scholarly journals Emergency cervical cerclage and pregnancy outcomes

2017 ◽  
Vol 6 (5) ◽  
pp. 1993
Author(s):  
N. Nagendra Prasad ◽  
Sherin Annamma Thampan ◽  
R. Nagarathnamma
Keyword(s):  
Retrospective Study ◽  
Spontaneous Abortion ◽  
Pregnancy Outcomes ◽  
Cervical Dilatation ◽  
Second Trimester ◽  
Cervical Cerclage ◽  
Live Births ◽  
Term Delivery

Background: To evaluate the effectiveness and safety of emergency cervical cerclage in women who presented with advanced cervical changes such as cervical dilatation and bulging foetal membranes.Methods: This is a retrospective study on all women treated with cervical cerclage presented in the late second trimester with advanced cervical dilatation (2 to 4cms) for whom emergency cervical cerclage by McDonald technique.Results: Out of the 24 patients for whom emergency cervical cerclage was performed, three patients had spontaneous abortion after cervical cerclage, two had PROM and eight of these patients had term delivery. Twenty-one fetus were live born after the period of viability. Nine of these babies were admitted to NICU and 50 percent of the neonates required only regular perinatal care.Conclusions: Post emergency cervical cerclage, the outcome in terms of prolongation of pregnancy, live births and neonatal survival is better.

scholarly journals Pregnancy outcomes from the global pharmacovigilance database on interferon beta-1b exposure

2020 ◽  
Vol 13 ◽  
pp. 175628642091031 ◽  
Author(s):  
Kerstin Hellwig ◽  
Fernando Duarte Caron ◽  
Eva-Maria Wicklein ◽  
Aasia Bhatti ◽  
Alessandra Adamo
Keyword(s):  
Cohort Study ◽  
Health Status ◽  
Spontaneous Abortion ◽  
Birth Defects ◽  
Pregnancy Outcomes ◽  
Congenital Anomalies ◽  
Interferon Beta ◽  
Live Births ◽  
Congenital Birth Defects ◽  
Pharmacovigilance Database

Background: The goal of the present cohort study was to review outcomes of patients exposed to interferon beta-1b during pregnancy. Methods: Pregnancy cases with exposure to interferon beta-1b reported to Bayer’s pharmacovigilance (PV) database from worldwide sources from January 1995 through February 2018 were retrieved for evaluation. Only cases where pregnancy outcomes were unknown at the time of reporting (i.e. prospective cases) were included in the analysis of this retrospective cohort study. Results: As of February 2018, 2581 prospective pregnancies exposed to interferon beta-1b were retrieved from the database; 1348 pregnancies had documented outcomes. The majority of outcomes [1106 cases (82.0%)] were live births. Health status was known for 981 live births (no known health status for 125). Most of the prospective pregnancies with known outcomes corresponded to live births with no congenital anomalies [896 cases (91.3%)]. Spontaneous abortion occurred in 160 cases (11.9%). Congenital birth defects were observed in 14/981 live births with known health status [1.4%, 95% confidence interval (CI) 0.78–2.38]. No consistent pattern in the type of birth defect was identified. Rates of both spontaneous abortion and birth defects were not higher than the general population. Conclusions: These PV data, the largest sample of interferon beta-1b-exposed patients reported to date, suggest no increase in risk of spontaneous abortion or congenital anomalies in women exposed during pregnancy.

scholarly journals Efficacy of an Emergency Cervical Cerclage Using Absorbable Monofilament Sutures

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Yuka Sato ◽  
Nobuhiro Hidaka ◽  
Takahiro Nakano ◽  
Saki Kido ◽  
Masahiro Hachisuga ◽  
...  
Keyword(s):  
Preterm Delivery ◽  
Spontaneous Abortion ◽  
Gestational Age ◽  
Perinatal Outcomes ◽  
Cervical Length ◽  
Cervical Cerclage ◽  
Extremely Preterm ◽  
Term Delivery ◽  
Gestational Age At Delivery ◽  
Full Term Delivery

Introduction. Although nonabsorbable woven tape has been widely used for cervical cerclage, technical difficulties that can occur with an effaced cervix because of the thickness of the tape, and the risks of local infection are two major concerns. This study investigated perinatal outcomes of pregnancies involving an emergency cervical cerclage using absorbable monofilament polydioxanone sutures, which is a narrow thread and protects against bacterial infection. Materials and Methods. We performed a chart review of patients who underwent emergency McDonald cerclage with polydioxanone sutures at our institution between 2007 and 2015. Gestational age at delivery, duration between cerclage and delivery, and neonatal prognosis were evaluated as primary outcomes. Results. Among the 23 patients (18 singleton and five twin pregnancies) evaluated, ultrasound-indicated (progressive cervical length shortening) were eight (35%) and physical examination-indicated (fetal membranes that prolapsed into the vagina or dilated cervix) were 15 patients (65%). The median gestational age at cerclage was 22+3 weeks (range, 17+5 to 25+3 weeks). Postoperative spontaneous abortion occurred in only one patient. The median gestational age at delivery was 32+5 weeks (range, 20+5 to 40+6 weeks). Extremely preterm delivery before 28 weeks of gestation occurred in four (17%) cases. Full-term delivery was achieved in 10 (42%) cases. The duration between cerclage and delivery ranged from 5 to 136 days (median, 77 days). Except for one case of spontaneous abortion, all newborns survived till hospital discharge. Conclusions. Although our series included some patients at high risk for spontaneous abortion and preterm delivery, satisfactory prolongation and favorable neonatal outcomes were achieved for most patients by using absorbable monofilament sutures, thus suggesting the efficacy of this type of suture for emergency cervical cerclage.

scholarly journals Outcome of Late Second Trimester Emergency Cerclage in Patients with Advanced Cervical Dilatation with Bulging Amniotic Membranes: A Report of Six Cases Managed at the Douala General Hospital, Cameroon

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Thomas Obinchemti Egbe ◽  
Theophile Nana Njamen ◽  
Gregory Halle Ekane ◽  
Jacques Kamgaing Tsingaing ◽  
Charlotte Nguefack Tchente ◽  
...  
Keyword(s):  
General Hospital ◽  
Neonatal Intensive Care ◽  
Neonatal Infection ◽  
Cervical Dilatation ◽  
Fetal Membranes ◽  
Second Trimester ◽  
Success Rates ◽  
Cervical Cerclage ◽  
Case Files ◽  
Amniotic Membranes

Purpose. To show the feasibility of emergency late second trimester cerclage with advanced cervical dilatation and bulging of amniotic membranes. Setting. Department of Obstetrics and Gynecology of the Douala General Hospital. Method. This is a retrospective study of case files of patients who underwent emergency late second trimester cerclage with advanced cervical dilatation, some with bulging of fetal membranes between June 2003 and June 2010. The modified Shirodkar technique was employed in all the cases. Results. Altogether, six patients (100%) underwent late second trimester cervical cerclage between 24 and 26 weeks of gestational age. Four cases (66.7%) carried on their pregnancies to term that resulted in healthy live-born babies all delivered vaginally. The other two cases (33.3%) presented with preterm premature rupture of fetal membranes (PPROM) which led us to undo the stitch with eventual delivery of live-born premature fetuses which died in the neonatal intensive care unit because of complications of prematurity and neonatal infection. Conclusion. In experienced hands and in the absence of other risk factors like infection, the success rates of this procedure are encouraging with improved prognosis. Finally, the modified Shirodkar technique yielded excellent results in our series.

scholarly journals Successful Cerclage at Advanced Cervical Dilatation in the Second Trimester

2013 ◽  
Vol 4 (2) ◽  
pp. 56-58
Author(s):  
Purnima Deb ◽  
Nighat Aftab ◽  
Tasneem Rangwala
Keyword(s):  
Decision Making ◽  
Blood Cell ◽  
Retrospective Review ◽  
Perinatal Outcome ◽  
Cervical Dilatation ◽  
Outcome Analysis ◽  
Tertiary Level ◽  
Second Trimester ◽  
Blood Cell Count ◽  
Cervical Cerclage

ABSTRACT The aim of our study is to verify whether some maternal features are related to pregnancy outcome of emergency cerclage when membranes are protruding through the dilated cervix. We present a retrospective review of 20 cases of emergency cervical cerclage performed over a 3 years period at Al Wasl hospital, a tertiary level centers in Dubai. Analysis shows presence of membrane prolapse with infection causing rupture of membranes, to be the strongest predictor of poor outcome. Analysis also reveals a significant association between initial white blood cell count and perinatal outcome. This information is helpful in decision making and counseling patients regarding the likely outcome. How to cite this article Deb P, Aftab N, Rangwala T. Successful Cerclage at Advanced Cervical Dilatation in the Second Trimester. Int J Infertility Fetal Med 2013;4(2):56-58.

scholarly journals 886. Pregnancy Outcomes Following Raltegravir Exposure

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S20-S21
Author(s):  
Hala Shamsuddin ◽  
Casey Raudenbush ◽  
Brittany Sciba ◽  
Erica N Gooch ◽  
Wayne Greaves ◽  
...  
Keyword(s):  
Spontaneous Abortion ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Pregnancy Outcomes ◽  
Congenital Anomalies ◽  
Reproductive Potential ◽  
First Trimester ◽  
Hiv Treatment ◽  
Safety Database ◽  
Live Births

Abstract Background Safety data are needed regarding HIV treatment in women of reproductive potential and during pregnancy. This review is to evaluate pregnancy outcomes following prospective exposures (exposure report prior to knowledge of pregnancy outcome) to raltegravir during pregnancy. Methods Exposures to raltegravir during pregnancy reported cumulatively through March 26, 2019 to the internal safety database at Merck & Co., Inc. were reviewed. This database includes all reports of pregnancy from clinical trials sponsored by the company, spontaneous post-marketing reports, and noninterventional data sources. Prospective pregnancy reports were evaluated to determine rates of spontaneous abortion, stillbirth, and congenital anomalies, including neural tube defects. Data from two ongoing cohorts of pregnant women with HIV-1 infection, not included in the internal safety database, were also reviewed. Results A total of 2,508 prospective pregnancy reports with reported outcomes were identified among women exposed to raltegravir: 919 from the internal safety database (Table 1) and 1,589 from the UK/Ireland and French pregnancy cohorts. Among the 2,508 prospective pregnancy exposures, 945 were in the first trimester, of which 757 were within the periconception period (within 28 days of conception). Of the 471 documented first trimester exposures identified in the internal safety database, the rates of spontaneous abortion (6.9%), stillbirth (1%), and congenital anomalies (1.5% per live births) were similar to the rates observed in the background populations of the United States Among outcomes following any exposure, the rate of congenital anomalies was 3.4% per live births. There were no reports of neural tube defects identified within the internal safety database or among the cohort data. Conclusion Prospectively collected pregnancy outcome data do not suggest an association between raltegravir exposure and spontaneous abortion, stillbirth, or congenital anomalies, including neural tube defects. These data support the current HIV treatment recommendations for the use of raltegravir 400 mg twice daily in women of reproductive potential and during pregnancy. Disclosures All Authors: No reported Disclosures.

scholarly journals Pregnancy outcomes in Chinese women with ulcerative colitis: A retrospective study of 23 pregnancies

2019 ◽  
Author(s):  
Sijian Li ◽  
Jinsong Gao ◽  
Jing Hu ◽  
Xiaoxu Chen ◽  
Juntao Liu ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Retrospective Study ◽  
Pregnancy Outcomes ◽  
Chinese Women ◽  
Adverse Pregnancy Outcomes ◽  
Active Group ◽  
Second Trimester ◽  
Significant Difference ◽  
Adverse Pregnancy ◽  
The Relationship

Abstract Background: Although China has a large population and increasing incidence of ulcerative colitis (UC), data on pregnancy outcomes in women with UC are insufficient and the relationship between simple clinical colitis activity index (SCCAI) and pregnancy outcomes has rarely been studied. This retrospective study aimed to assess the relationship between SCCAI and pregnancy outcomes of Chinese women with UC and explore factors affecting pregnancy outcomes. Methods: Overall, 23 pregnancies of 18 patients with UC were included. The following factors were analyzed: SCCAI before and during pregnancy; basic conditions, comorbidities, and treatment before and during pregnancy; frequency and details of pregnancy-related complications; and mode of delivery. Clinical characteristics, disease condition, and treatment details were compared between patients with and without adverse pregnancy outcomes. Results: The SCCAI was significantly lower in the remission group than in the active group (P < 0.001), except in the second trimester, but no significant difference in recurrence/exacerbation rate was found. There were 18 live births (remission group, 15; active group 3; P > 0.05). No significant difference in the frequency and characteristics of pregnancy-related complications was noted between the two groups. Outcomes of 15 pregnancies were satisfactory, but the other eight cases had adverse pregnancy outcomes. Patients with adverse pregnancy outcomes had higher SCCAI in the second trimester than the patients without adverse outcomes (P = 0.034). Multivariate analysis showed no statistically significant risk factor for adverse pregnancy outcomes. Conclusion: Chinese women with UC can usually achieve favorable pregnancy outcomes under multidisciplinary management, and a higher SCCAI in the second trimester has a positive correlation with adverse pregnancy outcomes.

Association between Thiopurines Use and Pregnancy Outcomes in Female Patients with Inflammatory Bowel Disease: A Meta-analysis

2020 ◽  
Vol 26 ◽  
Author(s):  
Yang Zhang ◽  
Dandan Li ◽  
Heng Guo ◽  
Weina Wang ◽  
Xingang Li ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Preterm Birth ◽  
Spontaneous Abortion ◽  
Bowel Disease ◽  
Pregnancy Outcomes ◽  
Congenital Malformations ◽  
Meta Analysis ◽  
Adverse Pregnancy Outcomes ◽  
Inflammatory Bowel ◽  
Adverse Pregnancy

Background: Conflicting data exist regarding the influence of thiopurines exposure on adverse pregnancy outcomes in female patients with inflammatory bowel disease (IBD). Objective: The aim of this study was to provide an up-to-date and comprehensive assessment of the safety of thiopurines in pregnant IBD women. Methods: All relevant articles reporting pregnancy outcomes in women with IBD received thiopurines during pregnancy were identified from the databases (PubMed, Embase, Cochrane Library, and ClinicalTrials.gov) with the publication data up to April 2020. Data of included studies were extracted to calculate the relative risk (RR) of multiple pregnancy outcomes: congenital malformations, low birth weight (LBW), preterm birth, small for gestational age (SGA), and spontaneous abortion. The meta-analysis was performed using the random-effects model. Results: Eight studies matched with the inclusion criteria and a total of 1201 pregnant IBD women who used thiopurines and 4189 controls comprised of women with IBD received drugs other than thiopurines during pregnancy were included. Statistical analysis results demonstrated that the risk of preterm birth was significantly increased in the thiopurine-exposed group when compared to IBD controls (RR, 1.34; 95% CI, 1.00-1.79; p=0.049; I 2 =41%), while no statistically significant difference was observed in the incidence of other adverse pregnancy outcomes. Conclusion: Thiopurines’ use in women with IBD during pregnancy is not associated with congenital malformations, LBW, SGA, or spontaneous abortion, but appears to have an association with an increased risk of preterm birth.

Comparison of pregnancy outcomes after second trimester amniocentesis between procedures performed by experts and non-experts

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Tanapak Wisetmongkolchai ◽  
Fuanglada Tongprasert ◽  
Kasemsri Srisupundit ◽  
Suchaya Luewan ◽  
Kuntharee Traisrisilp ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Loss Rate ◽  
Fetal Loss ◽  
Adverse Pregnancy Outcomes ◽  
Expert Group ◽  
Second Trimester ◽  
Single Institution ◽  
Adverse Pregnancy ◽  
In Pregnancy ◽  
Singleton Pregnancies

AbstractObjectivesTo compare the rate of fetal loss in pregnancy after second trimester amniocentesis between procedures performed by experts and non-experts and to assess other pregnancy complications as secondary outcomes.MethodsA retrospective cohort study was performed on singleton pregnancies that underwent mid-trimester amniocenteses in a single institution. The fetal loss rates of procedures performed by experts and non-experts were collected and analyzed. Other adverse pregnancy outcomes were also examined.ResultsIn total, 14,450 amniocenteses were performed during the study period. These included 11,357 (78.6%) procedures in the group expert operators and 3,093 (21.4%) procedures in the group non-expert operators. In the non-expert group, the fetal loss rate was slightly increased but not significantly (p=0.24).In addition, the higher number of spontaneous abortions was associated with blood-stained amniotic fluid sample (p<0.001; RR=9.28). Multiple needle insertions also increased in the non-expert group significantly. However, no difference in pregnancy outcomes was found between in single and multiple needle insertions.ConclusionsThe amniocentesis procedures performed by the non-experts was not increase the fetal loss rate. However, the other adverse pregnancy outcomes, including preterm birth, low birth weight and fetal growth restriction were significantly increased in the non-expert group.

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