The physiology and clinical significance of the uterine isthmus

Mann, Edward C.; Mclarn, William D.; Hayt, David B.

doi:10.1016/s0002-9378(16)36356-6

Cited by 62 publications

(8 citation statements)

References 11 publications

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“…The pregnancy was nearly always terminated by cesarean section. It should be noted that in none of the 32 cases of Mann et al (8), and in only one of the cases in the present material did labor begin before the 38th week of pregnancy.…”

Section: Discussioncontrasting

confidence: 48%

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Transabdominal Isthmic Cerclage for the Treatment of Incompetent Cervix

Olsen¹,

Tobiassen²

1982

Acta Obstet Gynecol Scand

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During the period from 1973 to 1980 transabdominal isthmic cerclage was performed on 32 patients. Twenty-nine patients experienced 35 pregnancies. In 23 cases (79%) the diagnosis was based on one or several second-trimester abortions. In the remaining 6 cases the diagnosis was based on clinical findings of an abnormal cervix. Both groups had fetal loss in first and third trimester. The operation was performed before pregnancy or during pregnancy up to the 14th week. The fetal salvage rate rose from 12% to 91.4%, and the prematurity rate was 6.7% after operation. Only one pregnancy was terminated prematurely, due to forcible labor.

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Section: Discussioncontrasting

confidence: 48%

“…Mann et al (8) described in 1961 a method of preconceptional restoration of the sphincteric function of the uterine isthmus. The cerclage was placed in the isthmic area by the vaginal route, a method not suit-able for pregnant patients.…”

Section: Discussionmentioning

confidence: 99%

Transabdominal Isthmic Cerclage for the Treatment of Incompetent Cervix

Olsen¹,

Tobiassen²

1982

Acta Obstet Gynecol Scand

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“…A sphincter function has been ascribed to the rat cervix in regulating uterine fluid discharge into the vagina (Blandau, 1945;Armstrong, 1968) and to the human isthmus in regulating the isthmal canal diameter (Asplund, 1952;Mann, McLaren & Hayt, 1961). Three further criteria can be applied to define a sphincter region.…”

Section: Discussionmentioning

confidence: 99%

THE INNERVATION OF THE RATCERVIX AND ITS PHARMACOLOGY In vitro AND In vivo

Hollingsworth

1974

British J Pharmacology

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1Contractions of the rat cervix and uterine horns were measured both in vitro and in vivo as changes in luminal perfusion pressure during perfusion at constant flow. 2 Spontaneous cervical and uterine horn contractions in vitro were reduced from rats pre-treated with 1701-oestradiol compared to those ovariectomized only or those pre-treated with 1703-oestradiol plus progesterone.3 The rat cervix exhibited similar in vitro sensitivities to methacholine, oxytocin, isoprenaline and phenylephrine as did the uterine horns. 4 Transmural stimulation produced cervical and uterine horn contractions, which were blocked by hyoscine or tetrodotoxin, suggesting a cholinergic motor innervation. This was supported by histological findings. 5In vivo, the injections of propranolol (1.9 x 10-7mol/kg) or pempidine (3.2 or 6.4 x 10-6 mol/kg) were followed by large cervical and smaller uterine horn contractions, suggesting an adrenergic inhibitory tone mediated by 3-adrenoceptors. 6 The evidence for a cervical sphincter is discussed.

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“…The incidence of incompetent cervix complicating pregnancy is estimated to be between 0.05 and 1% 3 and cervical incompetence is implicated as the cause of 16 to 25% of second trimester pregnancy losses. 4 - 5 Various surgical and nonsurgical approaches have been advocated since the early 1900s as treatment for incompetent cervix. The most widely used surgical methods are the Shirodkar and McDonald methods of cervical cerclage.…”

mentioning

confidence: 99%

Emergency Cervical Cerclage: A Retrospective Review of 51 Cases

Wong¹,

Farquharson²,

Dansereau³

1993

Amer J Perinatol

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Fifty-one patients underwent emergency cervical cerclage using Shirodkar or McDonald suture for incompetent cervix diagnosed during pregnancy. Fifteen patients had only sonographic evidence of cervical incompetence (group I). Eighteen patients had cervical dilation of less than 3 cm (group II), and 18 patients had cervical dilation of 3 cm or more (group III). Perinatal mortality was 0%, 50%, and 55.6%, respectively. The median length of time gained with the cerclage was 16 weeks in group I, 1.8 weeks in group II, and 1 week in group III. Twelve infants required prolonged stay in the neonatal intensive care nursery because of prematurity. Six of 30 surviving infants had some abnormal physical findings at the time of initial discharge from the nursery. Premature rupture of membranes was the most common perioperative and postoperative complication. Chorioamnionitis developed in 17 of the 51 cases. Maternal complications included cervicovaginal fistula, deep vein thrombophlebitis, and pulmonary edema.

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The physiology and clinical significance of the uterine isthmus

Cited by 62 publications

References 11 publications

Transabdominal Isthmic Cerclage for the Treatment of Incompetent Cervix

Transabdominal Isthmic Cerclage for the Treatment of Incompetent Cervix

THE INNERVATION OF THE RATCERVIX AND ITS PHARMACOLOGY In vitro AND In vivo

Emergency Cervical Cerclage: A Retrospective Review of 51 Cases

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