Introduction: Emergency cerclage in the second trimester is aestablished treatment for a dilated cervix. Aim: To report a case of a successful cerclage performed in a 33-year old woman in her secondpregnancy, after 5 years of non-successfulpregnancy outcomes. Case report: In her fourth month of pregnancy, the patient was hospitalized because of suprapubic pressure.After complete laboratory results, ultrasound and vaginal examination the patient was diagnosed with cervical shortening, cervical canal was opened 3cm, with prolapse and bulging of the fetal membranes in vagina. An amount of 120 ml of clear amniotic fluid was removed transabdominally under ultrasound guidance, and sent to the microbiological and genetical analysis. McDonald emergency cerclage of the cervical canal was performed. Patient was monitored few days on department and released home with advice of strict reduction of activity to minimum, and prescribed therapy due to that: antithrombotic, progesterone and antibiotic therapy. Conclusion: Amnioreduction at the time of emergency cerclage placement is associated with a lower rate of extreme prematurity and related neonatal morbidity. Successful outcome is not impossible, along with adequate antibiotic regimen, bed rest and regular obstetrical control/checkup.

The relationship between genetic risk factors of thrombophilia and pregnancy loss (PL) is being discussed. The focus has been on F5 1691G>A, F2 20210G>A, and MTHFR 677C>T polymorphisms that may predispose women to microthrombosis during the stages of embryo implantation and placentation. Although, the frequencies of these polymorphisms were reported in different populations, such studies have not yet been performed in Bosnian population. In this study, we determined the prevalence of F5 G>A (rs6025), F2 G>A (rs1799963) and MTHFR C>T (rs1801133) polymorphisms in Bosnian women. A total of 154 women with PL, mean age 33 (±5.4) years, were enrolled in the study. As a control group, 154 mothers [mean age 31.4 (±6.7) years] with at least one live-born child were included. We used real-time polymerase chain reaction (PCR) to determine the frequencies of F5 G>A and F2 G>A genotypes, and PCR-restriction fragment length polymorphism (RFLP) for analyzing MTHFR C>T genotypes. The frequency of heterozygotes for F5 and F2 was significantly higher in women with venous thrombosis (VT) compared to women without VT (p = 0.047 and p = 0.001, respectively). There was no significant difference in the distribution of MTHFR genotypes and alleles between these two groups. In addition, we observed no significant differences in the genotype and allele frequencies between the group with PL and control group, for all investigated polymorphisms. The allele frequencies for 1691A (F5), 20210A (F2), and 677T (MTHFR) reported in this study are consistent with the data obtained for other European countries, however, we were not able to confirm the association between the three polymorphisms and PL in Bosnian women.

ObjectivesThe aim of the study was to determine carotid intima-media thickness (CIMT) values in patients who developed and did not develop preeclampsia (PE), and to determine whether CIMT values could be predictors of PE development.MethodsThe study included pregnant women who were examined by regular ultrasound examination at the Materno-Infantil Presidente Vargas Hospital (HMIPV) in Porto Alegre, Brazil, from April 2016 to September 2017. The examinations were performed every three months. Patients were divided into two groups. The first group included patients diagnosed with PE (n=21) and second group included patients who did not have PE (n=199). A high frequency ultrasound device (12 MHz) with a semi-automatic method was used to estimate CIMT.ResultsCIMT was significantly higher in pregnant women with PE than in women without PE (55±0.11 vs. 0.44±0.06, respectively; p<0.001). Using a cut-off value of 0.51 mm, CIMT had a specificity of 77.9% and sensitivity of 81% in the diagnosis of PE. With CIMT ≥0.6 mm, the probability of a patient developing PE was 44.4%; with CIMT >0.42 mm, the probability was only 4.2%.ConclusionsAn increase in CIMT was associated with the onset of PE. CIMT values were significantly higher in patients who develop PE.