Transabdominal Cerclage: Different Indications, Optimal Outcome. Two Case Reports

Abstract

Case 125-years-old woman gravida 2 para 0 abortus 1 known case of congenital hypoplastic upper vagina, for that she underwent multiple vaginal surgeries including vaginal septum resection, vaginoplasty (vaginostomy). After the procedures, Patient was unable to get pregnant for 1 year, so she came back and hysteroscopy with examination under anesthesia was done, which revealed stenosed upper vagina and very short cervix with normal uterine cavity. Following the procedure, the patient got pregnant spontaneously, and attended our clinic pregnant at 6 weeks gestational age for follow up. Ultrasound examination revealed short cervical length of 1.7 cm long and counselled regarding the Transabdominal cerclage since she had hypoplastic upper vagina and limited transvaginal access.The patient had an uncomplicated transabdominal cerclage at 9 weeks gestation, she had a regular follow up in the clinic with ultrasound for the cervical length, cervical length surveillance was done at 15, 23, 25, 27, 30 and 35 weeks of gestation and the length was ranging between 2 and 2.2 cm. Elective caesarean section was performed at 38 weeks with no complications. The abdominal cerclage was kept in place. Case 234-years-old woman gravida 5 para 0 abortus 4 known case of diabetes mellitus type 2 on insulin and hypothyroidism on treatment, she has had a history of 4 second trimester miscarriages between 14 to 21 weeks gestation. Three of those miscarriages were managed by elective transvaginal cervical cerclage. Department of Obstetrics and Gynecology, Collage of Medicine, King Saud University, Riyadh, Saudi Arabia AbstractTransabdominal placement of a cerclage at the cervicoisthmic junction appears to be a safe and effective procedure for reducing the incidence of spontaneous pregnancy loss in selected patients with cervical insufficiency, we reported a case series of two woman with different indications for abdominal cerclage. Case 1 is a 25-years-old woman gravida 2 para 0 abortus 1 known case of hypoplastic upper vagina who had 2 vaginal repair (vaginostomy) and had abdominal cerclage for short cervix and delivered by caesarean section at 38 weeks a healthy baby boy. Case 2 is a 34-yearsold woman gravida 5 para 0 abortus 4 known case of diabetes mellitus type 2 and hypothyroidism, she has a history of 3 failed transvaginal cervical cerclage where all ended in miscarriages, so the fifth pregnancy was managed with transabdominal cerclage and she completed her pregnancy until 38 weeks of gestation and delivered a healthy baby boy by caesarean section.

Sexualitäten und Geschlechter

“…Autist*innen begegnen uns immer öfter, ob als Ermittler*innen und Patholog*innen in den Vorabendserien des Öffentlich-rechtlichen Rundfunks, als halbmagische Wesen in der Netflix-Serie Wednesday oder als Täter in schwedischen Thrillern. Workbook (1981). By synthesizing contemporaneous debates on sexual liberation, feminist perspectives, and nascent environmental consciousness, the authors present the concept of »Well-Sex« as a harmonious fusion of sexual contentment and holistic health.…”

“…Travis und Ardell gründeten Wellnesscenter in Wisconsin (Mill Valley Wellness Resource Center, 1975 gegründet durch Travis) und Florida (Campus Wellness Center an der University of Central Florida, 1984 gegründet durch Ardell), wo Wellnesskurse und -beratungen angeboten wurden (Hauß 2014: 483). Das im Folgenden vorgestellte Wellness Workbook ist Teil eines von Travis in der zweiten Hälfte der 1970er Jahre konzipierten umfassenden Wellnessprogramms aus Seminaren, Lehrbuch und Arbeitsbuch (Ryan/Travis 1981).…”