Expectant management compared with physical examination–indicated cerclage (EM-PEC) in selected women with a dilated cervix at 140/7-256/7 weeks: results from the EM-PEC international cohort study

Pereira, Leonardo; Cotter, Amanda; Gómez, Ricardo; Berghella, Vincenzo; Prasertcharoensuk, Witoon; Räsänen, Juha; Chaithongwongwatthana, Surasith; Mittal, Suneeta; Daly, Seán; Airoldi, Jim; Tolosa, Jorge E.

doi:10.1016/j.ajog.2007.05.041

Cited by 104 publications

(80 citation statements)

References 25 publications

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“…The results are shown in Table 1. [15][16][17][18][19][20][21][22][23][24][25] The number of patients that were treated each year ranges from 1 to 101, with majority of the cases done before pregnancy, and, in all, reveals very minimal intraoperative complications which were seen in only three cases -2009, 2013, and 2014, with intraoperative complications of 10.7, 4.5, and 1.6% respectively; others did not record any form of complications. There were no severe complications like infection, severe hemorrhage, and injury of peripheral organs.…”

Section: Resultsmentioning

confidence: 99%

Laparoscopic Cerclage in Pregnant and Nonpregnant Uterus: Emerging Need to change Conventional Management Approach

Ayegbusi¹

2017

WJOLS

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Cervical incompetence/insufficiency occurs in 0.1 to 1% of all pregnancies, and, traditionally, management involves transvaginal cervical cerclage. In some situations, however, such as in extremely short cervix following cone biopsy, congenital absent cervix, and in cases where transvaginal cerclage fails or is technically impossible, transabdominal approach via laparotomy is usually done. Recent data suggest that these methods should be reviewed in light of the advantages seen in the developments of minimal access surgical techniques.This article, therefore, compares both approaches (conventional and laparoscopy) and, in particular, discusses the use of laparoscopy in the management of cervical incompetence/ insufficiency both in pregnant and nonpregnant uterus.

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Section: Resultsmentioning

confidence: 99%

Laparoscopic Cerclage in Pregnant and Nonpregnant Uterus: Emerging Need to change Conventional Management Approach

Ayegbusi¹

2017

WJOLS

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“…Although cervical cerclage is an important treatment alternative for many women, 19,31 there is no accepted animal model for studying cerclage treatment. We chose a rodent model because rodents have been used extensively to study cervical softening during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Biocompatibility of a Sonicated Silk Gel for Cervical Injection During Pregnancy: In Vivo and In Vitro Study

et al. 2014

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Objective: To evaluate the biocompatibility of silk gel for cervical injection. Study Design: Silk gel was injected into the cervix of pregnant rats on day 13 (n ¼ 11) and harvested at day 17. Histology of silk gel was compared with suture controls. Also, human cervical fibroblasts were cultured on silk gel and tissue culture plastic (TCP) in vitro. Cell viability, proliferation, metabolic activity, gene expression (COL1A1, COL3A1, and COX2), and release of proinflammatory mediators (interleukin [IL] 6 and IL-8) were evaluated. Results: In vivo, a mild foreign body response was seen surrounding the silk gel and suture controls. In vitro, cervical fibroblasts were viable, metabolically active, and proliferating at 72 hours. Release of IL-6 and IL-8 was similar on silk gel and TCP. Collagen and COX2 gene expression was similar or slightly decreased compared with TCP. Conclusions: Silk gel was well tolerated in vivo and in vitro, which supports continuing efforts to develop silk gels as an alternative to cervical cerclage.

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“…Several retrospective observational series, mostly with no controls, also have claimed benefit of PEIC [5]. The largest cohort study was published in 2007 by Pereira et al [8]. They evaluated women with a dilated cervix who underwent expectant management vs PEIC.…”

Section: Commentmentioning

confidence: 99%

“…[3][4][5][6]8 The risk of PEIC placement includes: rupture of membranes (4% -19%), bleeding from cervical laceration and intrauterine infection [8][9][10][11][12][13]. Pessaries have been used to prevent preterm birth for over 50 years and have been evaluated for treatment of short cervix [14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Pessary versus cerclage versus expectant management for cervical dilation with visible membranes in the second trimester

Gimovsky

Suhag

Roman

et al. 2015

The Journal of Maternal-Fetal & Neonatal Medicine

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Expectant management compared with physical examination–indicated cerclage (EM-PEC) in selected women with a dilated cervix at 140/7-256/7 weeks: results from the EM-PEC international cohort study

Cited by 104 publications

References 25 publications

Laparoscopic Cerclage in Pregnant and Nonpregnant Uterus: Emerging Need to change Conventional Management Approach

Laparoscopic Cerclage in Pregnant and Nonpregnant Uterus: Emerging Need to change Conventional Management Approach

Biocompatibility of a Sonicated Silk Gel for Cervical Injection During Pregnancy: In Vivo and In Vitro Study

Pessary versus cerclage versus expectant management for cervical dilation with visible membranes in the second trimester

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