scholarly journals STUDY OF FETAL SALVAGE FOLLOWING MCDONALD'S ENCERCLAGE

2020 ◽  
pp. 42-43
Author(s):  
Krupa R. Mange ◽  
Vidyadhar B. Bangal
Keyword(s):  
Observational Study ◽  
Surgical Procedures ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Preterm Labour ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Second Trimester ◽  
Cervical Incompetence ◽  
Salvage Rate

Introduction - Mc Donald’s cervical encerclage is one of the surgical procedures, which has been proved beneficial in improving the fetal salvage in recurrent pregnancy loss in second trimester of pregnancy. Material and Methods-A retrospective observational study was carried out at tertiary care teaching hospital for a period of five years. Forty cases of bad obstetrical history that include repeated abortions and preterm labour probably due to cervical incompetence were included. Procedure was performed at various weeks of gestation ranging from 14-32 weeks. Results-Following Mc Donald’s procedure, 1 woman had abortion, and 6 had preterm labour and 33 women reached beyond 37weeks. In the present study, the average interval from Mc Donald’s encerclage to delivery was 130 days.Infant salvage rate in this study was 41% before and 88% after Mc Donald’s encerclage operation. Conclusion-Mc Donald’s cervical encerclage results in improving fetal outcome,when performed in properly selected cases.

scholarly journals The efficacy of cervical encerclage on the course of labour in well selected cases: a prospective study at a tertiary care hospital

2017 ◽  
Vol 6 (8) ◽  
pp. 3319
Author(s):  
Kunaal Shinde ◽  
Anand V. Karake ◽  
Gulabsingh Shekhawat ◽  
Hiralal Shivale
Keyword(s):  
Preterm Delivery ◽  
Preterm Labor ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Care Hospital ◽  
Perinatal Medicine ◽  
Short Cervix ◽  
Cervical Incompetence ◽  
A Prospective Study ◽  
Salvage Rate

Background: The two major problems for modern obstetrics and perinatal medicine are recurrent second trimester abortions and preterm delivery. Cervical insufficiency or incompetency is defined as the inability of the uterine cervix to retain a pregnancy in the absence of contractions or labor. Cervical encerclage is a simple but a resourceful procedure for improving the fetal outcome in cases proven with cervical incompetence, is a boon to modern obstetrics.Methods: A prospective analytical study was carried out at tertiary care teaching hospital for a period of ten years. Three hundred and twenty cases of bad obstetric history (repeated abortions, preterm labor) with previous pregnancy losses probably due to cervical incompetence or ultrasonographical evidence of short cervix were included in the study. These cases were subjected to cervical encerclage operation in the second trimester.Results: Out of the 289 cases, who underwent McDonald’s procedure, 12 women had abortion, 66 had preterm labor and 211 women reached term. Out of the 31 cases who underwent Wurm’s procedure; 4 had abortion, 17 had preterm delivery and 10 women reached to term.  In the present study, the average interval from cerclage to delivery was 115 days. It was observed that the fetal salvage rate was unsatisfactory in women having short cervix with open internal os before encirclage. Infant salvage rate in this study after encerclage operation was 86%.Conclusions: Cervical encerclage when done in properly selected cases, results in improvement in fetal salvage up to eighty percent.

scholarly journals RESCUE CERVICAL CERCLAGE WITH VAGINAL PESSARY SUPPORT AND ALTERNATIVE TOCOLYTICS IN CORONA POSITIVE , DCDA TWIN WITH HIGH LEAKING AND 16 WEEKS OF HOSPITALISATION LEADING TO SUCCESSFUL OUTCOME - A CASE REPORT

2021 ◽  
Vol 9 (5) ◽  
pp. 189-192
Author(s):  
Komal Vijaywargiya ◽  
◽  
Namrata Kachhara ◽  
Kalpana Jain ◽  
Aayushi Ruia ◽  
...  
Keyword(s):  
Case Report ◽  
Pregnancy Loss ◽  
Twin Pregnancy ◽  
Preterm Labour ◽  
Cervical Length ◽  
Successful Outcome ◽  
Cervical Cerclage ◽  
Cervical Incompetence ◽  
Trimester Pregnancy ◽  
Vaginal Pessary

A twin gestation invariably leads to a certain extent of cervical length shortening . If this reduction is also associated with gradual dilatation of internal os and various biochemical , mechanical changes in cervical matrix , this can lead to mid trimester pregnancy loss or preterm labour. This is a case report on Dichorionic , Diamniotic twin pregnancy with cervical incompetence in which rescue cerclage was performed along with judicious use of tocolysis and vaginal pessary.

P–555 Recurrent pregnancy loss is associated with changes in the pre-pregnant endometrial gland transcriptome

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
J Pearson-Farr ◽  
R Lewis ◽  
J Cleal ◽  
Y Cheong
Keyword(s):  
Gene Expression ◽  
Observational Study ◽  
Differential Gene Expression ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Small Sample ◽  
Specific Cell ◽  
Endometrial Gland ◽  
Egg Donor ◽  
Differential Gene

Abstract Study question Do endometrial gland factors influence recurrent pregnancy loss? Summary answer The endometrial gland transcriptome during the window of implantation is altered in women with recurrent pregnancy loss compared to controls. What is known already Secretions from endometrial glands contribute to the uterine environment that supports the attachment and implantation of the embryo in early pregnancy. Studies have attempted to identify an endometrial gene expression pattern associated with recurrent pregnancy loss however, the cellular heterogeneity within the endometrium may obscure important differences in specific cell populations. Study design, size, duration An observational study comparing controls and women with recurrent pregnancy loss. Participants/materials, setting, methods Endometrial samples were collected during the implantation period of the menstrual cycle from five matched participant egg donor controls and women with recurrent pregnancy loss. Endometrial glands were isolated from fresh endometrial biopsies and RNA sequencing was performed. A differential gene expression analysis and a gene ontology enrichment analysis was performed between egg donor controls and women with recurrent pregnancy loss. Main results and the role of chance This study reports a glandular epithelium specific gene expression profile and demonstrates differential gene expression of endometrial glands from women with recurrent pregnancy loss compared to controls. 18 genes were upregulated and 1 gene was downregulated in the endometrial glands from women with recurrent pregnancy loss compared to controls (5% false discovery rate). Biological processes which contain genes that were differentially expressed in women with recurrent pregnancy loss compared to controls include epithelial cell migration and regulation of secretion by the cell. Limitations, reasons for caution This is an observational study with a relatively small sample size. Wider implications of the findings: This study identified differences in gene expression in women with recurrent pregnancy loss that are specifically associated with endometrial glands rather than endometrium as a whole. These differences could be used to identify a perturbed endometrium, isolate causes of recurrent pregnancy loss and develop targeted therapies. Trial registration number Not applicable

scholarly journals Assessment of obstetric and gynaecological problems in females with bleeding disorders

2021 ◽  
Vol 10 (4) ◽  
pp. 1573
Author(s):  
Shruti Ashok Panchbudhe ◽  
Ashwini Sudhir Desai
Keyword(s):  
Pregnancy Loss ◽  
Prospective Observational Study ◽  
Postpartum Haemorrhage ◽  
Recurrent Pregnancy Loss ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Bleeding Disorder ◽  
Care Hospital ◽  
Bleeding Disorders ◽  
Obstetrics And Gynaecology

Background: Inherited bleeding disorders are not common but they are lifelong. Their effects on women are far greater than previously realised. Many clinicians are not familiar with these disorders but may encounter such women under acute conditions. Objectives were to study various obstetric and gynaecological problems in females with bleeding disorders and to assess the type of management given for these disorders.Methods: This was a prospective observational study carried out at Department of Obstetrics and Gynaecology at a tertiary care hospital in which 30 women of known bleeding disorder were studied and various obstetric and gynaecological problems including menorrhagia, metrorrhagia, dysmenorrhoea, mid-cycle pain, conception, haemorrhagic ovarian cyst, etc. were identified and studied in them.Results: 30 patients of known bleeding disorder who were found to have obstetric and gynaecological problem were studied. Idiopathic thrombocytopenic purpura constituted the major bleeding disorder (23%), followed by von Willebrand’s disease (17%) in our study. 21 patients had gynaecological problem and the most common gynaecological problem was menorrhagia (62%), followed by hemoperitoneum (10%), mid cycle pain (10%), persistent haemorrhagic cyst (7%), dysmenorrhea (7%) and endometriosis (4%). 20 patients had obstetric problems of which postpartum haemorrhage (59%) was a major problem followed by recurrent pregnancy loss (33%) and infertility (8%). The study concluded that both obstetric and gynaecological problems are common in patients of bleeding disorders and occur in distribution 66.66% and 70% respectively.Conclusions: The study conducted shows that obstetric and gynaecological problems are very common in patients of bleeding disorders and thus optimal management of these problems requires a   multidisciplinary team of approach. 

scholarly journals Causes of mid trimester pregnancy loss in a tertiary care hospital

2020 ◽  
Vol 3 (2) ◽  
pp. 64-69
Author(s):  
Bushra Zardad ◽  
Anisa Fawad ◽  
Ayesha Ismail ◽  
Shazia Mehreen ◽  
Sadia Bibi
Keyword(s):  
Pregnancy Loss ◽  
Tertiary Care ◽  
Relevant Information ◽  
Management Plan ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Second Trimester ◽  
Cross Sectional ◽  
Trimester Pregnancy ◽  
Increased Risk

Introduction: Mid trimester of pregnancy is relatively a safe time of pregnancy with minimal and no complications. Mid trimester pregnancy loss constitutes 1 to 5 % of total miscarriages. The purpose of this study is to evaluate the causes of second trimester miscarriages so as to improve the outcome in future pregnancies. Materials & Methods: This was a prospective cross-sectional study. Demographic features, relevant information and risk factors were recorded in a predesigned proforma. Detailed history was followed by thorough clinical examination and appropriate investigations were advised. Results: Total number of miscarriages admitted in the unit over the period of two years were 336 and among them 30 patients presented with second trimester miscarriages (8.9%). The mean age of the patients was 31.4 years. In 19 patients (63.4%) there were identifiable causes for the miscarriage. 7 patients (23.33%) had fibroids in the uterus, 5 patients (16.67%) had bacterial vaginosis, 4 patients (13.33%) had cervical incompetence and in 3 patients (10%) there were congenital abnormalities in the uterus. Conclusion: Patients with second trimester pregnancy loss are at significantly increased risk (10 times more likely) for recurrent second trimester loss. In 50 to 70% of patients no cause can be identified. After single loss there is 80% chance of successful pregnancy outcome in future. Even after two and three mid trimester losses still there is 60% chance of alive pregnancy next time, so thorough evaluation and management plan is needed to prevent this mishap in future pregnancies.

scholarly journals Study of bad obstetric history cases attending tertiary care centre, Tirupati

2021 ◽  
Vol 8 (4) ◽  
pp. 535-540
Author(s):  
Gowthami B ◽  
Sowjanya Kumari J ◽  
Lakshmi Narayanamma V
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Control Group ◽  
Chronic Hypertension ◽  
Age Group ◽  
Obstetric History

To assess the obstetric and medical risk factors in patients with bad obstetric history (BOH) and outcome of pregnancy in case of BOH. A prospective cross-sectional study was conducted in Government maternity hospital, Tirupati for a period of 1 year from December 2017 to November 2018. All pregnant women who were fulfilling inclusion criteria of BOH, as study group and all possible variable were compared with control group, who got selected randomly from the rest of deliveries. And analysed the results in terms of sociodemographic factors, risk factors, pregnancy complications, mode of delivery, maternal and foetal outcome. Of 102 pregnant women in BOH, 76.5% were in age group between 21-30yrs, and 14.7% in age group >30yrs. Primary Recurrent pregnancy loss (RPL) was 51% and that of secondary recurrent pregnancy loss was 49%.History of hypertensive disorders including preeclampsia, eclampsia and chronic hypertension, noted in 11.8% cases, which was higher than previous studies, indicating changing trends in incidence.In foetal complications IUGR (0% vs 9.8%, p=0.026) and IUFD (0% Vs 7.8%, p=0.05) were more in BOH group and statistically significant also. Even though the maternal complications were more in BOH group, there was no statistical significance (P=0.075).Among the various causes of RPL found in the present study, endocrine causes were seen in 12.7%, Anatomical causes were found in 11.8% and in about 63.7% cases no definite cause was found and aetiology was unexplained. Present study, supporting the change in definition of recurrent pregnancy loss from 3 consecutive losses to 2. So early evaluation and with appropriate interventions in most of couples outcomes were fruitful.

RESCUE CERVICAL CERCLAGE: PREVENTION OF A PREVIABLE BIRTH

2021 ◽  
pp. 36-37
Author(s):  
D. Sruthi ◽  
V. Radhalakshmi
Keyword(s):  
Uterine Cervix ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Signs And Symptoms ◽  
Salvage Procedure ◽  
Second Trimester ◽  
Cervical Cerclage ◽  
Successful Pregnancy ◽  
In Pregnancy

Pregnancy loss at any stage is distressing especially when this happens later in pregnancy, and this further worsens when it recurs in subsequent pregnancies. The reasons for recurrent pregnancy loss and preterm delivery are diverse and multifactorial. One of the main reasons for these complications is cervical insufciency, which means the inability of the uterine cervix to retain a pregnancy in the absence of signs and symptoms of clinical contractions, or labor or both in second trimester. Rescue cervical cerclage also known as Emergency cerclage/ rescue stitch is fundamentally a salvage procedure to prolong pregnancy in women with advanced cervical dilatation or prolapsed membranes in the second +3 trimester. Here, we present a case study of a 25-year-old antenatal woman Gravida 4 Para 0 with advanced cervical changes at 20 weeks who beneted from the rescue cervical cerclage procedure to have a successful pregnancy outcome.

Recurrent pregnancy loss

2019 ◽  
Vol 13 (7) ◽  
pp. 402-408
Author(s):  
Priyanka Krishnaswamy ◽  
Rohit Arora
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Recurrent Miscarriage ◽  
Second Trimester ◽  
Successful Pregnancy ◽  
Inherited Thrombophilia ◽  
Epidemiological Factors ◽  
Factors Influencing ◽  
Recurrent Pregnancy Losses ◽  
Male Factors

Miscarriage is defined as the spontaneous loss of a pregnancy before the fetus reaches viability; it includes all pregnancy losses from the time of conception until 24 weeks of gestation. Early miscarriages are common, occurring in 10–20% of all pregnancies, with 2% of second-trimester pregnancies being miscarried before 24 weeks of gestation. Recurrent miscarriage, defined as the loss of three or more consecutive pregnancies, affects 1% of couples trying to conceive with the chance of having two consecutive miscarriages being 5%. Clinical studies show that 3 in 4 women will have a successful pregnancy with supportive care alone. Therefore, couples should be given reassurance about their chances of a successful pregnancy in the future. In this review we look at the epidemiological factors influencing rates of miscarriage, acquired and inherited thrombophilia, genetic, anatomical, endocrine, immune, infective and male factors for recurrent miscarriage. Despite these potential causes, the majority (around 50%) of recurrent pregnancy losses remain unexplained.

scholarly journals Microbiological study of cervical flora in preterm labour

2020 ◽  
Vol 9 (3) ◽  
pp. 945
Author(s):  
Meenakshi Ruhil ◽  
Priti A. Hatkar
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Preterm Labour ◽  
Tertiary Care ◽  
P Value ◽  
Tertiary Care Centre ◽  
Microbiological Study ◽  
Spontaneous Preterm Delivery ◽  
Causative Factors ◽  
Secondary Objective

Background: Preterm labour occurs due to various causative factors. Genital infections contribute significantly to the preterm labour. Ours is a prospective, observational study looking at the cervical microbiota involved in the preterm labour. The cervical flora contributing to the occurrence of preterm labour was studied. The results were analyzed based on the microbiological study of cervical swabs. The primary objectives of this study were to determine the association of cervical microbiota of pregnant women with spontaneous preterm delivery. To characterize the effect of cervical microbiota on birth gestation. The secondary objective of this study was to analyse the role of cervical microbiota and its relationship between social and behavioural factors.Methods: It is a prospective, observational study, which includes 193 patients, studied over a period of one and a half year. It was conducted at our tertiary care centre after the approval by ethics committee, and the results were analysed. As this is a purely observational study, management decisions of treating obstetrician were not interfered with. No additional cost, intervention or injury was caused to the study subject.Results: In our study, cervical swab culture shows growth in 2.07% which is statistically insignificant. Though, it was found that preterm labour is more common with leucocytosis, i.e. WBC > 11000 cmm, which is found to be statistically significant (p value = 0.023).Conclusions: In our study, we found that there was no significant association of cervical flora with preterm labour, though we found an association with leucocytosis.

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