Successful experience with rescue cerclage for critical isthmicocervical insufficiency


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Resumo

Background: Preterm birth (PB) is one of the leading sociomedical problems in obstetrics, despite the ongoing large-scale prevention programs, including those implemented at national and international levels. The prognostic manifestation of spontaneous PB is isthmicocervical insufficiency (ICI) that occurs subclinically in some cases and, when its diagnosis is delayed or its manifestation is late, requires emergency measures that are rescue cerclage (emergency or salvage cerclage). Case report: A pregnant woman with a family obstetric history underwent surgical correction of critical ICI within the borderline period, which in combination with adequately chosen medical therapy and subsequent insertion of an unloading obstetric pessary, as well as carefully monitoring the vaginal microbiota against infections, made it possible to prolong the pregnancy to full term. Conclusion: The timely diagnosis of ICI makes it possible to implement a whole range of preventive measures in a planned manner after the necessary pre-examination; however, a rescue cerclage can be carried out as the only possible salvage measure aimed at prolonging pregnancy and improving perinatal outcomes in a number of cases due to the clinical scenario, with the surgeon’s sufficient experience and the capabilities of an obstetric hospital.

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Sobre autores

Zulfiya Khodzhaeva

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology Ministry of Health of the Russian Federation

Email: zkhodjaeva@mail.ru
Dr. Med. Sci., Professor, Deputy Director for Research of Obstetrics Institute of the Institution (Department of Obstetrics) 117997, Russia, Moscow, Ac. Oparin str., 4

Ksenia Gorina

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology Ministry of Health of the Russian Federation

Email: k_gorina@oparina4.ru
Junior Researcher the Department of Pregnancy Pathology 117997, Russia, Moscow, Ac. Oparin str., 4

Maria Iurova

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology Ministry of Health of the Russian Federation

Email: m_yurova@oparina4.ru
PhD student of the Department of Obstetrics and Gynecology 117997, Russia, Moscow, Ac. Oparin str., 4

Kamilla Muminova

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology Ministry of Health of the Russian Federation

Email: k_muminova@oparina4.ru
PhD, Junior Researcher the Department of Pregnancy Pathology 117997, Russia, Moscow, Ac. Oparin str., 4

Madina Oshkhunova

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology Ministry of Health of the Russian Federation

Email: m_ashunova@oparina4.ru
PhD student 117997, Russia, Moscow, Ac. Oparin str., 4

Nataly Klimenchenko

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology Ministry of Health of the Russian Federation

Email: n_klimenchenko@oparina4.ru
PhD, Senior Researcher the Department of Pregnancy Pathology 117997, Russia, Moscow, Ac. Oparin str., 4

Bibliografia

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