Handling of cervical insufficiency cases in our clinic Kliniǧimizdeki servikal yetmezlik olgularina yaklaşim
Ondokuz Mayis Universitesi Tip Dergisi, cilt.18, sa.2, ss.80-86, 2001 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 18 Sayı: 2
- Basım Tarihi: 2001
- Dergi Adı: Ondokuz Mayis Universitesi Tip Dergisi
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.80-86
- Anahtar Kelimeler: Cerclage, Cervical insufficiency, Mc Donald, Shirodkar
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Assessing of the effects of a variety of cerclage operations performed in our department in the pregnants with the diagnosis of cervical insufficiency, on pregnancy, type and duration of delivery and discussing the complications due to operations and comparing the results with the previous studies. 17 pregnant patients who were admitted to Department of Obstetrics and Gynecology. Firat University, School of Medicine between September 1997 and June 1999 were included in an interventional type of study. The patients who were devoid of uterine contractions, premature rupture of membranes, chorioamnionitis, or fetal structural and genetic abnormalities were classified into 3 groups in terms of the "grade of cervical dilatation" and the "transvaginal ultrasound results" in accordance with Wong et all's classification. Group 1 (n=13): No contraction and cervical dilatation. Cervical insufficiency signs exist on transvaginal ultrasound examination. Group 2 (n=2): No contraction: cervical dilatation <3cm. Group 3 (n=2): No contraction; cervical dilatation >3 cm. Elective surgery, and emergent Mc Donald cerclage operations and elective Shirodkar cerclage operations were performed in group 1, 3 and 2 respectively. For statistical methods, descriptive analyses of data were performed. In repeated measurements. Wilcoxon rank test was applied in which, p<0.05 was accepted as significant. Cerclage operations were accomplished in all patients. Uneventful delivery rate was found to be 71%, whereas Cesarean section 29%, and complication 0%. On basis of Wong classification, in group 1, 11 pregnants out of 13 were with uneventful delivery, and the last 2 with Cesarean section due to fetal distress. 2 pregnants in group 2 were approached with Cesarean+Gilliam Doleris+Burch operation: In group 3, one patient underwent early delivery on the 32nd week with Cesarean section and another one usual delivery on the 37th week. No complication was noted in any of the groups except prematurity encountered in the group 3. Cerclage operations can be life saving for fetus in the cervical insufficiency cases.