scholarly journals Ambispective study on Mac Donald suturing in pregnant ladies with cervical incompetence in Dhulikhel Hospital

2012 ◽  
Vol 8 (3) ◽  
pp. 321-324
Author(s):  
S R Tamrakur ◽  
C D Chawla
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Previous History ◽  
Cervical Length ◽  
University Teaching ◽  
Third Trimester ◽  
Cervical Cerclage ◽  
Trimester Abortion ◽  
Cervical Incompetence ◽  
History Of

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 

scholarly journals Cervical Consistency Index: A New Concept in Uterine Cervix Evaluation

2011 ◽  
Vol 5 (4) ◽  
pp. 411-415 ◽  
Author(s):  
Miguel A Parra-Saavedra ◽  
Libardo A Gómez ◽  
Amanda Barrero ◽  
Guido Parra ◽  
Felipe Vergara ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Reference Population ◽  
Consistency Index ◽  
Transvaginal Ultrasonography ◽  
Third Trimester ◽  
Cervical Cerclage ◽  
Significant Difference ◽  
Patients At Risk ◽  
History Of ◽  
Cervical Conization

ABSTRACT Objective To search an ultrasonographic marker to measure cervix consistency throughout pregnancy quantitatively by transvaginal ultrasonography and compare these values with the current pattern–the cervicometry. In a randomly selected population of pregnant and nonpregnant women using a new cervical consistency index (CCI) and compare these changes with the findings using cervicometry. Methods The cervical consistency index (CCI) and cervicometry were measured using transvaginal ultrasonography in a reference population of randomly selected women who were mature enough for reproduction, and women in their first, second and third trimester of pregnancy. Patients with history of cervical conization, two or more dilations and miscarriages, Müllerian abnormalities and history of cervix incompetence were excluded from this study. Furthermore, patients with multiple pregnancies and cervical cerclage were not allowed to participate in this study. Results A total of 162 patients were evaluated for cervicometry and CCI. Eighty of these women were not pregnant and the remaining 82 were pregnant. The database was analyzed using EPI-INFO version 6.0. Statistical values, such as the average, median and standard deviation between two groups, were analyzed. Statistically significant differences were found between nonpregnant and pregnant women in the first, second and third trimester regarding CCI with p < 0.0001. The cervix of pregnant women loses an average of 1.2% of consistency per week of pregnancy. Cervicometry did not show statistically significant difference among the groups (p = 0.4459). Conclusion CCI can quantitatively assess cervix consistency in pregnant and nonpregnant women, also found statistically significant differences between these groups and between the different trimesters of gestation, CCI also shows a remarkably circumscribed linear regression trend from early pregnancy. This ultrasound marker may serve in future for the early identification of patients at risk for preterm delivery. On cervicometry, there was no statistically significant differences between groups mentioned above.

scholarly journals The therapeutic effect of cervical cerclage in pregnancy with cervical incompetence

2018 ◽  
Vol 91 (2) ◽  
pp. 107-112
Author(s):  
Lészai Lehel ◽  
Túrós János Levente ◽  
Kiss Szilárd-Leó ◽  
Bereczky Lujza-Katalin ◽  
Nagy Katalin ◽  
...  
Keyword(s):  
Premature Birth ◽  
Premature Delivery ◽  
Second Trimester ◽  
Closure System ◽  
Cervical Cerclage ◽  
Trimester Abortion ◽  
Cervical Incompetence ◽  
History Of ◽  
Second Trimester Abortion ◽  
Late Miscarriage

Abstract The shortening of the cervix, cervical incompetence or insufficiency that causes late miscarriage or preterm birth syndrome gives importance and clinical significance for the cervical cerclage or cervical stitch as treatment. Nowadays closure of the cervix with cerclage surgery is an effective way of preventing premature opening of the cervix, helping the pregnancy near due date, thus significantly reducing the risk of miscarriage and premature delivery. The retrospective longitudinal cohort study is based on an examination of 164 pregnant woman who underwent cervical cerclage surgery at Obstetrics and Gynecology Clinic nr. I Târgu-Mureș, between 2000-2017. The McDonald’s method was used in every case that we have studied. Cerclage surgery was performed in most cases in the second trimester. The results in the study reflect that in the majority of the cases, intervention is effective in preventing premature opening of the cervix. Most women are multipara and had multiple gestational pregnancy, which can also contribute to the weakening and early opening of the cervical closure system. In 66.5% of the cases, at least one abortion or miscarriage is present in the history of the disease, which may also lead to a weakening of the cervical closing function. Following cerclage surgery, 11.6% abortion and 88.4% in childbirth occurred, and in most cases, intervention can effectively prevent second trimester abortion while reducing the risk of premature birth (65, 8% had no premature birth in our study).

scholarly journals Pre-Cerclage Cervical Length—A Reliable Predictor of Long-Term Pregnancy Sustenance After Therapeutic Cervical Cerclage: A Retrospective Study

2021 ◽  
Author(s):  
Emi Kondo ◽  
Eiji Shibata ◽  
Toshihide Sakuragi ◽  
Yukiyo Aiko ◽  
Takeshi Kawakami ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Inflammatory Marker ◽  
Cervical Length ◽  
Multiple Gestation ◽  
Cervical Insufficiency ◽  
Term Pregnancy ◽  
Cervical Cerclage ◽  
Term Birth

Abstract Background: The indication of therapeutic cerclage is still controversial. The purpose of this study was to assess pregnancy outcomes after cervical cerclage in women with shortened cervical length (CL) during pregnancy and/or with a medical history of cervical insufficiency. Methods: We included pregnant women who underwent cerclage in four perinatal medical centers between January 2009 and December 2010. We compared the outcomes of cerclage in terms of non-term and term births, as well as successful and unsuccessful cerclages. Cervical cerclage was defined as successful if pregnancy was continued for more than 13 weeks post-cerclage. Therapeutic and prophylactic cerclages were performed in pregnant women with pre-cerclage CL < 25 mm and ≥ 25 mm, respectively.Results: We screened 114 pregnant women, of whom 91 were included; 15 and 8 women were excluded for unknown pregnancy outcomes and multiple gestation, respectively. The rate of therapeutic cerclage was significantly higher in the non-term birth (68% vs. 38%, p <0.01; non-term group vs. term birth group), unsuccessful cerclage (79% vs. 43%, p =0.01; unsuccessful cerclage vs. successful cerclage) groups. Inflammatory marker levels (white blood cell count and C-reactive protein) were normal in both group sets, albeit no significantly different between-group differences. Receiver-operating characteristic curve analysis revealed that 87% of patients with pre-cerclage CL ≥ 17 mm sustained their pregnancies for more than 13 weeks post-cerclage. However, 64% of patients with pre-cerclage CL < 17 mm did not sustain their pregnancies for more than 13 weeks post-cerclage.Conclusions: Therapeutic cerclage should be performed in patients with cervical insufficiency having CL ≥ 17 mm, for long-term pregnancy sustenance.

scholarly journals Effect of Gestational Diabetes Mellitus History on Future Pregnancy Behaviors: The Mutaba’ah Study

2020 ◽  
Vol 18 (1) ◽  
pp. 58
Author(s):  
Nasloon Ali ◽  
Aysha S. Aldhaheri ◽  
Hessa H. Alneyadi ◽  
Maha H. Alazeezi ◽  
Sara S. Al Dhaheri ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Previous History ◽  
Previous Pregnancy ◽  
Prenatal Health ◽  
Supplement Use ◽  
History Of ◽  
Future Pregnancy

Gestational diabetes mellitus (GDM) increases the risk of adverse pregnancy outcomes in any pregnancy and recurrence rates are high in future pregnancies. This study aims to investigate the effect of self-reported history of previous GDM on behaviors in a future pregnancy. This is an interim cross-sectional analysis of the pregnant women who participated in the Mutaba’ah Study between May 2017 and March 2020 in the United Arab Emirates. Participants completed a baseline self-administered questionnaire on sociodemographic and pregnancy-related information about the current pregnancy and previous pregnancies. Regression models assessed the relationships between self-reported history of GDM and pre-pregnancy and pregnancy behaviors in the current pregnancy. Out of 5738 pregnant parous women included in this analysis, nearly 30% (n = 1684) reported a history of GDM in a previous pregnancy. Women with a history of previous GDM were less likely to plan their current pregnancies (adjusted odds ratio (aOR): 0.84, 95% confidence interval (CI) 0.74–0.96) and more likely to be worried about childbirth (aOR: 1.18, 95% CI 1.03–1.36). They had shorter interpregnancy intervals between their previous child and current pregnancy (aOR: 0.88, 95% CI 0.82–0.94, per SD increase). There were no significant differences between women with and without a history of GDM in supplement use, sedentary behavior, or physical activity before and during this current pregnancy. Nearly a third of parous pregnant women in this population had a history of GDM in a previous pregnancy. Pregnant women with a previous history of GDM were similar to their counterparts with no history of GDM in the adopted pre-pregnancy and prenatal health behaviors. More intensive and long-term lifestyle counseling, possibly supported by e-health and social media materials, might be required to empower pregnant women with a history of GDM. This may assist in adopting and maintaining healthy prenatal behaviors early during the pregnancy or the preconception phase to minimize the risk of GDM recurrence and the consequential adverse maternal and infant health outcomes.

“PREGNANCY OUTCOME IN CERVICAL INCOMPETENCE: COMPARISON OF COMBINED USE OF CERCLAGE AND ORAL PROGESTERONE VERSES HIGH DOSE OF VAGINAL PROGESTERONE”

2021 ◽  
pp. 150-153
Author(s):  
Preeti Gupta ◽  
Uma Jain ◽  
Jayshree Chimrani
Keyword(s):  
Mode Of Delivery ◽  
Neonatal Morbidity ◽  
Maternity Hospital ◽  
Cervical Length ◽  
High Dose ◽  
Spontaneous Preterm Birth ◽  
Cervical Cerclage ◽  
Cervical Incompetence ◽  
Vaginal Progesterone ◽  
Progesterone Supplementation

INTRODUCTION- Cervical insufciency, earlier known as cervical incompetence, is the inability of the cervix to maintain pregnancy till term due to structural or functional defects. Approximately 16.25% of second-trimester pregnancy losses and 2% of premature deliveries are due to cervical incompetence. OBJECTIVE- The purpose of this study was to compare the outcome of pregnancy in patients who underwent early (12-16 weeks) cervical cerclage along with oral progesterone supplementation versus those having remedied with high dose intravaginal progesterone supplementation. MATERIAL AND METHODst This retrospective study was conducted in a maternity hospital in Gwalior from 1 January 2018 to th 30 June 2021. Comprehensive history, thorough clinical examination, laboratory investigations, ultrasonography measurement of cervical length, mode of delivery, gestational age at the time of delivery, neonatal outcome, NICU admission, and other parameters were collected from the medical les. patients were divided into two groups. Ÿ Group 1(N-49) – Those who were remedied with high-dose vaginal progesterone supplementation continued uptil 34 wks of gestation. Group 2 (N-49) – Those who underwent Mc Donald type of cervical encerclage at 12-16 weeks along with oral progesterone (10 mg Duphaston twice daily dose) supplementation continued up till 34 weeks of gestation. RESULT- In our study, in the cervical cerclage group, only (4.1%) patients were delivered before 34 weeks while in the vaginal progesterone group (18.4%) patients were delivered before 34 weeks. In the cervical cerclage group (53.1%) patients were delivered between 34-37 weeks while in the vaginal progesterone group, (44.9%) of the patient delivered between 34-37 weeks. In the cervical cerclage group, the cesarean section rate was lower than only the vaginal progesterone group and admission to NICU of babies was also less (22.4%) in this group in comparison to the vaginal progesterone only group (36.7%). CONCLUSION- Our study showed that cervical cerclage plus oral progesterone supplementation in women with extremely shortened cervix signicantly decreased overall spontaneous preterm birth rates, prolonged pregnancy latency, and decreased the overall neonatal morbidity and mortality and is more effective than the vaginal progesterone group.

scholarly journals Utilization of preconception care and associated factors in Hosanna Town, Southern Ethiopia

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0261895
Author(s):  
Meron Admasu Wegene ◽  
Negeso Gebeyehu Gejo ◽  
Daniel Yohannes Bedecha ◽  
Amene Abebe Kerbo ◽  
Shemsu Nuriye Hagisso ◽  
...  
Keyword(s):  
Child Health ◽  
Pregnant Women ◽  
Birth Outcomes ◽  
Preconception Care ◽  
Previous History ◽  
Care Utilization ◽  
Adverse Birth Outcomes ◽  
Care Services ◽  
History Of ◽  
And Child Health

Introduction There is substantial body of evidence that portrays gap in the existing maternal and child health continuum of care; one is less attention given to adolescent girls and young women until they get pregnant. Besides, antenatal care is too late to reduce the harmful effects that a woman’s may have on the fetus during the critical period of organogenesis. Fortunately, preconception care can fill these gaps, enhance well-being of women and couples and improve subsequent pregnancy and child health outcomes. Therefore, the main aim of the current study was to assess preconception care utilization and associated factors among pregnant women attending antenatal care clinics of public health facilities in Hosanna town. Methods A facility based cross-sectional study design was carried out from July 30, 2020 to August 30, 2020. Data were collected through face-to-face interview among 400 eligible pregnant women through systematic sampling technique. Epi-data version 3.1 and SPSS version 24 was used for data entry and analysis respectively. Both bivariable and multivariable logistic regression analysis was conducted to identify association between dependent and independent variables. Crude and adjusted odds ratio with respective 95% confidence intervals was computed and statistical significance was declared at p-value <0.05. Result This study revealed that 76 (19%, 95% Cl (15.3, 23.2) study participants had utilized preconception care. History of family planning use before the current pregnancy (AOR = 2.45; 95% Cl (1.270, 4.741), previous history of adverse birth outcomes (AOR = 3.15; 95% Cl (1.650, 6.005), poor knowledge on preconception care (AOR = 0.18; 95% Cl (0.084, 0.379) and receiving counseling on preconception care previously (AOR = 2.82; 95% Cl (1.221, 6.493) were significantly associated with preconception care utilization. Conclusions The present study revealed that nearly one-fifth of pregnant women have utilized preconception care services. History of family planning use before the current pregnancy, previous history of adverse birth outcomes, poor knowledge on preconception care and receiving counseling on preconception care previously were significantly associated with preconception care utilization. Integrating preconception care services with other maternal neonatal child health, improving women’s/couples knowledge & strengthening counseling services is pivotal.

Prevalence of some hepatitis B virus markers among pregnant women attending antenatal clinic in Specialist Hospital Sokoto Nigeria

2020 ◽  
Vol 28 (3) ◽  
pp. 233-243
Author(s):  
O. Erhabor ◽  
S.Y. Mohammad ◽  
L. Bello ◽  
F.U. Onuigwe ◽  
Y. Abdulrahman ◽  
...  
Keyword(s):  
Public Health ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Pregnant Women ◽  
Previous History ◽  
Public Health Problem ◽  
Antenatal Clinic ◽  
B Virus ◽  
History Of ◽  
Hepatitis B Virus Markers

BACKGROUND: Hepatitis B virus infection is a global public health problem. The virus has infected more than one-third of the global population. It has been estimated that 360 million chronic carriers are living around the world with a high risk for developing cirrhosis, hepatic carcinoma and hepatic failure. OBJECTIVE: The aim of this study was to determine the prevalence of some hepatitis B markers among pregnant women attending antenatal clinic in Sokoto Specialist Hospital, Nigeria. METHODS: The hepatitis testing was carried out using the Skytec-Rapid Diagnostic HBV-5 rapid kit (Skytec-Rapid Diagnostic, USA). The kit is based on lateral flow chromatographic immunoassay for the qualitative detection of HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb in human serum or plasma. Panel format can conveniently test for five targets at once and utilizes all markers to help distinguish between acute and chronic infections. RESULTS: Out of 117 pregnant women tested, 15 were positive for HBsAg (12.8%), 6 positive for HBsAb (5.1%), 1 for HBeAg (0.9%), 14 tested positive for HBeAb (12.0%), and 14 tested for HBcAb (12.0%). The prevalence of HBsAg, HBsAb, HBeAg, HBcAb and HBcAb was compared based on ethnicity. HBsAb was significantly higher among the Hausa ethnic group (p= 0.001). The prevalence of HBsAb, HBeAg, HBcAb and HBcAb was not affected by ethnicity (p> 0.05). The prevalence of HBsAg, HBsAb, HBeAg, HBcAb and HBcAb was compared based on age. Infection by the hepatitis B virus markers was higher among young adult and middle age groups. The difference was however not statistically significant (p> 0.05). The prevalence of HBsAg, HBsAb, HBeAg, HBcAb and HBcAb was compared based on the educational status, previous history of blood transfusion, jaundice, employment status and previous history of still births among the pregnant subjects. There were no statistically significant differences in the prevalence of Hepatitis B virus markers (p> 0.05). CONCLUSION: The study observed a high prevalence of various hepatitis B viral markers among pregnant women attending antenatal care in Specialist Hospital Sokoto. There is need for routine screening of all pregnant women and infants born to hepatitis B positive mothers. Government and non-governmental organizations should intensify efforts to enlighten the general population on the public health importance of the disease and the importance of hepatitis screening. There is also need for the development of a treatment protocol for the management of pregnant women positive for hepatitis B to prevent mother to child transmission. There is an urgent need for the implementation of evidenced-based best practice of providing universal vaccination against hepatitis B for all hepatitis B negative women of child bearing age in particular and all Nigerians in general.

scholarly journals Reproductive and Obstetric Factors Are Key Predictors of Maternal Anemia during Pregnancy in Ethiopia: Evidence from Demographic and Health Survey (2011)

Anemia ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Taddese Alemu ◽  
Melaku Umeta
Keyword(s):  
Public Health ◽  
Pregnant Women ◽  
Health Survey ◽  
Health Problem ◽  
Previous History ◽  
Public Health Problem ◽  
Demographic And Health Survey ◽  
Under Five ◽  
History Of ◽  
Anemia During Pregnancy

Anemia is a major public health problem worldwide. In Ethiopia, a nationally representative and consistent evidence is lacking on the prevalence and determinants during pregnancy. We conducted an in-depth analysis of demographic and health survey for the year 2011 which is a representative data collected from all regions in Ethiopia. Considering maternal anemia as an outcome variable, predicting variables from sociodemographic, household, and reproductive/obstetric characteristics were identified for analyses. Logistic regression model was applied to identify predictors atP<0.05. The prevalence of anemia among pregnant women was 23%. Maternal age, region, pregnancy trimester, number of under five children, previous history of abortion (termination of pregnancy), breastfeeding practices, and number of antenatal care visits were key independent predictors of anemia during pregnancy. In conclusion, the level of anemia during pregnancy is a moderate public health problem in Ethiopia. Yet, special preventive measures should be undertaken for pregnant women who are older in age and having too many under five children and previous history of abortion. Further evidence is expected to be generated concerning why pregnant mothers from the eastern part of the country and those with better access to radio disproportionately develop anemia more than their counterparts.

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