scholarly journals Vaginal cervicoisthmic cerclage for cervical incompetence in pregnant women: Fernandez’s technique in 8 steps

2021 ◽  
Vol 5 (2) ◽  
pp. 032-033
Author(s):  
Jegaden Margaux ◽  
Debras Elodie ◽  
Pourcelot Anne-Gaëlle ◽  
Neveu Marie-Emmanuelle ◽  
Capmas Perrine ◽  
...  

Video objective: To demonstrate that surgical technique of vaginal cervicoisthmic cerclage must be performed in women with history of cervical incompetence with more than two late miscarriages before 24 weeks or premature deliveries before 28 weeks and after prior failure of preventive Mc Donald cerclage. In this video, the authors describe the complete procedure in 8 steps to standardize and facilitate the procedure in a simple and safe way during pregnancy. Design: Step-by-step video demonstration of the surgical technique. Setting: Tertiary Center for University Hospital.

2012 ◽  
Vol 8 (3) ◽  
pp. 321-324
Author(s):  
S R Tamrakur ◽  
C D Chawla

Background Cervical incompetence is one of the main contributors to repeated pregnancy loss, accounting for approximately 25% of the cases. Typically it results in progressive cervical dilatation, leading to a painless second- or early-third-trimester abortion. Objectives The main objective of the study was to explore the benefit from cervical cerclage in pregnant women with anatomical cervical incompetence Methods In a review of the operation and labour registers from January 2006 till January 2010, a total of 38 cervical cerclage procedures were performed at Dhulikhel Hospital (DH). In the study caste, parity, gestational age, diagnostic criteria, postoperative complications and pregnancy outcomes of the cases were analyzed. Results Two of the 38 cases didn’t come for delivery at Dhulikhel Hospital (Kathmandu University Teaching Hospital). Four women haven’t delivered at the time of data analysis. So pregnancy outcomes were analyzed among 32 cases while rests of the variables were analyzed among 38 cases. Of them 18 cases (47%) were Brahmin, 22 cases (58%) were between 20-25 years old and 32 cases (84%) were from Kavre district.  All cases were booked cases (they had antenatal care in the hospital) and 14 patients (37%) were third gravida. Most cases had 2 to 4 antenatal visits prior to suturing. Two cases were diagnosed with a bicornuate uterus. 21 cases (55%) had a previous history of at least one dilatation and evacuation.  33 cases (87%) were diagnosed with cervical incompetence clinically and confirmed by ultrasound. The remaining 13% were assessed, in the absence of a history of mid-trimester abortion, of having a high suspicion of cervical incompetence after mid-trimester scan with measurement of cervical length. In 18 cases (47%), cervical cerclage were done at 15 to 20 weeks of gestation. The postoperative period was uneventful in all 38 cases.  All cases (32) delivered in DH were assisted by consultant obstetricians. 19 out 32 cases (59%) were delivered vaginally at term. Conclusions38 cases were included in the study. Pregnancy outcomes were analyzed among 32 cases while rests of the variables were analyzed among 38 cases. 31 out 32 cases were delivered with good foetal weight. It clearly shows pregnant women with anatomical cervical incompetence were benefitted from cervical cerclage. The authors recommend an early trans vaginal scan in any patient with a history of mid trimester abortion or preterm labour. The cervical cerclage procedure therefore should be available more widely to benefit those patients with proven or strongly suspected cervical incompetence.DOI: http://dx.doi.org/10.3126/kumj.v8i3.6222 Kathmandu Univ Med J 2010;8(3):321-24 


2021 ◽  
Vol 15 (11) ◽  
pp. 3441-3443
Author(s):  
Uzma Parveen ◽  
Zahida Parveen Brohi ◽  
Aneela Sadaf

Objective: Frequency of backache and its treatment among pregnant women attending Isra University Hospital (IUH) OPD. Material and methods: This cross-sectional study was conducted at Out patient’s department of obstetrics\Gynaecology Isra hospital Hyderabad from February 2019 to Augusts 2019. A total of 80 pregnant women irrespective of their age, marital and literary status, visiting out-patient department of Isra University were included. All the females were assessed regarding backache and its treatment at gynaecological OPD. All the information was recorded via study proforma. Data was analyzed via SPSS version 20. Results: A total of 180 pregnant women were studied, and most of the women 40% were in age group of 31-40 years. Out of all, 22.2% women were primigravida, 40.6% were multigravidas and 36.7% women were grand multigravidas. The history of backache before pregnancy was among 20% of the females and 62.2% of women had developed backache during pregnancy, while 12.8% women had no complaint of backache. Out of 121 females who had backache during pregnancy, 28.30% had an onset of pain during 1st trimester, in 23.30% during 2nd trimester and in 48.30% during 3rd trimester of pregnancy. Out of all 32.20% women got relieved by taking rest, 63.90% women took analgesics as a treatment measure and 3.3% women took some other treatment options. Conclusion: It was observed that the more than 60% of all pregnant women experienced backache and mostly during 3rd trimester. Most of the females took treatment in the form of analgesics and some women got relieved by taking rest. Keywords: Pregnancy, backache, Management


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Azime Karakoc Kumsar ◽  
Feride Taskin Yilmaz ◽  
Gulbahtiyar Demirel

PurposeThe aim of this study is to determine the preferences to participate in diabetes screening program of women with gestational diabetes mellitus (GDM) in postpartum period.Design/methodology/approachThe data of retrospective and descriptive study were collected using “Individual Identification Form” and “Information Form for the Screening of Diabetes in the Postpartum Period” from 151 women in referred to obstetrics and gynecology clinic of a university hospital in Turkey.FindingsOnly 21.9% of women had diabetes screening in postpartum period and 21.2% of the participants were diagnosed with type 2 diabetes. It was determined that the participants mostly participated in screening because of the diabetes history in their family (30.3%). Women who had diabetes screening in postpartum period had lower level of education than those who did not and their level of knowledge about the screening in postpartum and the history of abortion were higher (p < 0.01).Originality/valueThe rate of participation in the screening for diabetes in the postpartum period is very low in pregnant women diagnosed with GDM. It was determined that the educational status, history of previous abortion and knowledge level of the women were factors that prevented participation in diabetes screening. This research is original because there are inadequacy of studies examining determining the participation status of pregnant women with GDM to diabetes screening in the literature. This study will contribute to health professionals in order to improve preventive factors and increase the participation of pregnant women with GDM in diabetes screening in the postpartum period.


Author(s):  
Bi-A Seo ◽  
Sung-Gon Kim ◽  
Sung-Young Huh ◽  
Dong-Hyeong Lee ◽  
Hyun-Sook An ◽  
...  

Abstract Background The purpose of this study is to investigate the drinking behavior of Korean pregnant women in 2017 and to compare the changes of drinking status with the results of the research conducted in 1997 and 2008. Methods Pregnant women at one obstetrics and gynecology hospital and one university hospital were the subjects of the study. They were filled out questionnaire. Results The rate of positive responses to CAGE increased 16.0% in 2008 and 16.3% in 2017 compared to 11.8% in 1997 (P = 0.046). Blackout history rate was keep increasing from 1997 to 2017 (8.8% versus 27.7% versus 36.3%, P &lt; 0.001). The rate of family history of alcohol was nearly doubled in 2017 (30.3%) compared to 1997 (17.6%) and 2008 (16.3) (P &lt; 0.001). The rate of pregnant women who drink alcohol during pregnancy decreased from 57.5% in 1997 to 39.5% in 2008 and decreased to 25.6% in 2017 (P &lt; 0.001). The rate of pregnant women who drink alcohol after knowing the pregnancy was decreased in 2017 (6.9%) compared to 2008 (23.5%) (P &lt; 0.001). Conclusion According to the results of the study in 2017, the rate of pregnant women who drink alcohol after pregnancy was decreased compared to 1997 and 2008. However drinking behavior severity has increased in 2017.


Author(s):  
Ola Ammoura ◽  
Jalid Sehouli ◽  
Christine Kurmeyer ◽  
Rolf Richter ◽  
Nadja Kutschke ◽  
...  

Abstract Introduction The aim of this study was to record the perinatal data of refugee women at Charité Hospital, Berlin, and to evaluate possible differences in pre-, peri- and postnatal outcomes compared with indigenous women. Material and Methods All pregnant women who gave birth in the period from 1 January 2014 to 30 September 2017 and were registered at least once in the hospital as “refugee” were included in the analysis. The data recorded from the refugee women were compared with the perinatal data of the German Federal obstetric analysis for the year 2016, which was published by the IQTIG (Institut für Qualitätssicherung und Transparenz im Gesundheitswesen [Institute for Quality Assurance and Transparency in Healthcare]). Results The analysis comprised 907 refugee women and 928 infants (21 twin pregnancies). Pregnant refugee women were significantly younger than the pregnant women from the Federal analysis (birth before the age of 30: 66 vs. 41%, p < 0.001, RR: 1.6, 95% CI: 62.9 – 69.2). They had a history both of more pregnancies (≥ 3 pregnancies: 29.4 vs. 13.4%, p < 0.001, RR: 2.2, 95% CI: 26.4 – 32.5) and of more miscarriages (> 2 miscarriages: 9.7 vs. 5.9%, p < 0.001, RR: 1.6, 95% CI: 7.9 – 11.8) and more often had a history of suffering from psychological stress (11.1 vs. 4.1%, p < 0.001, RR: 2.70, 95% CI: 9.2 – 13.4). There were more premature births (10.3 vs. 3.0%, p < 0.001, RR: 3.36, 95% CI: 8.4 – 12.4), post-term pregnancies (8.5 vs. 0.5%, p < 0.001, RR: 15.4, 95% CI: 6.7 – 10.5), and cases of postpartum anaemia (28.7 vs. 22.0%, p < 0.001, RR: 1.30, 95% CI: 25.7 – 31.7) and puerperal endometritis (1 vs. 0.2%, p = 0.006, RR: 4.3, 95% CI: 0.5 – 1.9) compared with the Federal analysis. The neonatal outcome showed an increased rate of hypotrophy (11 vs. 7%, p < 0.001, RR: 1.6, 95% CI: 9.1 – 13.2), more stillbirths (0.7 vs. 0.2%, p = 0.006, RR: 3, 95% CI: 0.2 – 1.4) and increased congenital malformations (2.8 vs. 0.4%, p < 0.001, RR: 3, 95% CI: 0.2 – 1.4). Conclusion Both refugee women and their infants showed significant differences. Despite the average younger age of the pregnant refugee women, the rates of premature birth and stillbirth and congenital malformations were significantly more frequent. More intensive antenatal screening with differentiated foetal organ diagnostics including psychosomatic care could contribute to early identification and prompt diagnosis. As regards the postpartum anaemia and puerperal endometritis, which occur more often in refugee women, midwife engagement and an improvement in the living situation in homes and accommodation facilities could be of great importance.


Author(s):  
Heather A. Rosett ◽  
Madison K. Krischak ◽  
Sarika Sachdeva ◽  
Kristin E. Weaver ◽  
Robert Phillips Heine ◽  
...  

Objective Outside of pregnancy, urinary pathogens such as Proteus and Klebsiella are considered more pathogenic than E. coli. During pregnancy, the implications of lower urinary tract infection (LUTI) with more pathogenic bacteria are unclear. Thus, we sought to compare the risk of progression from LUTI to pyelonephritis among women infected with these more pathogenic urinary bacteria to those infected with E. coli. Study Design Retrospective cohort of pregnant women with LUTI at single tertiary center from July 2013 to May 2019. Pathogenic infections (PI) were defined as asymptomatic bacteriuria or acute cystitis urinary cultures positive for Proteus, Klebsiella, Enterobacter, Citrobacter, Acinetobacter, Staphylococcus, or Raoultella species. Demographic, infectious, antepartum, and postpartum data abstracted. Pregnant women with PI compared with those with E. coli. Primary outcome was progression to pyelonephritis. Secondary outcomes included pyelonephritis length of stay (LOS) >6 days, preterm birth (PTB), low birthweight (LBW), and measures of pyelonephritis-related morbidity. Results Of 686 pregnant women with LUTIs, 313 had urine culture growing out either PI or E. coli, with 59 (12%) growing PI and 254 (54%) growing E. coli. Women with PI were more likely to be African American, have chronic hypertension, and have history of preeclampsia. The primary species causing PI were Klebsiella (n = 29) and Proteus (n = 11). PI were not more likely to progress to pyelonephritis than E. coli LUTIs (10.9 vs. 14.5%; p = 0.67). Median LOS for pyelonephritis and other measures of pyelonephritis-related morbidity did not differ nor did PTB or LBW rates. After controlling for race, body mass index, history of preeclampsia, and history of pyelonephritis, PI were not associated with increased odds of progression to pyelonephritis (adjusted odds ratio: 0.69, 95% confidence interval: 0.27–1.80). Conclusion Bacteria traditionally considered to be more pathogenic outside of pregnancy do not progress to pyelonephritis at higher rates than E. coli in pregnancy, and are associated with similar pyelonephritis-related morbidity. Larger studies are needed to confirm these findings. Key Points


2021 ◽  
Vol 4 (2) ◽  
pp. 055-059
Author(s):  
Sayed Sayed Mohamed ◽  
Khalifa Ahmed Khedr ◽  
Abd Allah Shehata Nesreen Abd El Fattah ◽  
AM Eweis Mohamed ◽  
M Shawky Sherwet

Objective: To observe the predominance of fetal anomalies in pregnant women in a multi-centric setting. Methods: This prospective observational study included 20225 pregnant women who came for antenatal care in University Hospital and fetal medicine units from 2016 to 2019. Fetal anatomical scanning was done for all participants. Results: One hundred eighty-three cases had fetal congenital anomalies, yielding a prevalence of around 0.9%. Third of cases had positive consanguinity, this increased in cases of skeletal and thoracic anomalies. The presence of past history of anomalies was evident in 8.2% mostly with skeletal and heart anomalies. History of drug intake was only verified in 1.6% of cases. Sixty-three women out of 183 (34.4%) were diagnosed to have anomalies in fetal nervous system. Conclusion: Prenatal diagnosis are recommended for early detection of congenital anomalies and counselling.


2020 ◽  
Vol 99 (11) ◽  

The authors present an outline of the development of thyroid surgery from the ancient times to the beginning of the 20th century, when the definitive surgical technique have been developed and the physiologic and pathopfysiologic consequences of thyroid resections have been described. The key representatives, as well as the contribution of the most influential czech surgeons are mentioned.


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