Fertility and pregnancy outcomes after transvaginal cervico-isthmic cerclage.
Eur J Obstet Gynecol Reprod Biol
; 218: 21-26, 2017 Nov.
Article
en En
| MEDLINE
| ID: mdl-28926726
ABSTRACT
INTRODUCTION:
Prematurity is the leading cause of neonatal morbidity and mortality. Cervical insufficiency seems to be the main risk factor. Treatment is cervical cerclage. In case of failure, a cervico-isthmic cerclage by Fernandez' technique, with the placement of a polypropylene sling by vaginal approach during the first trimester of pregnancy, has proven its effectiveness. The aim of our study is to report effectiveness of Fernandez' cervico-isthmic cerclage in subsequent pregnancies. MATERIALS ANDMETHODS:
This retrospective study, was conducted from March 2002 to April 2014 in the gynecologic department of two teaching hospitals. The inclusion criterion was history of cervico-isthmic cerclage using Fernandez's technique during the previous pregnancy. This study received IRB approval number CEROG 2016-GYN-0302.RESULTS:
125 women underwent a definitive cervico-isthmic cerclage. The total percentage of neonatal survival after 14 weeks was 91% and the total percentage of neonatal survival after 24 weeks of gestation was 98.2%. Out of 114 women, 33 desired a second pregnancy. Out of which 29 had a spontaneous pregnancy. The percentage of total neonatal survival rate after 14 weeks was 92.86% and the percentage of total neonatal survival after 24 weeks was 96.3%. Out of the 29 women with a second pregnancy, 5 women achieved a third pregnancy. The five births occurred after 37 weeks of gestation with a percentage of total neonatal survival of 100%.CONCLUSION:
The cervico isthmic cerclage using the technique of Fernandez makes it possible to obtain subsequent pregnancies without further surgery with very satisfactory results regarding neonatal survival.Palabras clave
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Incompetencia del Cuello del Útero
/
Cerclaje Cervical
/
Nacimiento Prematuro
/
Fertilidad
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Adult
/
Female
/
Humans
/
Newborn
/
Pregnancy
Idioma:
En
Revista:
Eur J Obstet Gynecol Reprod Biol
Año:
2017
Tipo del documento:
Article
País de afiliación:
Francia