Cervical incompetence is an important cause of late abortion and premature birth, clinical features of painless cervical dilatation in mid p
Cervical incompetence is an important cause of late abortion and premature birth, clinical features of painless cervical dilatation in mid pregnancy, resulting in rupture of amniotic sac bulging and / or membranes, resulting in late abortion and premature birth.
The diagnosis of cervical incompetence mainly depends on the clinical symptoms and signs, namely mid pregnancy painless cervical dilatation, fetal bursa is prominent, and the exclusion of causes such as infection, placental abruption, PPROM other factors such as late miscarriage or premature birth. Cervical incompetence first pregnancy often end in late abortion.
Treatment of cervical incompetence includes conservative treatment and surgical treatment. Conservative treatment, including restricted activities, bed rest, application of progesterone, the application of cervical support, and its clinical efficacy is not clear. Surgical treatment of the cervical cerclage has certain clinical curative effect, including a variety of operation, basically divided into abdominal and vaginal surgery. Transvaginal cervical cerclage, MacDonald Shirodkar method; transabdominal cervical cerclage in diagnosis and in vaginal surgery after failure can be considered in early pregnancy or pregnancy, can be implemented by open or laparoscopic surgery. But the problem is the need for cesarean section delivery, if the mid trimester of labor, there will be a certain risk.
Cervical cerclage surgery indications:
(1) based on the typical history, which is more than 1 times the painless abortion history, excluding infections caused by other factors.
(2) dilation of the cervix and the presence of an infection (or by ultrasonography) were observed clinically.
(3) accompanied by a late miscarriage or preterm birth (less than 34 weeks) in the second trimester (less than 24 weeks) of transvaginal ultrasound cervical length < 25 mm.
The timing of operation: Based on the history of prophylactic cerclage cerclage - recommended in 13-16 weeks of pregnancy; on the basis of clinical symptoms and signs, treatment of cerclage cerclage (or emergency rescue should be carried out in the event of cerclage).