Infant outcomes following midtrimester emergency cerclage in the presence of fully dilated cervix and prolapsing amniotic membranes into the vagina
JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE, cilt.29, sa.15, ss.2437-2441, 2016 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 29 Sayı: 15
- Basım Tarihi: 2016
- Doi Numarası: 10.3109/14767058.2015.1087495
- Dergi Adı: JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.2437-2441
- Anahtar Kelimeler: Cerebral palsy, emergency cerclage, neurodevelopmental outcome, preterm birth, rescue cerclage, PRETERM LABOR, CEREBRAL-PALSY, PREGNANCY, 2ND-TRIMESTER, INFECTION, COHORT, BIRTH
- Süleyman Demirel Üniversitesi Adresli: Evet
Özet
Objective: To investigate the morbidity of infants, whose delivery was prolonged by an emergency cervical cerclage (EC).Methods: Ante- and postnatal data on subsequent EC procedures performed between 14 and 28 weeks of gestation for advanced cervical dilatation with prolapsing of amniotic membranes at a single institution within a 5-year-period were retrieved.Results: We identified 21 fetuses from 18 pregnancies. Median gestational age [interquartile range, IQR] at EC and prolongation of pregnancy was 21.5 [15-26] weeks and 49.3 [24-92] days, respectively. There were 4 (19%) stillbirths, 3 (14%) neonatal deaths, and 1 (5%) infant death. Ten infants (59% of livebirths) were admitted to neonatal intensive care unit and hospitalized for a median period of 11 [6-66] d. Of the surviving fetuses (14/21, 66.7%), 9 (42.8%) were intact, whereas 3 (17.6% of livebirths) had cerebral palsy (CP), 1 was diagnosed with hypothyroidism, and another had growth failure at 12 months of follow-up.Conclusion: EC seems to be beneficial only in a subset of pregnancies presenting with full cervical dilatation accompanied by prolapsing amniotic membranes into the vagina, and there is a requirement for more objective selection criteria. Neonatal morbidity, especially neurodevelopmental disability should be discussed thoroughly prior to this procedure.