Natl Vital Stat Rep, 2015. 64(1): p. 1-65 . 4. Stupin JH, David M, Siedentopf JP, Dudenhausen JW. Emergency cerclage versus bed rest for amniotic sac prolapse before 27 gestational weeks. A retrospective, comparative study of 161 women. Eur J Obstet Gynecol Reprod Biol. 2008. 139:32-7. 5. McNamee KM, Dawood F, Farquharson RG. Mid-trimester pregnancy loss. Obstet Gynecol Clin North Am. 2014. 41(1): 87-102.
  • 6. Shirodkar VN: A new method of operative treatment for habitual abortion in the second trimester of pregnancy. Antiseptic, 1955; 52: 299
  • 7. McDonald IA: Suture of the cervix for inevitable miscarriage. J Obstet Gynaecol Br Emp, 1957; 64: 346–50
  • 8. Seravalli V, Potti S, Berghella V: Risk of intrapartum cervical lacerations in women with cerclage. J Matern Fetal Neonatal Med, 2013; 26(3): 294–98
  • 9. ACOG Practice Bulletin No.142: Cerclage for the management of cervical insufficiency. Obstet Gynecol, 2014. 123(2 Pt 1): p. 372-9.
  • 10. Saccone G, Rust O, Althuisius S, Roman A, Berghella V. Cerclage for short cervix on ultrasonography: meta-analysis of trials using individual patient-level data. Obstet Gynecol, 2005. 106(1): p. 181-9
  • 11. Debby A, Sadan O, Glezerman M, Golan A: Favorable outcome following emergency second trimester cerclage. Int J Gynaecol Obstet, 2007; 96(1): 16–19
  • 12. Gundabattula SR, Marakani LR, Dasari S et al: Outcomes of pregnancy in women who had rescue cerclage for cervical insufficiency: a single-center retrospective study. J Obstet Gynaecol Res, 2013; 39(8): 1293–300
  • 13. Cavus Y, Uysal A, Balsak D et al: Emergency cervical cerclage: effect on pregnancy outcome and mode of delivery. J Matern Fetal Neonatal Med, 2014; 27(1): 80–83
  • 14. Keeler SM, Kiefer D, Rochon M et al: A randomized trial of cerclage vs. 17 alpha-hydroxyprogesterone caproate for treatment of short cervix. J Perinat Med, 2009; 37(5): 473–79
  • 15. Treadwell MC, Bronsteen RA, Bottoms SF: Prognostic factors and complication rates for cervical cerclage: a review of 482 cases. Am J Obstet Gynecol, 1991; 165(3): 555–58
  • 16. Lisonkova S, Sabr Y, Joseph KS: Diagnosis of subclinical amniotic fluid infection prior to rescue cerclage using gram stain and glucose tests: an individual patient meta-analysis. J Obstet Gynaecol Can, 2014; 36(2): 116–22
  • 17. American College of Obstetricians and Gynecologists: ACOG Practice Bulletin. Cervical insufficiency. Obstet Gynecol, 2003; 102: 1091–99
  • 18. Abu Hashim H, Al-Inany H, Kilani Z. A review of the contemporary evidence on rescue cervical cerclage. Int J Gynecol Obstet. 2014;124:198–203.
  • 19. Zhu LQ, Chen H, Chen LB, Liu YL, Tian JP, Wang YH, Zhang R, Zhang JP.Effects of emergency cervical cerclage on pregnancy outcome:a retrospective study of 158 cases. Med Sci Monit. 2015 May 15;21:1395-401. doi: 10.12659/MSM.893244.
  • 20. Pang Q, Jia X, Chen L. Perinatal Outcomes After Emergency Cervical Cerclage for Cervical Insufficiency with Prolapsed Membranes. Med Sci Monit. 2019 Jun 6;25:4202-4206
  • 21. Aoki S, Ohnuma E, Kurasawa K et al: Emergency cerclage versus expectant management for prolapsed fetal membranes: a retrospective, comparative study. J Obstet Gynaecol Res, 2014; 40(2): 381–86
  • 22. Abo-Yaqoub S, Mohammed AB, Saleh H: The effect of second trimester emergency cervical cerclage on perinatal outcome. J Matern Fetal Neonatal Med, 2012; 25(9): 1746–49
  • 23. Althuisius SM, Dekker GA, Hummel P, van Geijn HP: Cervical incompetence prevention randomized cerclage trial. Cervical incompetence prevention randomized cerclage trial: emergency cerclage with bed rest versus bed rest alone. Am J Obstet Gynecol, 2003; 189(4): 907–10
  • 24. Wang S, Feng L. A single-center retrospective study of pregnancy outcomes after emergency cerclage for cervical insufficiency. Int J Gynaecol Obstet. 2017 Oct;139(1):9-13. doi: 10.1002/ijgo.12244. Epub 2017 Jul 6.
  • 25. Fortner KB, Fitzpatrick CB, Grotegut CA, et al. Cervical dilation as a predictor of pregnancy outcome following emergency cerclage. J Matern Fetal Neonatal Med. 2012. 25:1884-8.
  • 26. Tezcan B, Hezelgrave N, Shennan A: The role of cervical ultrasound screening in determining the timing of emergency cerclage. J Obstet Gynaecol, 2012; 32(5): 444–46
  • 27. Uzun Cilingir I, Sayin C, Sutcu H, İnan C, Erzincan S, Yener C, Varol F. Does emergency cerclage really works in patients with advanced cervical dilatation? J Gynecol Obstet Hum Reprod. 2019; 48: 387-390
  • 28. Owen J, Hankins G, Iams JD, et al. Multicenter randomized trial of cerclage for preterm birth prevention in high-risk women with shortened midtrimester cervical length. Am J Obstet Gynecol. 2009. 201(4):375.e1-8.
  • 29. Berghella V, Keeler SM, To MS, Althuisius SM, Rust OA. Effectiveness of cerclage according to severity of cervical length shortening: a meta-analysis. Ultrasound Obstet Gynecol. 2010. 35:468-73
Toplam 27 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Kadın Hastalıkları ve Doğum
Bölüm Araştırma Makaleleri
Yazarlar

Emine Karabük Bu kişi benim 0000-0003-2055-3000

Pınar Kadiroğulları 0000-0002-3268-4940

Nazlı Albayrak Bu kişi benim 0000-0002-3405-028X

Talat Umut Kutlu Dilek 0000-0003-4297-3081

Özlem Pata

Yayımlanma Tarihi 31 Aralık 2020
Gönderilme Tarihi 16 Mayıs 2020
Kabul Tarihi 20 Haziran 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 17 Sayı: 4

Kaynak Göster

Vancouver Karabük E, Kadiroğulları P, Albayrak N, Dilek TUK, Pata Ö. Pregnancy Outcomes After Emergency Cerclage For Cervical Insufficiency A Retrospective Study. JGON. 2020;17(4):580-4.