Amnioreduction in emergency cervical cerclage: A series of eight cases

Zhang, Yuan; Han, Zhenyan; Gao, Qian; Bai, Xin; Hou, Hongyan

doi:10.1002/ijgo.13153

Cited by 5 publications

(4 citation statements)

References 3 publications

(4 reference statements)

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“…A 2019 case series by Zhang et al . documented eight patients who underwent amnioreduction as an adjunct to cervical cerclage for cervical incompetence with benefits in prolonging GA.[ 5 ] With fetal OA, polyhydramnios will likely to recur hence close monitoring with repeated amnioreductions may prove beneficial. In our experience, both interventions were integral in prolonging gestation, thereby optimizing conditions for successful reconstructive surgery.…”

Section: Discussionmentioning

confidence: 99%

Polyhydramnios Secondary to Esophageal Atresia – Cervical Cerclage and Serial Amnioreduction to Prolong Gestational Age in Select Cases

Baey,

Toh,

Chiang

et al. 2024

Journal of Indian Association of Pediatric Surgeons

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Section: Discussionmentioning

confidence: 99%

Polyhydramnios Secondary to Esophageal Atresia – Cervical Cerclage and Serial Amnioreduction to Prolong Gestational Age in Select Cases

Baey,

Toh,

Chiang

et al. 2024

Journal of Indian Association of Pediatric Surgeons

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“…The main purpose of amnioreduction prior to ECC is to reduce intrauterine pressure. After amnioreduction, it can be observed that the distension of the membranes was markedly reduced and makes it easier to expose dilated cervical edge, in turn reducing the surgical difficulty and improving outcomes [21,[23][24][25][26]. In our study, 11 cases with advanced cervical dilation at least 3 cm, including two cases near fully dilated before the operation, underwent successful ECC without procedure-related rupture of membrane, suggesting that the amnioreduction may be a feasible option before ECC in such conditions.…”

Section: Discussionmentioning

confidence: 99%

“…In 1979, Robert C. Goodwin reported for the first time the application of amnioreduction before ECC to reduce the tension of the protruding amniotic sac in the vagina [21]. Since then, several studies have reported on amnioreduction prior to ECC for bulging membranes, however, the pregnancy outcomes were inconsistent due to the heterogeneity of cases [22][23][24][25][26]. To improve the success of ECC procedure and pregnancy outcomes among patients with large bulging membranes, our hospital started to adopt amnioreduction prior to ECC since December 2016.…”

Section: Introductionmentioning

confidence: 99%

The Role of Amnioreduction in Emergency Cervical Cerclage with Bulging Membranes: A Retrospective Comparative Study

et al. 2022

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The purpose of this study was to investigate the role of amnioreduction in patients who underwent emergency cervical cerclage (ECC) with bulging membranes during the second trimester. This retrospective comparative study included 46 singleton pregnant women who had cervical dilation at least 1 cm with bulging membranes beyond the external cervical os and underwent ECC at the Third Affiliated Hospital of Sun Yat-sen University between December 2016 and December 2021. Cases were categorized as amnioreduction group (n = 16) and non-amnioreduction group (n = 30) according to whether amnioreduction was performed prior to ECC. The gestational age and cervical dilation at cerclage, operative time, prolongation of pregnancy, and outcomes of pregnancy were compared between the two groups. All 46 patients underwent successful ECC excepted one case with intraoperative rupture of membrane in non-amnioreduction group. In the amnioreduction group, the cervical dilation at cerclage was larger than that in the non-amnioreduction group (4.5 ± 2.2 vs. 2.2 ± 1.2 cm, P < 0.001), and had more patients with cervical dilation ≥4 cm (50.0% vs. 10.0%, P = 0.004). However, the gestational age at cerclage, operative time, prolongation of pregnancy, gestational age at delivery were not significantly different between the two groups (22.9 ± 2.8 vs. 22.9 ± 3.2 weeks, 31.1 ± 9.2 vs. 27.9 ± 11.4 min, 21.3 ± 21.5 vs. 38.7 ± 40.2 days, 25.9 ± 4.5 vs. 28.4 ± 6.1 weeks; P > 0.05). The rates of delivery ≥28 weeks, ≥32 weeks, and live birth were 20.0% vs. 80.0%, 12.5% vs. 26.7%, 56.3% vs. 66.7% (P > 0.05) in amnioreduction group and non-amnioreduction group, respectively. In conclusion, even in cases with larger cervical dilation, the application of amnioreduction with ECC is possible to get the acceptable pregnancy outcomes. These findings suggested that amnioreduction may be a safe and feasible option to be applied before ECC, especially for those with advanced cervical dilation and bulging membranes.

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“…Among those methods, amnioreduction facilitates the replacement of the protruding membrane by reducing the hydrostatic force. Through several studies, amnioreduction has been proven to be a feasible method [ 10 , 11 , 12 , 13 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of Amnioreduction before Physical Examination-Indicated Cerclage on Pregnancy Outcomes: A Propensity Score Matched Study

Hong

Kim

et al. 2023

JCM

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This study investigated the effects of amnioreduction before physical examination-indicated cerclage on pregnancy outcomes using a propensity score matching analysis. This multicenter retrospective cohort study included women who underwent cerclage operations due to painless cervical dilation in the second trimester (14–28 weeks). The primary outcome was the time from operation until delivery. Secondary outcomes included preterm birth rate and neonatal outcomes. Primary and secondary outcomes were compared between those with amnioreduction and those without amnioreduction. Of 103 women, 31 received preoperative amnioreduction (amnioreduction group) and 72 women did not (no-amnioreduction group). Since there were differences in baseline characteristics and preoperative ultrasound findings between the two groups, we matched 25 women with amnioreduction and 25 women without amnioreduction using a propensity score. In the matched cohort, the amnioreduction group showed a shorter time from operation to delivery than the group without amnioreduction and the hazard ratio of amnioreduction was 2.5 (95% confidence interval; 1.4–4.7). In addition, the preterm birth rate before 28 weeks of gestation and the neonatal composite outcome were higher in the amnioreduction group than that in the group without amnioreduction. Amnioreduction before physical examination-indicated cerclage was associated with poor pregnancy and neonatal outcomes. Therefore, careful consideration is required when performing amnioreduction before cerclage operation.

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Amnioreduction in emergency cervical cerclage: A series of eight cases

Cited by 5 publications

References 3 publications

Polyhydramnios Secondary to Esophageal Atresia – Cervical Cerclage and Serial Amnioreduction to Prolong Gestational Age in Select Cases

Polyhydramnios Secondary to Esophageal Atresia – Cervical Cerclage and Serial Amnioreduction to Prolong Gestational Age in Select Cases

The Role of Amnioreduction in Emergency Cervical Cerclage with Bulging Membranes: A Retrospective Comparative Study

Effects of Amnioreduction before Physical Examination-Indicated Cerclage on Pregnancy Outcomes: A Propensity Score Matched Study

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