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Transabdominal cerclage (TAC) for patients with ultra-short uterine cervix after uterine cervix surgery and its impact on pregnancy
- Source :
- Journal of Obstetrics and Gynaecology Research. 44:61-66
- Publication Year :
- 2017
- Publisher :
- Wiley, 2017.
-
Abstract
- Aim Patients with an ultra-short uterine cervix as a result of large conization, repeated conization or radical trachelectomy (RT), are at high risk of preterm premature rupture of the membrane, which leads to preterm birth. We have commenced performing transabdominal cerclage (TAC) of the uterine cervix for these patients. In this study, we examined the safety of TAC and its impact on pregnancy. Methods We have performed TAC in 11 patients before pregnancy: in six after large cervical operations, such as repeated conization; and in five for difficulties with cervical cerclage after RT. After laparotomy, a Teflon thread was placed in the avascular space between the uterine vessels and the uterine muscle, and tied. The clinical course of the patients after TAC and their pregnancy course were retrospectively reviewed. Results TAC was performed safely without any complications. The mean operative duration was 53 ± 10 min, and the mean blood loss during the operation was 49 ± 64 mL. Seven women conceived within 2 years after TAC. Their pregnancy courses were favorable. Five of the women underwent scheduled cesarean sections, while two pregnancies are ongoing. Conclusions Although there are risks of various complications as a result of the use of non-absorbable thread and the need for two extra laparotomies, TAC can be a safe and useful option for patients who show cervical incompetence after large uterine cervical operations, such as RT or large conization.
- Subjects :
- medicine.medical_specialty
Pregnancy
030219 obstetrics & reproductive medicine
Obstetrics
business.industry
medicine.medical_treatment
Obstetrics and Gynecology
Retrospective cohort study
Trachelectomy
medicine.disease
Surgery
Abdominal wall
03 medical and health sciences
0302 clinical medicine
medicine.anatomical_structure
Uterine cervix
030220 oncology & carcinogenesis
Laparotomy
medicine
Cervical cerclage
Incompetent cervix
business
Subjects
Details
- ISSN :
- 13418076
- Volume :
- 44
- Database :
- OpenAIRE
- Journal :
- Journal of Obstetrics and Gynaecology Research
- Accession number :
- edsair.doi...........7548de49946b572f21f4a0c40850fa5c