Use of a uniconcave balloon in emergency cerclage

Son, Ga Hyun; Chang, Kylie Hae-Jin; Song, Ji-Eun; Lee, Keun-Young

doi:10.1016/j.ajog.2014.07.022

Cited by 18 publications

(10 citation statements)

References 7 publications

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“…First, the bulging membrane was pushed back into the uterine cavity with a uni-concave inflated balloon. Then, the McDonald technique was performed with one suture using 5 mm Mersilene tape placed in a purse-string fashion; the balloon was then deflated and the purse-string suture was tied as the instrument was withdrawn [ 24 ].…”

Section: Methodsmentioning

confidence: 99%

Effects of emergency cerclage on the neonatal outcomes of preterm twin pregnancies compared to preterm singleton pregnancies: A neonatal focus

Chun

Lee

et al. 2018

PLoS ONE

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ObjectiveTo evaluate the efficacy and safety of emergency cerclage (EC) in preterm twins by comparing neonatal outcomes of preterm twins with those of preterm singletons.Study designThis is a single-institution retrospective study of preterm infants born to women who underwent EC from 2008 to 2014. We compared various maternal and neonatal factors. The primary and secondary goals were to compare the maternal and neonatal morbidities and neonatal mortality, respectively.ResultsOne hundred fifty-three infants were included comprising 32(21%) twins and 121(79%) singletons. The mean gestational age (GA) at the time of EC and the number of days from EC to delivery were not significantly different (47.9±27.5 vs. 48.3±35.5). The rate of preterm delivery at ≤32 weeks GA (69% vs. 79%) and ≤28 weeks GA (50% vs. 55%), and other prematurity-associated morbidities were not significantly different. The survival rate during hospitalization was 75% (24/32) in twins and 88% (107/121) in singletons (P = 0.054). Death within 7 days after birth occurred in 8 twins (25%) and 7 singletons (6%) (P = 0.001). All of the infants were <1,000 g with a GA of ≤27 weeks.ConclusionCompared to EC in singleton pregnancies, EC in twin pregnancies resulted in a higher mortality rate for preterm babies. EC might be considered a salvage procedure for selective twin pregnancies with cervical insufficiency.

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Section: Methodsmentioning

confidence: 99%

Effects of emergency cerclage on the neonatal outcomes of preterm twin pregnancies compared to preterm singleton pregnancies: A neonatal focus

Chun

Lee

et al. 2018

PLoS ONE

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“…Son et al proposed a special uniconcave balloon (Figure 3), but in their study, pregnancies after emergency sutures were prolonged up to 37 weeks only in 20.9% and in 25% it ended before 24 weeks [63]. This tool is convenient to use for the operator, but the results are disappointing [64].…”

Section: Emergency Suture Proceduresmentioning

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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“…Therefore, successfully replacing the bulging membranes into the uterus is the key step for ECC. Some devices including moist gauze and inflated balloon (Foley catheter, cervical cook balloon, uniconcave balloon and balloon tamponade) have been used during ECC [11,14,31,32]. However, for women with advanced cervical dilation or increased pressure of intra-amniotic sac, the above devices may not be effective due to limited contact area with membranes, limited supporting force or risk of rupture of membranes.…”

Section: Discussionmentioning

confidence: 99%

The Role of Amnioreduction in Emergency Cervical Cerclage with Bulging Membranes: A Retrospective Comparative Study

et al. 2022

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The purpose of this study was to investigate the role of amnioreduction in patients who underwent emergency cervical cerclage (ECC) with bulging membranes during the second trimester. This retrospective comparative study included 46 singleton pregnant women who had cervical dilation at least 1 cm with bulging membranes beyond the external cervical os and underwent ECC at the Third Affiliated Hospital of Sun Yat-sen University between December 2016 and December 2021. Cases were categorized as amnioreduction group (n = 16) and non-amnioreduction group (n = 30) according to whether amnioreduction was performed prior to ECC. The gestational age and cervical dilation at cerclage, operative time, prolongation of pregnancy, and outcomes of pregnancy were compared between the two groups. All 46 patients underwent successful ECC excepted one case with intraoperative rupture of membrane in non-amnioreduction group. In the amnioreduction group, the cervical dilation at cerclage was larger than that in the non-amnioreduction group (4.5 ± 2.2 vs. 2.2 ± 1.2 cm, P < 0.001), and had more patients with cervical dilation ≥4 cm (50.0% vs. 10.0%, P = 0.004). However, the gestational age at cerclage, operative time, prolongation of pregnancy, gestational age at delivery were not significantly different between the two groups (22.9 ± 2.8 vs. 22.9 ± 3.2 weeks, 31.1 ± 9.2 vs. 27.9 ± 11.4 min, 21.3 ± 21.5 vs. 38.7 ± 40.2 days, 25.9 ± 4.5 vs. 28.4 ± 6.1 weeks; P > 0.05). The rates of delivery ≥28 weeks, ≥32 weeks, and live birth were 20.0% vs. 80.0%, 12.5% vs. 26.7%, 56.3% vs. 66.7% (P > 0.05) in amnioreduction group and non-amnioreduction group, respectively. In conclusion, even in cases with larger cervical dilation, the application of amnioreduction with ECC is possible to get the acceptable pregnancy outcomes. These findings suggested that amnioreduction may be a safe and feasible option to be applied before ECC, especially for those with advanced cervical dilation and bulging membranes.

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Use of a uniconcave balloon in emergency cerclage

Cited by 18 publications

References 7 publications

Effects of emergency cerclage on the neonatal outcomes of preterm twin pregnancies compared to preterm singleton pregnancies: A neonatal focus

Effects of emergency cerclage on the neonatal outcomes of preterm twin pregnancies compared to preterm singleton pregnancies: A neonatal focus

Emergency Cervical Cerclage

The Role of Amnioreduction in Emergency Cervical Cerclage with Bulging Membranes: A Retrospective Comparative Study

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