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Abdominal cerclage in twin pregnancy after radical surgical conization.

Kyvernitakis I, Lotgering F, Arabin B - Case Rep Obstet Gynecol (2014)

Bottom Line: Radical and repeated cone biopsies are associated with a high risk of spontaneous preterm birth.A history-indicated transabdominal cervicoisthmic cerclage was performed at 12 + 4/7 gestational weeks because of assumed cervicoisthmic insufficiency.Transabdominal cerclage in twin pregnancy has rarely been described, but it may be considered in case of extreme cervical shortening after radical cervical surgery, as it would in singleton pregnancy.

View Article: PubMed Central - PubMed

Affiliation: Department of Prenatal and Perinatal Medicine, Clara Angela Foundation, Koenigsallee 36, 14193 Berlin, Germany ; Department of Pre- and Perinatal Medicine, Center of Mother and Child, University Hospital of Giessen and Marburg, Philipps University of Marburg, Campus Marburg, Baldinger Straße 1, 35043 Marburg, Germany.

ABSTRACT
Radical and repeated cone biopsies are associated with a high risk of spontaneous preterm birth. A 30-year-old gravida 1 presented with a spontaneous dichorionic twin pregnancy. She had a history of two radical surgical conizations. By speculum examination, no cervical tissue was detected. A history-indicated transabdominal cervicoisthmic cerclage was performed at 12 + 4/7 gestational weeks because of assumed cervicoisthmic insufficiency. The pregnancy continued until 34 + 3/7 weeks when the patient developed preeclampsia indicating Cesarean delivery. Transabdominal cerclage in twin pregnancy has rarely been described, but it may be considered in case of extreme cervical shortening after radical cervical surgery, as it would in singleton pregnancy.

No MeSH data available.


Related in: MedlinePlus

Inner cervical length of 11.4 mm at 12 + 4/7 gestational weeks before abdominal cerclage (a) and at 20 weeks after the transabdominal cervicoisthmic cerclage. The Mersilene band is shown as an echogenic structure at the cervicoisthmic junction (C) and seemed to have increased the cervical length to 25 mm (not shown).
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fig1: Inner cervical length of 11.4 mm at 12 + 4/7 gestational weeks before abdominal cerclage (a) and at 20 weeks after the transabdominal cervicoisthmic cerclage. The Mersilene band is shown as an echogenic structure at the cervicoisthmic junction (C) and seemed to have increased the cervical length to 25 mm (not shown).

Mentions: A 30-year-old primigravida with dichorionic/diamniotic (DC/DA) twins was referred to our unit of Marburg University at 11 weeks of gestation. Three years before, the patient had been exposed to two radical surgical conizations because of severe cervical dysplasia and carcinoma in situ, which was only completely removed after a second conization. Speculum examination showed a blind vaginal top without cervix. Transvaginal sonography (TVS) at 12 weeks demonstrated a short inner cervical length of 11.4 mm (below the 3rd centile), without funneling (Figure 1(a)).


Abdominal cerclage in twin pregnancy after radical surgical conization.

Kyvernitakis I, Lotgering F, Arabin B - Case Rep Obstet Gynecol (2014)

Inner cervical length of 11.4 mm at 12 + 4/7 gestational weeks before abdominal cerclage (a) and at 20 weeks after the transabdominal cervicoisthmic cerclage. The Mersilene band is shown as an echogenic structure at the cervicoisthmic junction (C) and seemed to have increased the cervical length to 25 mm (not shown).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3926403&req=5

fig1: Inner cervical length of 11.4 mm at 12 + 4/7 gestational weeks before abdominal cerclage (a) and at 20 weeks after the transabdominal cervicoisthmic cerclage. The Mersilene band is shown as an echogenic structure at the cervicoisthmic junction (C) and seemed to have increased the cervical length to 25 mm (not shown).
Mentions: A 30-year-old primigravida with dichorionic/diamniotic (DC/DA) twins was referred to our unit of Marburg University at 11 weeks of gestation. Three years before, the patient had been exposed to two radical surgical conizations because of severe cervical dysplasia and carcinoma in situ, which was only completely removed after a second conization. Speculum examination showed a blind vaginal top without cervix. Transvaginal sonography (TVS) at 12 weeks demonstrated a short inner cervical length of 11.4 mm (below the 3rd centile), without funneling (Figure 1(a)).

Bottom Line: Radical and repeated cone biopsies are associated with a high risk of spontaneous preterm birth.A history-indicated transabdominal cervicoisthmic cerclage was performed at 12 + 4/7 gestational weeks because of assumed cervicoisthmic insufficiency.Transabdominal cerclage in twin pregnancy has rarely been described, but it may be considered in case of extreme cervical shortening after radical cervical surgery, as it would in singleton pregnancy.

View Article: PubMed Central - PubMed

Affiliation: Department of Prenatal and Perinatal Medicine, Clara Angela Foundation, Koenigsallee 36, 14193 Berlin, Germany ; Department of Pre- and Perinatal Medicine, Center of Mother and Child, University Hospital of Giessen and Marburg, Philipps University of Marburg, Campus Marburg, Baldinger Straße 1, 35043 Marburg, Germany.

ABSTRACT
Radical and repeated cone biopsies are associated with a high risk of spontaneous preterm birth. A 30-year-old gravida 1 presented with a spontaneous dichorionic twin pregnancy. She had a history of two radical surgical conizations. By speculum examination, no cervical tissue was detected. A history-indicated transabdominal cervicoisthmic cerclage was performed at 12 + 4/7 gestational weeks because of assumed cervicoisthmic insufficiency. The pregnancy continued until 34 + 3/7 weeks when the patient developed preeclampsia indicating Cesarean delivery. Transabdominal cerclage in twin pregnancy has rarely been described, but it may be considered in case of extreme cervical shortening after radical cervical surgery, as it would in singleton pregnancy.

No MeSH data available.


Related in: MedlinePlus