OP19.09: Qualitative characteristics of uterine Doppler waveforms during early gestation in patients after conservative myomectomy

Abstract

Objectives: To evaluate the cervical augmentation after cervical operations using three-dimensional ultrasound. Methods: Three-dimensional volume data sets of the cervix volume were acquired in women with cervical incompetence or complicated pregnancy history who underwent a cervical operation like cerclage or early total cervix closure, before and after operation. The cervical augmentations achieved by the operations were compared. Results: The data of 21 pregnancies between the 19 th and 25 th weeks of gestation who underwent either a cerclage or early total cervix closure were analyzed using the Pearson test. The cervical volume before cervical operation had a mean dimension of 18.38 cm 3 , after cervical operation we measured a mean volume of 36.38 cm 3 , which was significantly higher (P < 0.0001, 95% CI −73.62 to −32.88). Conclusions: Women with cervical incompetence or complicated pregnancy history who underwent a cervical operation like cerclage or early total cervix closure had a significant cervical augmentation on 3D measurement, so we recommend these operations for appropriate indications. OP19.08The role of amniodrainage in emergency cerclage: a technique to improve materno-fetal outcome Eligibility criteria: patients with a cervical dilation greater than 2 cm and effacement greater than 80% with a prolapse of the fetal membranes in the vagina, in pregnancies between 18 and 26 weeks, without any background history of cervical insufficiency. Amniodrainage was carried out until an amniotic fluid index (AFI) of 6 cm was achieved. After obtaining results of a negative Gram stain, all patients underwent a McDonald type of cervical cerclage. After the procedure all surgeons were asked, through an analog visual scale, to assess their perception of the severity of the prolapse of the membranes in the vagina. Results: We assessed nine patients with an average gestational age of 22 weeks. The average cervical dilatation was 3.7 cm. The average prolongation of gestational age postprocedure was 12 weeks. The average fetal weight upon birth was 1824 g. In our study 100% of the amniotic liquid cultures were negative. 100% of the amniodrainage was successful and free from complications. The post-operative sonographic measurement of cervical length was 15 mm. The procedure was successful in 88.8% of the cases; there was an intraoperational rupture of the amniotic membranes in one case with a dilation of 7 cm. Assessment of the prolapse of the fetal membranes by the surgeons through the analog visual scale found a reduction of the severity of the prolapse of 80% on average. Conclusions:The results in our small group of patients show that routine amnioreduction prior to emergency cerclage does help, making the procedure easier and safer, by diminishing the severity of the prolapse of the membranes in the vagina. We speculate that this modification to the original technique may have a positive impact on the final materno-fetal outcome. Moscow Medical Academy, Russian FederationObjectives: Our purpose was to assess th...