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Results for “Uterine Cervical Incompetence”

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At least 19 recordsLinked to original sources
PubMed2003

Vaginal sonography and cervical incompetence.

Uterine contractions, decidual activation, and cervical competence comprise the fundamental components in contemporary models of the spontaneous preterm birth syndrome, but their relative importance and interactive pathways remain poorly defined. Moreover, the traditional concept that the cervix is either competent or incompetent has been challenged because cervical competence more likely functions along a biologic continuum. Cervical incompetence is a clinical diagnosis characterized by recurrent painless dilation and spontaneous midtrimester birth. Although the efficacy of cerclage for cervical incompetence has never been fully confirmed in randomized clinical trials, the role of cerclage has been expanded to include women with "risk factors" for spontaneous preterm birth or nonreassuring sonographic cervical findings in the mid trimester. Evidence from randomized trials suggests that cerclage has limited efficacy in women with risk factors for cervical incompetence. Results of both retrospective cohort series and randomized trials of cerclage in women with shortened cervical length are inconclusive. We believe that women with a prior early spontaneous preterm birth and shortened midtrimester cervical length represent an ideal population for the conduct of a randomized trial of cerclage, which is currently underway.

Cerclage, Cervical↗
PubMed1990

Uterine activity in patients with cervical cerclage.

Cervical cerclage is the traditional management of cervical incompetence. Uterine activity among these patients has never been studied. This retrospective report details the contraction frequency in 96 patients with cerclage who underwent daily home uterine activity monitoring. Twenty-three percent (22) developed preterm labor and 12% (11) had preterm delivery related to failed tocolysis or rupture of the membranes. Uterine activity in the group who developed preterm labor was significantly greater than in those who labored at term. The objective contraction frequency data obtained by uterine activity monitoring are of clinical significance to physicians managing such patients.

Female↗
PubMed1977

[Pregnancy after conisation for atypical epithelial processes of the uterine cervix (author's transl)].

At the First Department of Obstetrics and Gynecology, University of Vienna Medical School, 148 females aged under 35 years at the time of conisation were examined between 1963 and 1974 to determine their desire for children, their fertility status and the course of pregnancy. After conisation a total of only 42 females (28,4%) wanted children. Of 104 patients with preinvasive carcinoma, a desire for children was reported by no more than 21 (20,2%); among the cases with dysplasia, the number of women desiring children was equally 21 (47,7%). By the end of 1976, after a followup period of 1 to 13 years, 16 of 42 females wanting children failed to conceive, while the remaining 26 gave birth to 20 children. Judging from our admittedly small material, conisation thus apparently has no effect on conception. However, the course of pregnancy was found to be impaired in some cases by the incompetent cervical function. Twelve patients required a Shirodkar operation, which failed to prevent late abortion in 2 cases and premature delivery in 4. Nine women gave birth at or at best 3 weeks before term without preventive methods.

Adult↗
PubMed1997

Screening for bacterial vaginosis and cervicitis aimed at preventing premature delivery.

OBJECTIVE: We performed screening and treatment of bacterial vaginosis and cervicitis during pregnancy for prevention of premature delivery. The incidence and the etiology of lower genital tract infections and premature delivery were examined to elucidate the effectiveness and problems of this trial. METHODS: Three hundred sixty-five pregnant women who attended the obstetrical outpatient clinic in our hospital were included as subjects. The screening was done at prenatal-care visits around the 10th, 20th, and 30th gestational weeks. RESULTS: Fifty-eight women were diagnosed as bacterial vaginosis and 54 women were successfully treated. Thirty-five women were diagnosed as cervicitis and all were cured. Nine women (2.5%) delivered before the 37th gestational week and 1 women delivered before the 35th gestational week because of cervical incompetence. CONCLUSIONS: The treatment of bacterial vaginosis and cervicitis may prevent microbes in the lower genital tract from penetrating the intrauterine cavity and thereby reduce the incidence of premature delivery.

Adolescent↗
PubMed1986

Pregnancy and delivery after cone biopsy of the cervix.

Seventy-seven women had 98 pregnancies after a cone biopsy of the cervix. There were 62 deliveries, 26 legal abortions, 9 spontaneous abortions and 1 ectopic pregnancy. Cervical cerclage was done for 22 out of 62 conized parturients (35.4%) and for none in the matched control group. There were 4 (6.4%) preterm deliveries in the cone biopsy group and 1 in the control group. The perinatal mortalities were 3.2% and 0% respectively. The mean duration of labour was 2.4 h shorter in the conized parturients than in the controls (P less than 0.05) but there were no difference in the mode of delivery in the two groups.

Abortion, Spontaneous↗
PubMed1985

[Bacterial colonization of the cervix and complications later in the course of pregnancy following cerclage].

In 107 patients undergoing cerclage operation, cervical bacterial flora was documented in a prospective study. Complications due to bacterial contamination were recorded. Postoperatively there was an increase in cervical bacteria, both in number and variety. The results were highly significant. The incidence of premature labor, premature rupture of membranes, puerperal and neonatal infections is higher than the level in our own institution and the overall level in Bavaria. Our results suggest that cerclage involves an increased risk of cervical contamination with subsequent complications during pregnancy, puerperium and newborn period.

Bacteria↗
PubMed1982

Outcome of third trimester pregnancies after cryotherapy of the uterine cervix.

A retrospective study was undertaken to assess the effect of cryotherapy of the uterine cervix on the outcome of third trimester pregnancies. It was concluded that cryosurgery of the cervix had no effect on the onset or progress of labour, or on the infant, an important advantage compared with cold-knife conization as a therapy for young women with cervical intraepithelial neoplasia.

Adolescent↗
PubMed1982

Does cervix conization increase the risk of complications in subsequent pregnancies?

In a series of 414 patients who underwent cervix conization because of cancer in situ, the risk of complications in subsequent pregnancies was analyzed by studying the outcome of their 923 pregnancies before and after cone biopsy. After conization the incidence of late spontaneous abortion was seven times higher than before. Moreover, 20.5% of pregnancies following cone biopsy required cervix cerclage because of suspected cervical insufficiency, or cesarean section because of a scarred cervix stenosis.

Abortion, Spontaneous↗
PubMed1978

[Conisation during pregnancy (author's transl)].

The paper reviews 15 cases undergoing conisation during pregnancy. In 2 conisation was immediately followed by radical operation for invasive squamous carcinoma. 11 patients had pre-invasive carcinoma by microscopic evidence on serial step sections, while the remaining 2 showed high-grade dysplasia of the cervix. Atypical tissue was successfully removed in toto in 6 of the 8 cases with lesions predominantly localizing at the cervical surface. Of the 5 abnormal epithelial processes which were almost entirely endocervical only 1 was completely removed. Abortion occurred in 4 of the 13 patients undergoing conisation without prophylactic cerclage. Shirodkar's operation was done at the time of conisation in 7 cases, in one after an interval of 10 weeks. This prophylactic measure failed to prevent prematurity in 2 cases, while the remaining 6 gave birth to living and mature infants between the 37th and the 40th week of gestation.

Abortion, Spontaneous↗
PubMed1991

[Conization and pregnancy--an analysis of various therapeutic measures for the prevention of premature labor].

In the period under review from 1/6/1980 to 31/3/1990 119 women with a state after conisation of the cervix have been delivered. For treatment of a resultant cervical incompetence there were used in 46% a cervical cerclage, in 7% a support pessary, in 20% the combination of cerclage: pessary and in 27% conservative measures. Retrospectively the final gestational week, the proportion prematured rupture of membranes, of prematurity and dates of the fetal outcome have been examined. The results demonstrate that a selection of patients has to be made with state after conisation according to the seriousness of the cervical incompetence giving the adequate indication for a conservative or active (cerclage and/or pessary) treatment referrend to pregnancy length and the uterine cervix findings. A general determination of only one treatment method for prophylaxis of therapy with state after cervix conisation is not advisable, be cause the results of all examined patient groups--after selection--were not significantly different.

Adult↗
PubMed1992

[Cervix cerclage. A 20-year case load].

Uterine cervical incompetence is the most common cause of habitual abortion in the second trimester of pregnancy and premature delivery; cervical cerclage still represents the only surgical treatment for cervical incompetence. In the last 20 years (1971-1990) we performed 272 Mac Donald cervical cerclages in patients between the 8th and the 34th week of pregnancy. In 16 cases the outcome of pregnancy is unknown; 198 women (73.3%) subsequentely delivered healthy infants later than 37 weeks' gestation or weighing more than 2500 g.

Abortion, Habitual↗