Cervical Cerclage—Its Role in the Pregnant Anomalous Uterus

Golan, Abraham; Langer, R.; Wexler, Shraga; Segev, Eitan; Niv, David; David, Menachem P.

doi:10.1097/00006254-199103000-00009

Cited by 34 publications

(40 citation statements)

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“…Cervical cerclage has been attempted in many patients with unicornuate uterus, often with impressive results. Golan et al suggested that cerclage placement be considered in all patients with uterine malformations, although in their study the number of patients with unicornuate uterus was too small to draw conclusions (30). Ambramovici et al, in a similar study, placed cerclages in women with uterine anomalies and no evidence of cervical incompetence.…”

Section: Complicationsmentioning

confidence: 99%

Pregnancy outcomes in unicornuate uteri: a review

Reichman

Laufer

Robinson

2009

Fertility and Sterility

215

198

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Section: Complicationsmentioning

confidence: 99%

Pregnancy outcomes in unicornuate uteri: a review

Reichman

Laufer

Robinson

2009

Fertility and Sterility

215

198

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“…Similar results were obtained in other studies. 13,15,17 Although these studies suggest a benefit of routine cerclage placement, neither study was randomised and both lacked controls making them subject to selection bias.…”

Section: Discussionmentioning

confidence: 99%

Reproductive outcome of women with unicornuate uterus

Akar

Bayar

Yıldız

et al. 2005

Aust NZ J Obst Gynaeco

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This study was undertaken to examine the reproductive impact of unicornuate uterine abnormalities cases in a group of 571 women with a uterine anomaly. Hospital records of 1784 patients who presented to the infertility outpatient clinic with infertility, recurrent pregnancy loss, pain or acute abdomen during the study period between January 1991 and January 2001, were reviewed retrospectively. The reproductive performance of women with unicornuate uterus was poor, with a live birth rate of only 29.2%, prematurity rate of 44%, miscarriage rate of 29%, and an ectopic pregnancy rate of 4%.

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“…Authors such as Golan and colleagues maintain that the only surgery indicated for these cases is cervical cerclage, although this will not prevent first trimester miscarriages. 43 We believe the most suitable approach to diagnosing a uterine malformation should take into account the clinical features and the patient's reproductive goals. We have used 3D US to diagnose and plan the most appropriate treatment, with good results.…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional Ultrasonography in the Diagnosis of Müllerian Duct Anomalies

Bermejo¹,

Cantarero²,

Marquina³

et al. 2009

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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Aims:We studied the effectiveness of three-dimensional (3D) ultrasonography in the diagnosis of uterine malformations.Methods: 175 patients with clinical or ultrasonographic suspicion of uterine malformation were studied between November 2004 and June 2008. In all women we measured uterine volume for processing and later reconstruction of 3D images. Cases in which no anomaly was detected with the 3D technique were excluded from study. A thorough physical genital examination with speculum was done before or after ultrasonography, except in three women with an imperforate hymen. Uterine malformations were recorded in detail, and the findings were catalogued according to the American Fertility Society (AFS) classification. In 32 women magnetic resonance (MR) imaging was also used, and agreement between the two techniques was calculated with the kappa index. Results:The 175 müllerian anomalies we analyzed were diagnosed as agenesis (1 case), unicornuate uterus (1 genuine, 1 communicating), didelphys uterus (4), bicornuate uterus (22), septate uterus (80, 8 with two cervices) and arcuate uterus (68). For 1 unicornuate, 3 bicornuate, 25 septate (4 with two cervices) and 3 arcuate uteri we performed MR imaging. Diagnostic correlation between 3D ultrasonography and MR imaging was obtained in all cases according to the AFS classification (kappa = 100%); concordance was also seen for descriptions of associated uterine malformations except for two cases: 1 bicornuate uterus with the additional presence of a cervical septum as detected by MR imaging, which was not found on hysteroscopy for resection, and 1 septate uterus that appeared to have two cervices on 3D ultrasonography in a patient in whom physical examination was not possible, and in whom MR imaging showed a complete septum with hypointense signals (kappa = 93.45%; 95% confidence interval 80.75-100%).Discussion: Owing to its ability to clearly render contours of anatomical structures, 3D ultrasonography provides detailed images of uterine malformations and yields very similar results to those obtained with MR imaging. For an accurate comparison of the two techniques, ultrasonography should be accompanied by gynecologic physical exploration, since the two methods yield equivalent results for the relation between the uterine cavity and the fundus. MR imaging is especially useful to evaluate the cervix and vagina.

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Cervical Cerclage—Its Role in the Pregnant Anomalous Uterus

Cited by 34 publications

References 0 publications

Pregnancy outcomes in unicornuate uteri: a review

Pregnancy outcomes in unicornuate uteri: a review

Reproductive outcome of women with unicornuate uterus

Three-dimensional Ultrasonography in the Diagnosis of Müllerian Duct Anomalies

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