Indomethacin and Antibiotics in Examination-Indicated Cerclage

Miller, Emily S.; Grobman, William A.; Fonseca, Linda; Robinson, Barrett K.

doi:10.1097/aog.0000000000000228

Cited by 57 publications

(51 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Subgroup analysis of women who had TVS‐CL < 10 mm, or received tocolytics or antibiotics as additional therapy to cerclage, showed that cerclage may reduce the incidence of PTB; well‐powered trials should be carried out in these groups of patients. Notably, there is evidence in the literature that adjunctive perioperative tocolytics and/or antibiotics might increase the efficacy of the cervical cerclage. Biological plausibility would support these results, as there are several pathways to PTB and these involve mechanical weakness of the cervix from prior surgical procedures or other factors which could be treated with cerclage, infection which could be treated by antibiotics and uterine contractions which could be treated by tocolytics.…”

Section: Discussionmentioning

confidence: 94%

Cerclage for sonographic short cervix in singleton gestations without prior spontaneous preterm birth: systematic review and meta‐analysis of randomized controlled trials using individual patient‐level data

Berghella

Ciardulli

Rust

et al. 2017

Ultrasound in Obstet & Gyne

137

View full text Add to dashboard Cite

In singleton gestations without prior spontaneous PTB but with TVS-CL < 25 mm in the second trimester, cerclage does not seem to prevent preterm delivery or improve neonatal outcome. However, in these pregnancies, cerclage seems to be efficacious at lower CLs, such as < 10 mm, and when tocolytics or antibiotics are used as additional therapy, requiring further studies in these subgroups. Given the low quality of evidence, further well-designed RCTs are needed to confirm the findings of this study. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

show abstract

Section: Discussionmentioning

confidence: 94%

Cerclage for sonographic short cervix in singleton gestations without prior spontaneous preterm birth: systematic review and meta‐analysis of randomized controlled trials using individual patient‐level data

Berghella

Ciardulli

Rust

et al. 2017

Ultrasound in Obstet & Gyne

137

View full text Add to dashboard Cite

show abstract

“…Preterm rupture of membranes, preterm labour and chorioamnionitis were ruled out. Patients were admitted receiving indomethacin to prevent contraction and decrease fetal urine output as a theoretically way to decrease intra-amniotic pressure21 22 as well as ampicillin/sulbactan 1.5 g twice a day as prophylactic antibiotic therapy 21 23…”

Section: Methodsmentioning

confidence: 99%

Non-invasive emergent cerclage using a plastic sling: case series

Azpurua¹,

Paredes

Navas

et al. 2017

BMJ Innov

View full text Add to dashboard Cite

Cervical incompetence represents a controversial problem for the modern obstetrician. Treatment modalities since its description have changed with time. Shirodkar and McDonald cerclage techniques have remained the mainstay in the treatment of women with incompetent cervices performed either electively or emergently. The most feared complication of an emergency cervical cerclage is the rupture of membranes during the procedure, especially when the cervix is wide open and the membranes are protruding. To decrease that complication, some methods to reduce the prolapsed membranes have been used: filling the bladder with 0.45% saline solution through a Foley catheter, performing an amniocentesis to decrease intra-amniotic pressure and subsequent reduction of the prolapsed membranes as well as the use of balloons to push the membranes back into the uterus before the placement of a suture. Nevertheless, the introduction of such a sharp instrument like a needle in order to place the suture is a very risky step. Lately, a silicone pessary has also been used to perform cerclages but with disparate results. We present the successful use of an innovative method in 3 patients with cervical incompetence who presented with pregnancies <24 weeks and cervical effacement with protruding membranes into the vagina.

show abstract

“…A meta-analysis published in 2015 (n = 772 women from 11 studies, n = 496 underwent emergency cerclage placement, n = 276 were managed expectantly) found a significant prolongation of pregnancy and reduction of perinatal mortality after placement of an emergency cerclage for cervical dilation (duration of pregnancy: plus 5.4 weeks, perinatal mortality reduced from 58.5 % to 29.1 %) [42]. The administration of indomethacin and cefazolin increased the percentage of women who did not give birth within the following 4 weeks (92.3 vs. 62.5 %) [43].…”

Section: Emergency Cerclagementioning

confidence: 99%

Prevention and Therapy of Preterm Birth. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry Number 015/025, February 2019) – Part 2 with Recommendations on the Tertiary Prevention of Preterm Birth and the Management of Preterm Premature Rupture of Membranes

Berger

Abele

Bahlmann

et al. 2019

Geburtshilfe Frauenheilkd

View full text Add to dashboard Cite

Aims This is an official guideline of the German Society for Gynecology and Obstetrics (DGGG), the Austrian Society for Gynecology and Obstetrics (ÖGGG) and the Swiss Society for Gynecology and Obstetrics (SGGG). The aim of this guideline is to improve the prediction, prevention and management of preterm birth based on evidence obtained from recently published scientific literature, the experience of the members of the guideline commission and the views of self-help groups. Methods The members of the participating medical societies and organizations developed Recommendations and Statements based on the international literature. The Recommendations and Statements were adopted following a formal consensus process (structured consensus conference with neutral moderation, voting done in writing using the Delphi method to achieve consensus). Recommendations Part 2 of this short version of the guideline presents Statements and Recommendations on the tertiary prevention of preterm birth and the management of preterm premature rupture of membranes.

show abstract

Indomethacin and Antibiotics in Examination-Indicated Cerclage

Abstract: I.

Cited by 57 publications

References 11 publications

Cerclage for sonographic short cervix in singleton gestations without prior spontaneous preterm birth: systematic review and meta‐analysis of randomized controlled trials using individual patient‐level data

Cerclage for sonographic short cervix in singleton gestations without prior spontaneous preterm birth: systematic review and meta‐analysis of randomized controlled trials using individual patient‐level data

Non-invasive emergent cerclage using a plastic sling: case series

Prevention and Therapy of Preterm Birth. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry Number 015/025, February 2019) – Part 2 with Recommendations on the Tertiary Prevention of Preterm Birth and the Management of Preterm Premature Rupture of Membranes

Contact Info

Product

Resources

About