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 Prediction of Outcomes for Emergency Cervical Cerclage in the Presence of Protruding Membranes

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Purnima Deb ◽  
Nighat Aftab ◽  
Shabana Muzaffar
Keyword(s):  
Decision Making ◽  
Blood Cell ◽  
Cell Count ◽  
Pregnancy Outcomes ◽  
Retrospective Review ◽  
Perinatal Outcome ◽  
Outcome Analysis ◽  
Tertiary Level ◽  
Blood Cell Count ◽  
Cervical Cerclage

The aim of our study is to verify whether some maternal features are related to pregnancy outcomes 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-year period at Al Wasl hospital, a tertiary level centre 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.

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 Leukocytosis during cervical preparation with osmotic dilators for dilation and evacuation

2021 ◽  
Vol 9 ◽  
pp. 205031212098673
Author(s):  
Lyndsey S Benson ◽  
Jordan Stevens ◽  
Elizabeth A Micks ◽  
Sarah W Prager
Keyword(s):  
Confidence Interval ◽  
Blood Cell ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
P Value ◽  
Second Trimester ◽  
Blood Cell Count ◽  
Median Increase ◽  
Cervical Preparation

Objectives: To describe leukocytosis trends during cervical preparation with osmotic dilators for second-trimester dilation and evacuation procedures, and to determine whether there is a difference in leukocytosis seen with laminaria versus Dilapan-S. Methods: We conducted a retrospective cohort study of 986 women presenting for dilation and evacuation from April 2008 through March 2009 at an outpatient clinic network. We included all procedures at ⩾14 weeks’ gestation where laminaria or Dilapan-S dilators were used for overnight dilation. All women had routine white blood cell testing during the study period. Results: There was a median increase of 2.4 × 103/μL white blood cell count (95% confidence interval 2.2–2.7 × 103/μL) from beginning of cervical preparation to the day of procedure (95% confidence interval and p value). Women receiving laminaria ( n = 805) versus Dilapan-S ( n = 181) had a greater increase in white blood cell count from baseline (median increase 2.7 versus 1.2 × 103/μL, p < 0.001), including when adjusting for age, gestational age, parity, baseline white blood cell count, and number of dilators placed. Conclusion: There is increased leukocytosis during the course of cervical preparation with osmotic dilators, and this is increased with use of laminaria versus Dilapan-S. Rates of clinically recognized infection in second-trimester abortion are low regardless of dilator type used.

The effect of second trimester emergency cervical cerclage on perinatal outcome

2012 ◽  
Vol 25 (9) ◽  
pp. 1746-1749 ◽  
Author(s):  
Salwa Abo-Yaqoub ◽  
Abdel-Baset F. Mohammed ◽  
Huda Saleh
Keyword(s):  
Perinatal Outcome ◽  
Second Trimester ◽  
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.

Cigarette Smoking Increases Thromboxane A2 Formation without Affecting Platelet Survival in Young Healthy Females

1992 ◽  
Vol 68 (05) ◽  
pp. 583-588 ◽  
Author(s):  
Annika Dotevall ◽  
Christina Rångemark ◽  
Elsa Eriksson ◽  
Jack Kutti ◽  
Hans Wadenvik ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cigarette Smoking ◽  
Blood Cell ◽  
Urinary Excretion ◽  
Life Span ◽  
Cell Count ◽  
Thromboxane A2 ◽  
Blood Cell Count ◽  
Platelet Activity ◽  
Pai 1

SummarySmoking is a risk factor for the development of atherosclerotic cardiovascular disease, in men as well as in women. An increased urinary excretion of the thromboxane metabolite 2,3-dinor-thromboxane B2 (Tx-M) has been observed in smokers of both genders, suggesting that cigarette smoking may facilitate cardiovascular disease via an action on the platelets. The present study addressed the hypothesis that the increased Tx-M excretion in female smokers reflects a true facilitation of platelet reactivity in vivo, rather than an increased destruction of the platelets. In healthy female volunteers (aged 20–46 years, 18 smokers and 17 non-smokers) platelet life-span and indices of platelet activity were determined, together with plasma levels of plasminogen activator inhibitor-1 (PAI-1), fibrinogen, peripheral blood cell counts and hematocrit. The urinary excretion of Tx-M was higher in smokers than in non-smokers (361 vs. 204 pg/mg creatinine, respectively, p <0.05), while plasma and urinary β-thromboglobulin, plasma platelet factor 4, platelet mean life-span and platelet production rate did not differ between the groups. PAI-1 activity, white blood cell count and hematocrit were higher in smokers than in non-smokers (p <0.05). These data indicate that smoking facilitates platelet formation of thromboxane A2 without affecting platelet survival; i.e. it increases the activity of platelets without affecting their viability to a measurable extent. Such an increase in platelet activity, operating in parallel to a reduced fibrinolytic activity and a higher hematocrit and white blood cell count, may play an etiological role in smoking-induced cardiovascular disease in women.

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