1/13. Management of cervical cerclage after preterm premature rupture of membranes.The optimal management of preterm premature rupture of membranes (PPROM) in a patient with a cerclage is controversial. The issues are whether the latency period between rupture of membranes and delivery is decreased if the cerclage is removed and whether there is an increased rate of maternal or neonatal infection if the cerclage is kept in place. The data are sparse in directing management of women with prophylactic cerclages placed earlier in their pregnancies who rupture membranes. Latency seems to be increased if the cerclage is kept in place, but maternal and neonatal infectious morbidity is increased also. In women at early gestational ages, keeping the cerclage in place may be warranted until labor ensues. In more advanced gestations, it seems preferable to immediately remove the cerclage upon diagnosis of PPROM.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
2/13. Preterm premature rupture of membranes in a patient with the hypermobility type of the ehlers-danlos syndrome. A case report.OBJECTIVES: This report wants to focus on the risk of severe prematurity in patients with the hypermobility type of the ehlers-danlos syndrome (EDS), a heritable disorder of connective tissue. Although various obstetrical complications have been reported in patients with EDS, most reports specifically comment on the severe complications in patients with the vascular type of EDS, including uterine and arterial rupture. pregnancy outcome in patients presenting the hypermobility type of EDS is poorly documented. CASE: A 33-year-old nullipara was referred for preconceptual genetic counseling with a history of easy bruising, generalized joint hypermobility and chronic arthralgia and myalgia. The diagnosis of the hypermobility type of EDS was confirmed on clinical examination. During her first pregnancy, she underwent a prophylactic McDonald cerclage at 14 weeks' gestation. Premature rupture of membranes occurred at 23 weeks' gestation. A female infant was delivered at 26 weeks and died 3 h after birth. Electron-microscopic examination showed collagen fibre abnormalities in the fetus' skin, which were compatible with the diagnosis of EDS. CONCLUSIONS: patients with the hypermobility type of EDS can have an increased risk for pregnancy complications, including prematurity due to cervical incompetence and to premature rupture of membranes. We therefore demand the clinician's alertness for possible signs of this underdiagnosed type of EDS and recommend the collaboration between the obstetrician and the medical geneticist in the obstetrical management of these patients.- - - - - - - - - - ranking = 0.85714285714286keywords = membrane (Clic here for more details about this article) |
3/13. Laparoscopic removal of a transabdominal cervical cerclage.Cervical incompetence has been acknowledged as a significant entity predisposing patients to second-trimester miscarriage. Various surgical techniques and approaches have been used in an attempt to prolong pregnancy and improve perinatal outcome. These include transvaginal and transabdominal cervical cerclage. Some patients require the placement of a transabdominal cervicoisthmic cerclage. Should the cerclage fail or the patient have preterm premature rupture of membranes, removal of the cerclage may be necessary. As a result the application of laparoscopy for the management of cervicoisthmic cerclage removal has been advocated in an effort to limit surgical complications. We report a case of laparoscopic removal of a transabdominally placed cervical cerclage in a 32-year-old woman at 16 weeks' gestation with preterm premature rupture of membranes and inevitable miscarriage. laparoscopy appeared to be a safe and effective means of managing the removal of this transabdominally placed cervicoisthmic cerclage.- - - - - - - - - - ranking = 0.28571428571429keywords = membrane (Clic here for more details about this article) |
4/13. Emergency cerclage. A successful challenge despite advanced second trimester cervical dilatation.A 22-year-old, primigravida /- 20 weeks of gestation presented with abdominal pain. She was diagnosed as a case of advanced cervical incompetence. We carried out an emergency cerclage after 24 hours from her admission, while the cervix was fully dilated with bulging of the membranes and prolapse of both lower limbs in the middle of the vagina. She delivered normally at 38 weeks of gestation with favorable outcomes. We believe that even if miscarriage is inevitable, the so called emergency cerclage might be considered.- - - - - - - - - - ranking = 0.14285714285714keywords = membrane (Clic here for more details about this article) |
5/13. Ultrasonographic diagnosis of incompetent cervix. A case report.The ultrasonographic findings of an incompetent cervix, the protrusion of the lower pole of the fetal membranes through the dilated internal os, may precede physical changes in the cervix. The symptoms at that time may be nonspecific. As this case report indicates, we believe that action--either close observation, conservative treatment or surgical intervention--should follow the detection of this condition.- - - - - - - - - - ranking = 0.14285714285714keywords = membrane (Clic here for more details about this article) |
6/13. prenatal diagnosis of candida albicans chorioamnionitis.The use of diagnostic amniocentesis has been proposed for the evaluation of patients with clinical suspicion of chorioamnionitis, such as those with premature rupture of membranes and premature labor. We describe a patient in whom the diagnosis of Candida chorioamnionitis was made after diagnostic amniocentesis with the assistance of a simple and rapidly performed potassium hydroxide smear.- - - - - - - - - - ranking = 0.14285714285714keywords = membrane (Clic here for more details about this article) |
7/13. Congenital incompetence of the cervical os: reduction of bulging membranes with a modified Foley catheter.A case is described of congenital incompetence of the cervix associated with pronounced bulging of the fetal membranes through the cervical os. The patient, a primigravida, presented at 25 weeks' gestation without any evidence of uterine activity. She had no past history of cervical surgery or disease. The tip beyond the bulb of a size 22 Foley catheter was removed. We inflated the bulb progressively while applying sustained, gentle pressure to the bag of forewaters. Upon reducing the membranes to within the uterine cavity, we inflated the bulb of the catheter further with saline to a total volume of 25 cc. This procedure maintained the catheter within the uterine cavity and facilitated the insertion of a MacDonald cerclage in the region of the internal cervical os.- - - - - - - - - - ranking = 0.85714285714286keywords = membrane (Clic here for more details about this article) |
8/13. Maternal sepsis, uterine rupture and coagulopathy complicating cervical cerclage.A previously healthy woman with a Shirodkar cerclage for cervical incompetence had a spontaneous rupture of the membranes at the 37th week of pregnancy. Three days later after a short period of weak labor pains, she developed a severe sepsis, uterine rupture and coagulopathy leading to renal failure, beta-hemolytic streptococcus group B and peptostreptococcous could be cultured from the amniotic fluid immediately after rupture of the membranes and from the uterus and placenta.- - - - - - - - - - ranking = 0.28571428571429keywords = membrane (Clic here for more details about this article) |
9/13. Ultrasound evaluation of sutures following cervical cerclage for incompetent cervix uteri.This prospective study was designed to determine whether it is possible to visualize cerclage suture material by ultrasound and to evaluate the clinical usefulness of ultrasound examination after cervical cerclage during pregnancy. Ultrasound examinations demonstrated suture material in all patients in this study. The 5-mm-wide Mersiline tape suture, used in the Shirodkar procedure, was easier to visualize by ultrasound than the no. 2 nylon suture used in the McDonald procedure. Ultrasound examination can be helpful in evaluating the location and effectiveness of the sutures and in detecting protrusion of the membranes beyond the sutures before it is clinically apparent. The sonographic demonstration of the relationship of the protruding membranes to the level of the sutures can be valuable in patient management.- - - - - - - - - - ranking = 0.28571428571429keywords = membrane (Clic here for more details about this article) |
10/13. Intracervical fibrin instillation as an adjuvant to treatment for second trimester rupture of membranes.We describe a pregnancy complicated by premature rupture of the membranes at 24 weeks. Delivery with successful outcome was postponed till 31 weeks by cerclage, ritodrine and intracervical instillation of fibrin.- - - - - - - - - - ranking = 0.71428571428571keywords = membrane (Clic here for more details about this article) |
| | Next -> |