Closure of the incompetent internal cervical os by whatever method presents few technical difficulties when attempted before effacement and dilatation have occurred. In the latter situation, unless the protruding fetal membranes can be reduced safely, their rupture during placement of the sutures is sometimes difficult to avoid. The following procedure has been evolved to facilitate the operation.
Sunzmory:The fetal lie, presentation, and position was recorded serially from the 16th week of gestation until delivery in 100 pregnant women.The incidence of these characteristics varied with gestation and parity, with stabilization of fetal lie occurring at the 22nd week in nulliparous patients, and at the 30th week in parous patients; the frequency of longitudinal lie rose from 63%, at 16 weeks of gestation to 99% at 32 weeks of gestation.Only 1 persistent breech presentation and I persistent transverse lie occurred in the 100 patients. The predominant position in the cephalic presentations was left occipital with a significantly higher incidence in the nullipara.Considerable variability of lie, presentation, and position occurred in serial examinations, and late spontaneous version from breech to vertex occurred in 4 multiparous patients.
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