Recurrence rates after abdominal and vaginal cerclages in women with cervical insufficiency: a validated cohort study

Sneider, Kirstine; Christiansen, Ole Bjarne; Sundtoft, Iben Blaabjerg; Langhoff‐Roos, Jens

doi:10.1007/s00404-017-4315-y

Cited by 23 publications

(18 citation statements)

References 22 publications

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“…It is also a mechanical barrier that prevents exposure and prolapse of the fetal membranes and in combination with the mucus plug protects against ascending infection [17,18]. Cervical insufficiency means that the cervix is weak and unable to remain closed until the date of delivery, manifesting itself in painless softening and shortening of the cervix without contractions [18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Emergency Cervical Cerclage

Wierzchowska-Opoka

Kimber-Trojnar

Leszczyńska‐Gorzelak

2021

JCM

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Despite the progress of medicine in the last decades, recurrent pregnancy loss, premature birth, and related complications are still a vast problem. The reasons for recurrent pregnancy loss and preterm delivery are diverse and multifactorial. One of the main reasons for these complications is cervical insufficiency, which means that the cervix is weak and unable to remain closed until the date of delivery. It manifests as painless softening and shortening of the cervix without contractions. The aim of the study was to review the available literature on rescue sutures, which are an emergency treatment in pregnancies with premature cervical dilatation and protrusion of the fetal membranes in the second trimester of pregnancy. This review confirms that emergency cerclage reduces the rate of preterm birth in patients with advanced cervical insufficiency. This procedure prolongs gestational age and improves the chances of survival of the newborn without increasing the risk of chorioamnionitis and preterm premature rupture of membranes.

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Section: Introductionmentioning

confidence: 99%

Emergency Cervical Cerclage

Wierzchowska-Opoka

Kimber-Trojnar

Leszczyńska‐Gorzelak

2021

JCM

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“…Untimely cervical ripening may lead to cervical insufficiency, which is responsible for recurrent spontaneous abortion and preterm birth [30][31][32]. A sonographic short cervix is a major risk factor for spontaneous preterm delivery (sPTD) [33], the leading cause of infant death below the age of five [34,35].…”

Section: Introductionmentioning

confidence: 99%

Photoacoustic imaging of the uterine cervix to assess collagen and water content changes in murine pregnancy

Yan¹,

Gomez‐Lopez²,

Basij³

et al. 2019

Biomed. Opt. Express

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The uterine cervix plays a central role in the maintenance of pregnancy and in the process of parturition. Cervical remodeling involves dramatic changes in extracellular matrix composition and, in particular, of collagen and water content during cervical ripening (a term that describes the anatomical, biochemical, and physiologic changes in preparation for labor). Untimely cervical ripening in early gestation predisposes to preterm labor and delivery, the leading cause of infant death worldwide. Inadequate ripening of the cervix is associated with failure of induction or prolonged labor. The current approach to evaluate the state of the cervix relies on digital examination and sonographic examination. Herein, we present a novel imaging method that combines ultrasound (US) and photoacoustic (PA) techniques to evaluate cervical remodeling by assessing the relative collagen and water content of this organ. The method was tested in vitro in extracted collagen phantoms and ex vivo in murine cervical tissues that were collected in mid-pregnancy and at term. We report, for the first time, that our imaging approach provides information about the molecular changes in the cervix at different gestational ages. There was a strong correlation between the results of PA imaging and the histological assessment of the uterine cervix over the course of gestation. These findings suggest that PA imaging is a powerful method to assess the biochemical composition of the cervix and open avenues to non-invasively investigate the composition of this organ, which is essential for reproductive success.

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“…Частота преждевременных родов при ИЦН составила от 28,6% во 2 группе до 62,5% в 1 группе, что не противоречит исследованиям других авторов, при этом экстремально ранние преждевременные роды имели место только у женщин с цервиковагинальными инфекциями [1,2,3,4,5,6,7].…”

Section: дискуссияunclassified

“…Истмико-цервикальная недостаточность (ИЦН) -одна из ведущих причин преждевременных родов. Беременность, осложненная ИЦН, заканчивается преждевременно в 44-57% случаев, а частота рождения детей с экстремально низкой массой тела достигает 38,8% [1,2,3,4,5,6,7]. Ситуацию с недоношенностью при беременности, осложненной ИЦН, усугубляет высокая частота ВУИ, которая диагностируется у 37,5% новорожденных, а при экстремально ранних преждевременных родов увеличивается до 53% случаев [8,9].…”

Section: Introductionunclassified

Isthmico-cervical insufficiency associated with cervicovaginal infections: features of the course of pregnancy and perinatal outcomes

Долгушина

Alikhanova

Kurnosenko

et al. 2021

jour

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Introduction. The formation of isthmic-cervical insufficiency (ICI) in 80% is associated with intraamnial inflammation, this is the subject of discussion of new mechanisms of the pathogenesis of premature cervical remodeling. In this regard, it is of interest to study the relationship of ICS with intrauterine and cervicovaginal infections during pregnancy and their impact on the course and outcomes of pregnancy, which was the purpose of our study.Methods. A prospective cohort study included 100 pregnant women with ICI, taken by a continuous sample. All patients at the time of ICI manifestation underwent a comprehensive clinical and laboratory examination aimed at diagnosing cervicovaginal infections, according to e results of which the pregnant women were divided into 2 groups: the first group consisted of 72 women with ICI and cervicovaginal infections, the second group — 28 women with ICI and normocenosis of the vagina.Results. There were no significant differences between the compared groups in terms of the history of miscarriage, extragenital pathology and the frequency of complications of this pregnancy. Intrauterine infection during pregnancy in patients of group 1 was observed 4 times more often, being 55.6% (40) versus 14.3% (4) in group 2 (RR = 3.9, 95% CI = 1.5-9.9, p <0.001). Preterm birth was significantly more frequent in women of group 1, accounting for 62.5% (45), in group 2 — 28.6% (8). Perinatal mortality cases were observed only in group 1, amounting to 97‰ (7). In children from women in group 1, complications of the early neonatal period were more common, primarily due to prematurity. In addition, IUI in newborns was diagnosed 10 times more often in group 1, reaching 38.8% (26) of cases, compared with group 2 — 3.6% (1) (RR = 10.87, 95% CI = 1.55–76.22, p <0.001).Discussion. Perinatal outcomes in ICI associated with cervicovaginal infections are characterized by the presence of perinatal mortality, a higher incidence of preterm birth and IUI of the newborn than in women with ICI without cervicovaginal infection.

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Recurrence rates after abdominal and vaginal cerclages in women with cervical insufficiency: a validated cohort study

Abstract: Cervical insufficiency was diagnosed in 24% of women with an initial second trimester spontaneous miscarriage/delivery. In second and third pregnancies, recurrence rates were significantly lower after prophylactic vaginal or abdominal cerclage compared with no cerclage.

Cited by 23 publications

References 22 publications

Emergency Cervical Cerclage

Emergency Cervical Cerclage

Photoacoustic imaging of the uterine cervix to assess collagen and water content changes in murine pregnancy

Isthmico-cervical insufficiency associated with cervicovaginal infections: features of the course of pregnancy and perinatal outcomes

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