Emergency cerclage versus bed rest for amniotic sac prolapse before 27 gestational weeks

Stupin, Jens H.; David, Matthias; Siedentopf, Jan-Peter; Dudenhausen, Joachim W.

doi:10.1016/j.ejogrb.2007.11.009

Cited by 111 publications

(95 citation statements)

References 19 publications

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“…Although most studies report the use of some kind of prophylactic antibiotics, some do not [4,9,14,15]. Results in the latter studies do not seem to differ from those including the systematic use of antibiotics.…”

Section: Discussionmentioning

confidence: 64%

“…In fact, in the review by Namouz et al [1], only 5 studies [4,9,15,18,29] reported a higher number of cases, and another 3 [7,23,30] reported 40 cases or more. In addition, in most studies a standard protocol of management was not followed, and in some reports (i.e.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, in our study, the proportion of immediate and late complications was in line with figures reported by other authors. Stupin et al [4] and Park et al [21] reported that 7.8 and 5.4% of cases had rupture of membranes within 24 h, respectively, and Liddiard et al [8] and Debby et al [9] reported that 33 and 29% of cases, respectively, had PPROM. Chorioamnionitis was described in 12.5-50% of cases in the review by Namouz et al [1], and Caruso et al [19] reported the need for a second emergency cerclage in 8% of women, which is in line with our study.…”

Section: Discussionmentioning

confidence: 99%

“…Although the threshold for viability is considered to be 23-24 weeks of gestation [3], most of the published data regarding emergency cerclage include gestational ages up to 27 weeks [4,5,6,7,8,9,10]. Recent ACOG recommendations [11] state that the safety and efficacy of cerclage in the treatment of patients with cervical insufficiency after fetal viability have not been adequately assessed.…”

Section: Discussionmentioning

confidence: 99%

“…the one by Stupin at al. [4]) women with undetermined signs of infection were included. In our study, a well-described standardized protocol was introduced in 2007, making replication of our results in a different clinical setting plausible.…”

Section: Discussionmentioning

confidence: 99%

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Emergency Cerclage: Improvement of Outcomes by Standardization of Management

et al. 2015

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Introduction: Cervical dilatation followed by prolapse and ballooning of membranes into the vagina at mid-gestation is a critical situation. The aim of this study was to describe the outcome of emergency cerclage in a tertiary referral center during a 10-year period (2001-2010) in which a defined selection of women and standard protocol were introduced. Subjects and Methods: Thirty-nine cases of emergency cervical cerclage performed before 24 completed weeks were retrospectively reviewed. Data related to maternal history, diagnosis, procedure details, postoperative management and perinatal outcome were recorded. Maternal characteristics and perinatal outcomes are described. Results: Gestational age at cerclage (mean ± SD) was 22.1 ± 2.0 weeks with 61% (24/39) of women presenting bulging membranes. Gestational age at delivery and cerclage-to-delivery time (mean ± SD) were 28.6 ± 6.2 weeks and 49.1 ± 36.5 days, respectively. Only 38.5% (15/39) of the whole group and 44.1% (15/34) of those who reached 24.0 weeks delivered beyond 28 weeks of gestational age. Neonatal survival before discharge was 82.4% (28/34). Discussion: Perinatal outcomes after emergency cerclage are still poor with more than half of the cases delivering before 28 weeks. A standard protocol may help in the management of these rare cases.

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Emergency Cerclage: Improvement of Outcomes by Standardization of Management

et al. 2015

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A single‐center retrospective study of pregnancy outcomes after emergency cerclage for cervical insufficiency

Wang

2017

Intl J Gynecology & Obste

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Bed Rest in Pregnancy

Bigelow

Stone

2011

Mount Sinai J Medicine

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The use of bed rest in medicine dates back to Hippocrates, who first recommended bed rest as a restorative measure for pain. With the formalization of prenatal care in the early 1900s, maternal bed rest became a standard of care, especially toward the end of pregnancy. Antepartum bed rest is a common obstetric management tool, with up to 95% of obstetricians utilizing maternal activity restriction in some way in their practice. Bed rest is prescribed for a variety of complications of pregnancy, from threatened abortion and multiple gestations to preeclampsia and preterm labor. Although the use of bed rest is pervasive, there is a paucity of data to support its use. Additionally, many well-documented adverse physical, psychological, familial, societal, and financial effects have been discussed in the literature. There have been no complications of pregnancy for which the literature consistently demonstrates a benefit to antepartum bed rest. Given the well-documented adverse effects of bed rest, disruption of social relationships, and financial implications of this intervention, there is a real need for scientific investigation to establish whether this is an appropriate therapeutic modality. Well-designed randomized, controlled trials of bed rest versus normal activity for various complications of pregnancy are required to lay this debate to rest once and for all.

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Emergency cerclage versus bed rest for amniotic sac prolapse before 27 gestational weeks

Cited by 111 publications

References 19 publications

Emergency Cerclage: Improvement of Outcomes by Standardization of Management

Emergency Cerclage: Improvement of Outcomes by Standardization of Management

A single‐center retrospective study of pregnancy outcomes after emergency cerclage for cervical insufficiency

Bed Rest in Pregnancy

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