Noninvasive Cerclage for the Management of Cervical Incompetence: A Prospective Study

Acharya, Ganesh; Eschler, Bettina; Grønberg, Martin; Hentemann, Martha; Ottersen, Tom; Maltau, Jan Martin

doi:10.1097/01.ogx.0000206343.06995.36

Cited by 4 publications

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“…Antczak-Judycka A, et al (2003) compararam 35 pacientes tratadas com pressário em relação a 22 pacientes tratadas com cerclagem cervical, onde foi analisado que ambos os métodos mostraram-se igualmente eficazes em termos de prolongamento da gravidez. Os autores observaram que o uso de pessário está associado a menor frequência de trabalho de parto prematuro e prolongamento de idade gestacional em mulheres que apresentam colo do útero incompetente ou em risco de trabalho de parto ( LUDMIR J, SEHDEV HM, et al, 2002;ACHARYA G, et al 2006;ARABIN B, et al, 2013).…”

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Incompetência istmocervical: uma revisão narrativa com ênfase no tratamento

Gonçalves¹,

Brum

Vasquez

2021

Acervo Saúde

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Objetivo: Identificar através de uma revisão narrativa os tratamentos existentes e seus resultados na Incompetência Istmocervical. Revisão bibliográfica: A Incompetência Istmocervical é um quadro clínico que determina a fragilidade do sistema oclusivo da matriz cervical, de modo que o colo uterino não se mantém fechado, não detendo o produto da concepção até o final da gestação. Sua incidência geral é de 4,5:1.000 partos. O diagnóstico clínico é o mais utilizado, tendo como aliado o diagnóstico por imagem. O tratamento da Incompetência Istmocervical pode ser clínico ou por técnicas cirúrgicas e vai depender do momento em que o diagnóstico é realizado e das condições clínicas da paciente. Considerações finais: Com base no exposto anteriormente, a incompetência istmocervical acomete pacientes que apresentam anormalidades congênitas, adquiridas ou pós traumáticas no colo uterino. Existem métodos cirúrgicos e não cirúrgicos para o tratamento deste quadro, porém, devemos considerar que cada paciente deve ser tratada de forma individualizada, considerando sua condição clínica.

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“…Hospital Universitário Getúlio Vargas (HUGV), Manaus -AM. *E-mail: biancam_macedo@hotmail.com2 Universidade Federal do Amazonas (UFAM), Manaus -AM.…”

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confidence: 99%

Incompetência istmocervical: uma revisão narrativa com ênfase no tratamento

Gonçalves¹,

Brum

Vasquez

2021

Acervo Saúde

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“…This device has been modi ed and improved by Arabin. 35 Nowadays both, progesterone and pessaries have been used to prevent PTB in patients with a short cervix, although the e ciency of these treatments is extensively debated in the literature with disputable results for vaginal progesterone [36][37][38][39][40][41] , cervical pessary [42][43][44][45][46][47][48] , and their combination or comparisons. [49][50][51][52] This study was designed to explore the impact of the cervical conization size (CCS) followed by cervical length (CL) changes on the PTB rates of asymptomatic singleton pregnancies compared to POs in women without cervical conization and to estimate the e ciency of vaginal progesterone alone next to its combination with a pessary to prevent PTB in patients with a short cervix.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Cervical Conization Size Followed by Cervical Length Changes on Preterm Birth Rates in Asymptomatic Singleton Pregnancies

Firichenko

Stark²,

Mynbaev

2021

Preprint

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The study aimed to explore the impact of the cervical conization size (CCS) followed by cervical length (CL) changes on preterm birth (PTB) rates in asymptomatic singleton pregnancies compared to pregnancy outcomes (POs) in women with an intact cervix, and to estimate the PTB prevention efficiency in patients with a short cervix (vaginal progesterone alone group (PAG) vs. progesterone-pessary group (PPG)). POs in populations with similar age, ethnicity, residency, education, and harmful habits who underwent cervical conization compared to the women with an intact cervix, and sub-populations with the sufficient CL vs. short cervix, and the PTB prevention efficiency of PAG and PPG were retrospectively analyzed. PTB risks depend on the CCS which is the key point, further, during pregnancy, the larger CCS is associated with the short cervix, and higher PTB risks, notably increased among nulliparous women, and the smaller CCS followed by the sufficient CL and lower PTB risks predominantly observed in women with the prior parity. The USCL assessment is the PTB risk predicting tool, and it can be supplemented with the CCS to increase its diagnostic value. There was no substantial impact on the POs associated with the PTB prevention modes, whereas, the CL changes during pregnancy depending on the CCS is more critical in POs.

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“…Secondary outcome measures are time to delivery, preterm birth rate before 32 and 37 weeks, days of admission in neonatal intensive care unit, maternal morbidity, maternal admission days for preterm birth and costs [66]. Only one small study reported some positive effect of pessary insertion in twins [67].…”

Section: Pessariesmentioning

confidence: 99%

Twin and Preterm Labor: Prediction and Treatment

Aboulghar

Islam

2013

Curr Obstet Gynecol Rep

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Twin pregnancies are increasing. Preterm birth is a major health problem with high incidence all over the world. It is known to have a higher incidence in twin pregnancies as well as being higher in IVF/ICSI pregnancies. Prediction of preterm birth in twins through transvaginal cervical length measurement and vaginal fetal fibronectin measurement are good and well-documented methods. However, this could not be applied to IVF pregnancies. Prevention of preterm birth by administration of vaginal natural progesterone or IM synthetic progesterone injections is not effective in twins. The situation was similar with administration of progesterone to IVF twin pregnancies. Prophylactic cerclage for prevention of preterm birth in twins resulted in an increase of the incidence of preterm birth. Tocolytics also are ineffective, although nifedipine may have a role in treatment of threatened preterm birth in twins.

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Noninvasive Cerclage for the Management of Cervical Incompetence: A Prospective Study

Cited by 4 publications

References 0 publications

Incompetência istmocervical: uma revisão narrativa com ênfase no tratamento

Incompetência istmocervical: uma revisão narrativa com ênfase no tratamento

The Impact of Cervical Conization Size Followed by Cervical Length Changes on Preterm Birth Rates in Asymptomatic Singleton Pregnancies

Twin and Preterm Labor: Prediction and Treatment

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