DIAGNOSIS AND RESULTS OF TREATMENTS FOR ISTHMIC-CERVICAL INCOMPETENCE

Objective.To study the clinical and diagnostic characteristics of isthmic-cervical incompetence (ICI) and to evaluate the efficiency of different methods for its correction. Subjects and methods. A study group comprised 296 pregnant women aged 18 to 40 years, who were diagnosed as having ICI; a control group included 20 pregnant women without ICI. The study was retrospective and prospective. It involved vaginal, ultrasound, Doppler, hormonal (testosterone, dehydroepiandrosterone sulfate) studies and examinations for urogenital infections and connective tissue dysplasia (CTD). Results. The risk factors for ICI are polymenorrhea (14.3%), changes in the menstrual cycle before antecedent pregnancy (18%), sexually transmitted infections (52.4%), miscarriages (17.9%), complicated previous pregnancies (55.8%), and CTD (42.2%) (p<0.05). Structural changes in the cervix uteri, such as its shortening, softening, centralization along the pelvis axis, or cervical dilation, which are characteristic for ICI, occur most frequently (52%) at 16-20 weeks’ gestation. Pregnancy after surgical correction of CI is more often accompanied by threatening miscarriage (87.9%) and that after medical correction is followed by the development of colpitis (26.7%) (p<0.05). The full-term baby birth rate after both correction methods for ICI is 93.3%.

isthmic-cervical incompetence, risk factors, surgical correction