The Effect of Cervical Encerclage on Plasma Prostaglandin Concentrations During Early Human Pregnancy

Bibby, J. G.; Brunt, J.; Mitchell, M. D.; Anderson, Anne B. M.; Turnbull, A. C.

doi:10.1111/j.1471-0528.1979.tb10677.x

Cited by 24 publications

(9 citation statements)

References 9 publications

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“…(Bacchus & Hay, 1970;Bibby et al, 1979;Elimian et al, 1999;Jewelewicz, 1991;Yeast & Garite, 1988). Emergency procedures are associated with 80% fetal survival if cervix dilatation is less than 5cm but only 24% if it is more than 5cm (Jewelewicz, 1991 ,7-12,6) * cerclage based on sonographic or clinical criteria promises a hypothetical benefit preventing birth of very low birth weight infants in a narrow selection of patients (Ayers et al, 1988;Michaels et al, 1991) In higher order multiple pregnancies prophylactic cervical cerclage remains a prenatal intervention of undetermined value.…”

Section: Discussionmentioning

confidence: 99%

Routine Cervical Cerclage in Higher Order Multiple Gestation — Does It Prolong the Pregnancy?

Strauß¹,

Heer

Janssen

et al. 2002

twin res

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P reterm birth following cervical dilatation is the greatest threat to infants of a multiple pregnancy. Lacking reliable data concerning the effect of prophylactic cerclage, we compared a study group to controls for maternal and perinatal outcome. Sixteen of 94 triplet-, 9 of 18 quadruplet/quintupletpregnancies, treated with prophylactic cerclage, were retrospectively compared to those without cervical cerclage respectively. Kruskal-Wallis test and Mann-Whitney-U test were performed as non-parametric one way analysis of variance. For the analysis of frequencies Chi Square test or Fisher's exact test were performed. Odds ratio with 95% confidence interval was used to compare the need for intravenous tocolysis as well as perinatal morbidity and mortality. Gestational age at delivery was not different from the controls in all studied groups. Birth weight revealed a 200g dominance for the "no cerclage-triplets", while this significant difference was inverted for quadruplets/quintuplets (1245g vs. 1069g). With respect to gestational age at birth, need for hospitalisation or medical intervention no benefit was achieved. Moreover, perinatal outcome analysed by arterial pH, APGARScore and perinatal mortality was not altered by a prophylactic cerclage. Perinatal morbidity for quadruplets and quintuplets was even higher in cerclage pregnancies. Therefore, these retrospective results disclaim a positive impact of cervical cerclage on pregnancy management or perinatal outcome in multifetal pregnancies.Prematurity has the highest impact on the outcome of multiple pregnancies. The risk of preterm birth and analogous adverse fetal outcome increases with the number of fetuses. For twins, it is up to four times that in singletons (Day et al., 1997). The incidence of preterm delivery is reported to be 30-50% in twins and 66-100% in higher order multiples (Crowther, 1998). Preterm labor, premature preterm rupture of the membranes (PPROM) or cervical dilatation can lead to preterm delivery. Effective prevention of preterm birth would be the major breakthrough with a significant impact on the outcome of multiple pregnancies.Cervical dilatation is a frequent complication particularly in case of multiple pregnancies and is sometimes considered an indication for prophylactic cervical cerclage. The true incidence of the cervical affection is difficult to assess. In the literature, a range from 8-15% is reported.Several prenatal interventions aimed at prolonging multiple pregnancies have been validated. Two trials that assessed the value of prophylactic cervical cerclage in 50 and 194 twin pregnancies found no difference concerning the risk of preterm birth or perinatal mortality (Dor et al., 1982;Rush et al., 1984). Nevertheless, the presented data is too sparse to give any clear picture of the potential effects of routine cerclage in twins.The aim of this study is to evaluate the effect of prophylactic cervical cerclage on perinatal outcome of higher order multiple pregnancies in order to clarify the "cerclage dilemma". Materials and M...

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Section: Discussionmentioning

confidence: 99%

Routine Cervical Cerclage in Higher Order Multiple Gestation — Does It Prolong the Pregnancy?

Strauß¹,

Heer

Janssen

et al. 2002

twin res

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“…Recent work (Bibby et al, 1979) has demonstrated that, during the early part of the second trimester of pregnancy, cervical encerclarge is associated with a rapid significant rise of 13, 14-dihydro-15-keto prostaglandin F (PGFM), which reflects an increase in intra-uterine production of prostaglandin F, which in turn is known to influence capilary permeability (Vane, 1971).…”

Section: Commentsmentioning

confidence: 99%

The Effect of Cervical Encerclarge on Uterine Dimensions

Levin¹,

Brook²,

Feingold³

et al. 1980

Acta Obstet Gynecol Scand

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“…Release of PGF,,, measured as an increase in the plasma levels of its metabolite, 13,14-dihydro-15-keto-PGF2, (PGFM), has been demonstrated both in sheep and in pregnant women following manual stimulation of the cervix (Mitchell ef al. 1977a, b) and in response to more traumatic stimuli such as encerclage procedures (Bibby et al 1979). At least in sheep, the PGF,, response to cervical stimulation appears to increase towards term (Mitchell et al 1977b).…”

mentioning

confidence: 99%

Effect of cervical application of prostaglandin (PG) E₂ on plasma 13,14‐dihydro‐15‐keto‐PGF_2α and oxytocin in pregnant women at term

Fuchs

Husslein²,

Kofler³

et al. 1983

BJOG

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Summary. The concentrations of 13,14‐dihydro‐15‐keto‐prostaglandin F2α (PGFM) and oxytocin were measured by radioimmunoassay in the peripheral plasma of 21 women with low Bishop scores in whom cervical ripening and labour were induced with a cervical cap containing 1.5 mg of prostaglandin (PG) E2, left in place for 6 h. Blood samples were taken before and at 3, 6, 9 and 24 h after the cap was applied. Four women (control group) had a cap without PGE2. Labour began in 13 women receiving PGE2, 12 of whom were delivered within 24 h. In these women plasma PGFM rose progressively to levels seen during spontaneous labour, paralleling the changes in cervical dilatation. The increase became significant at 6 h, when cervical dilatation was 4.5 cm (SEM 0.5). Plasma oxytocin also increased significantly while the cap was in place and then decreased. Plasma PGFM and oxytocin did not change in the control subjects, and in the eight women needing further induction of labour the initial rises were transient and not statistically significant.

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The Effect of Cervical Encerclage on Plasma Prostaglandin Concentrations During Early Human Pregnancy

Cited by 24 publications

References 9 publications

Routine Cervical Cerclage in Higher Order Multiple Gestation — Does It Prolong the Pregnancy?

Routine Cervical Cerclage in Higher Order Multiple Gestation — Does It Prolong the Pregnancy?

The Effect of Cervical Encerclarge on Uterine Dimensions

Effect of cervical application of prostaglandin (PG) E₂ on plasma 13,14‐dihydro‐15‐keto‐PGF_2α and oxytocin in pregnant women at term

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The Effect of Cervical Encerclage on Plasma Prostaglandin Concentrations During Early Human Pregnancy

Cited by 24 publications

References 9 publications

Routine Cervical Cerclage in Higher Order Multiple Gestation — Does It Prolong the Pregnancy?

Routine Cervical Cerclage in Higher Order Multiple Gestation — Does It Prolong the Pregnancy?

The Effect of Cervical Encerclarge on Uterine Dimensions

Effect of cervical application of prostaglandin (PG) E2 on plasma 13,14‐dihydro‐15‐keto‐PGF2α and oxytocin in pregnant women at term

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Resources

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Effect of cervical application of prostaglandin (PG) E₂ on plasma 13,14‐dihydro‐15‐keto‐PGF_2α and oxytocin in pregnant women at term