Management of Patients With Cervical Insufficiency

Levakov, S A; Боровкова, Е И; Шешукова, Н. А.; Borovkov, I. M.

doi:10.17749/2313-7347.2016.10.2.064-069

Cited by 4 publications

(1 citation statement)

References 3 publications

(4 reference statements)

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“…Среди многочисленных факторов, провоцирующих преждевременные роды, особое место занимает истмико-цервикальная недостаточность (ИЦН). При ее выявлении после 24 недель беременности методом выбора является назначение микронизированного прогестерона и установка акушерского разгружающего пессария [8]. Важная роль в возникновении преждевременных родов отводится также инфекции, в том числе бактериальному вагинозу [3,6].…”

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Evaluation of the Children Health Status, That Born in Women With Cervical Incompetence and the Threat of Pretern Birth in the Conditions of the Crimean Republican Perinatal Center

Babich¹,

Babich²,

Sadovaya³

2018

Zdor. obraz. XXI veke (Ž. naučn. statej)

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Evaluation of the Children Health Status, That Born in Women With Cervical Incompetence and the Threat of Pretern Birth in the Conditions of the Crimean Republican Perinatal Center

Babich¹,

Babich²,

Sadovaya³

2018

Zdor. obraz. XXI veke (Ž. naučn. statej)

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Etiologic, diagnostic, and management aspects of patients with isthmic-cervical insufficiency

Yashchuk

Yakovleva²,

Мусин³

et al. 2023

V.F.Snegirev Archives of Obstetrics and Gynecology

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Isthmic-cervical insufficiency (ICI) is one of the main causes of recurrent miscarriage, leading to an increase in perinatal mortality rates and a deterioration of womens reproductive health. There are currently several methods for diagnosing ICI during pregnancy. In the non-pregnant state, its diagnosis is mainly made retrospectively based on a history of preterm birth due to shortening of the cervix. The main treatment for ICI during pregnancy is cervical cerclage. Despite the well-established technique, this surgical intervention is not always effective for prolonging pregnancy and is associated certain pregnancy risks, including uterine contractions, bleeding, and infection. Cases of cervical rupture after suturing have also been reported, which can ultimately lead to miscarriage or preterm delivery. There have been repeated cases of pregnancy loss in women even after the timely detection of ICI and surgical treatment, suggesting that these women are at risk of miscarriage in the future. For such patients, it is necessary to develop an examination algorithm to identify the various aspects of their cervical insufficiency and treatment at the pregravid stage.

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Prevention and treatment of bacterial vaginosis in pregnant women with isthmic-cervical insufficiency

Романенко

Суліменко

2020

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Purpose of the study was to evaluate the effectiveness of clindamycin in combination with metronidazole and miconazole in complex therapy in pregnant women suffering from vaginal dysbiosis with ischemic-cervical insufficiency with threat of premature birth, which used an unloading obstetric pessary.Materials and methods. 100 pregnant women with bacterial vaginosis in the III trimester of pregnancy with isthmic-cervical insufficiency, threat of premature birth and using of an obstetric pessary were examined. 50 women of group I (comparison) received therapy according to the orders of the Ministry of Health of Ukraine, and 50 women of group II (main) used the treatment and preventive measures proposed by study authors, which included Banbact® suppositories for 3 days, and then Gynex® Forte complex drug for 7 days, after which a probiotic of 7 days was prescribed.Results of the study. The clinical effect of treatment in main group was achieved in 100% of cases. The amniotest was negative in all cases after treatment. In both groups was a slight shift to the alkaline side of the vaginal contents (pH 5.0–5.5), in the comparison group 2.5 times more often than in the main one. A significant decrease in the vaginal pH was observed in persons of group II after treatment at 37–38 weeks of pregnancy, no increase in pH >5.5 was detected; pH shift to the alkaline side was observed 3.5 times more often in group I.Most pregnant women in both groups achieved normocenosis after treatment. However, in group I a moderately expressed leukocyte reaction, the prevalence of leukocytes over epithelial cells, and a decrease in normal vaginal flora were noted 2.4 times more often (p <0.05). In 10.0% of pregnant women in group I single spores and pseudo mycelium of fungi, coccal or mixed flora were revealed against the background of a moderate leukocyte reaction (p <0.05).A pronounced leukocyte reaction was retained in 6 (12.0%) women of group II at 37–38 weeks, accompanied by a delay in the fetus development. Mixed flora persisted 3.7 times more often in women of group I. 22 species of microorganisms were identified in group I in the third trimester, while in pregnant women of group II – 14 species.Conclusions. The study revealed the high efficiency of complex treatment for bacterial vaginosis and normalization of the genital tract microflora in the third trimester in pregnant women with isthmic-cervical insufficiency. This helped to reduce the frequency of the threat of abortion, development of placental insufficiency, and delayed fetal development. The clinical efficacy of Banact® and Ginex® Forte was combined with their good tolerance; therefore these drugs are safe during pregnancy, which allows them to be used in practical obstetrics.

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Management of Patients With Cervical Insufficiency

Cited by 4 publications

References 3 publications

Evaluation of the Children Health Status, That Born in Women With Cervical Incompetence and the Threat of Pretern Birth in the Conditions of the Crimean Republican Perinatal Center

Evaluation of the Children Health Status, That Born in Women With Cervical Incompetence and the Threat of Pretern Birth in the Conditions of the Crimean Republican Perinatal Center

Etiologic, diagnostic, and management aspects of patients with isthmic-cervical insufficiency

Prevention and treatment of bacterial vaginosis in pregnant women with isthmic-cervical insufficiency

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