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Emergency cerclage. A successful challenge despite advanced second trimester cervical dilatation
Khaled B Soliman1, Mohamed M Abbas, Nisreen K Aref
1Department of Obstetrics and Gynecology, King Abdul-Aziz Specialist Hospital, PO Box 10127, Taif, Kingdom of Saudi Arabia. khaled_b_s@yahoo.com
Saudi Medical Journal
|April 7, 2006
Summary
Emergency cerclage may be considered even in cases of advanced cervical incompetence with fully dilated cervix and prolapsed membranes. This intervention can lead to favorable pregnancy outcomes, even when miscarriage seems inevitable.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
Background:
- Cervical incompetence is a significant cause of mid-trimester pregnancy loss.
- Timely intervention is crucial for managing advanced cervical incompetence.
Observation:
- A 22-year-old primigravida at 20 weeks gestation presented with abdominal pain and diagnosed cervical incompetence.
- The patient had a fully dilated cervix with bulging membranes and prolapsed lower limbs.
Findings:
- An emergency cerclage was successfully performed 24 hours after admission.
- The patient achieved a normal delivery at 38 weeks gestation with a favorable outcome.
Implications:
- Emergency cerclage can be a viable option in advanced cervical incompetence, even with significant cervical dilation and membrane prolapse.
- This case suggests that cerclage may be considered even when miscarriage appears imminent, potentially altering the course of pregnancy.
- Further research into the efficacy and indications for emergency cerclage in severe cervical incompetence is warranted.
