Experience of laparoscopic transabdominal cerclage for correcting cervical incompetence

Capa

Citar

Texto integral

Acesso aberto Acesso aberto
Acesso é fechado Acesso está concedido
Acesso é fechado Acesso é pago ou somente para assinantes

Resumo

Relevance: The significance and relevance of the issue of miscarriage due to cervical incompetence have been determined. According to Order 1130n and relevant clinical guidelines, the main methods for treating cervical incompetence are the combined use of progestogens in combination with obstetric pessaries or surgical correction. The article presents the experience of using laparoscopic transabdominal cerclage (LTC) in K.A. Gutkin Republican Perinatal Center, Petrozavodsk, Russia. LTC can be considered as a method of choosing the correction of cervical incompetence in patients with repeated cases of termination of pregnancy.

Case report: This is a clinical observation of a favorable termination of pregnancy after LTC in a patient with a congenital abnormality of the reproductive apparatus and habitual miscarriage due to cervical incompetence. Surgical treatment was performed at the preconception stage by applying the tape “Cervix-Set” to the uterine isthmus. The patient became pregnant after ART, cryopreservation. During pregnancy, the patient was admitted to an obstetric hospital three times as there was a threat of pregnancy termination. The length of the closed part of the cervix remained within normal values during cervicometry. The pregnant woman had a cesarean section to deliver her baby at 36 weeks 1 day gestation due to premature rupture of membranes.

Conclusion: Given the limited experience of managing patients with LTC, it is necessary to conduct further studies on the effectiveness and safety of this operation.

Texto integral

Acesso é fechado

Sobre autores

Tatiana Ldynina

K.A. Gutkin Republican Perinatal Center

Autor responsável pela correspondência
Email: scipeople@mail.ru

obstetrician-gynecologist at the Obstetrics Department

Rússia, Petrozavodsk

Oleg Pogodin

K.A. Gutkin Republican Perinatal Center

Email: scipeople@mail.ru

obstetrician-gynecologist, Head of the Gynecology Department

Rússia, Petrozavodsk

Alexander Ivshin

Petrozavodsk State University

Email: scipeople@mail.ru
ORCID ID: 0000-0001-7834-096X

PhD, Associate Professor, Head of the Department of Obstetrics and Gynecology, Dermatovenerology of the Medical Institute

Rússia, Petrozavodsk

Elena Shakurova

K.A. Gutkin Republican Perinatal Center

Email: scipeople@mail.ru

obstetrician-gynecologist, Deputy Chief Physician for Medical Affairs

Rússia, Petrozavodsk

Bibliografia

  1. Калелов А., Гасанова Э. Диагностика и коррекция истмико-цервикальной недостаточности. Journal of Science. Lyon. 2021; 24: 30-33. [Kalelov A., Gasanova E. Diagnostics and correction of isthmic-cervical insufficiency. Journal of Science. Lyon. 2021; 24: 30-3. (in Russian)].
  2. Борщева А.А., Перцева Г.М., Алексеева Н.А. Истмико-цервикальная недостаточность в структуре причин невынашивания беременности. Медицинский вестник Юга России. 2020; 11(1): 34-40. [Borschova A.A., Pertceva G.M., Alekseeva N.A. Isthmic-cervical insufficiency in the structure of the reasons for mortaring of pregnancy. Medical Herald of the South of Russia. 2020; 11(1): 34-40. (in Russian)]. https://dx.doi.org/10.21886/2219-8075-2020-11-1-34-40.
  3. Guzman E.R., Mellon R., Vintzileos A.M., Ananth C.V., Walters C., Gipson K. Relationship between en-docervical canal length between 15-24 weeks gestation and obstetric history. J. Matern. Fetal Med. 1998; 7(6): 269-72. https://dx.doi.org/10.1002/(SICI)1520-6661(199811/12)7:6<269::AID-MFM3>3.0.CO;2-4.
  4. Ищенко А.И., Борисова Н.И., Землина Н.С., Гончаренко Н.В., Хохлова И.Д., Джибладзе Т.А., Александров Л.С., Горбенко О.Ю., Азарова О.Ю., Гадаева И.В., Будникова К.А., Асамбаева А. Новая методика хирургической коррекции истмико-цервикальной недостаточности. Вопросы гинекологии, акушерства и перинатологии. 2022; 21(6): 120-4. [Ishchenko A.I., Borisova N.I., Zemlina N.S., Goncharenko N.V., Khokhlova I.D., Dzhibladze T.A., Aleksandrov L.S., Gorbenko O.Yu., Azarova O.Yu., Gadaeva I.V., Budnikova K.A., Asambaeva A. New technique for surgical correction of isthmic-cervical insufficiency. Gynecology, Obstetrics and Perinatology. 2022; 21(6): 120-4. (in Russian)]. https:// dx.doi.org/10.20953/1726-1678-2022-6-120-124.
  5. Министерство здравоохранения Российской Федерации. Клинические рекомендации. Истмико-цервикальная недостаточность. 2021. [Ministry of Health of the Russian Federation. Clinical guidelines. Isthmico-cervical insufficiency. 2021. (in Russian)].
  6. Shirodkar V.N. A new method of operative treatment for habitual abortions in the second trimester of pregnancy. Antiseptic. 1955; 52: 299-300. Available at: https://scholar.google.com/scholar_lookup?hl=en&volume=52&publication_year=1955&pages=299-300&journal=Antiseptic&author=Shirodkar+V.N.&title=A+new+method+of+operative+treatment+for+habitual+abortions+in+the+second+trimester+of+pregnancy.
  7. McDonald I.A. Suture of the cervix for inevitable miscarriage. J. Obstet. Gynaecol. Br. Emp. 1957; 64(3): 346-50. https://dx.doi.org/10.1111/j.1471-0528.1957.tb02650.x.
  8. Ades A., Dobromilsky K.C., Cheung K.T., Umstad M.P. Transabdominal cervical cerclage: laparoscopy versus laparotomy. J. Minim. Invasive Gynecol. 2015; 22(6): 968-73. https://dx.doi.org/10.1016/j.jmig.2015.04.019.
  9. Доброхотова Ю.Э., ред. Истмико-цервикальная недостаточность. Методические рекомендации ФГБОУ ВО РНИМУ им. Н.И. Пирогова Минздрава России; 2018. [Dobrokhotova Yu.E., ed. Isthmico-cervical insufficiency. Methodological recommendations of the Pirogov Russian National Research Medical University of the Ministry of Health of Russia; 2018. (in Russian)].
  10. Ades A., Parghi S., Aref-Adib M. Laparoscopic transabdominal cerclage: Outcomes of 121 pregnancies. Aust. N. Z. J. Obstet. Gynaecol. 2018; 58(6): 606-11. https://dx.doi.org/10.1111/ajo.12774.
  11. Olsen S., Tobiassen T. Transabdominal isthmic cerclage for the treatment of incompetent cervix. Acta Obstet. Gynecol. Scand. 1982; 61(5): 473-5. https://dx.doi.org/10.3109/00016348209156593.
  12. Benson R.C., Durfee R.B. Transabdominal cervico uterine cerclage during pregnancy for the treatment of cervical incompetency. Obstet. Gynecol. 1965; 25: 145-55.
  13. Novy M.J. Transabdominal cervicoisthmic cerclage: A reappraisal 25 years after its introduction. Am. J. Obstet. Gynecol. 1991; 164(6): 1635-42. https://dx.doi.org/10.1016/0002-9378(91)91448-6.
  14. Scibetta J.J., Sanko S.R., Phipps W.R. Laparoscopic transabdominal cervicoisthmic cerclage. Fertil. Steril. 1998; 69(1): 161-3. https:// dx.doi.org/10.1016/s0015-0282(97)00444-5.
  15. Lesser K.B., Childers J.M., Surwit E.A. Transabdominal cerclage: a laparoscopic approach. Obstet. Gynecol. 1998; 91(5 Pt 2): 855-6. https://dx.doi.org/10.1016/s0029-7844(97)00655-8.
  16. Burger N.B., Einarsson J.I., Brölmann H.A., Vree F.E., McElrath T.F., Huirne J.A. Preconceptional laparoscopic abdominal cerclage: a multicenter cohort study. Am. J. Obstet. Gynecol. 2012; 207(4): 273.e1-12. https://dx.doi.org/10.1016/j.ajog.2012.07.030.
  17. Tulandi T., Alghanaim N., Hakeem G., Tan X. Pre and post-conceptional abdominal cerclage by laparoscopy or laparotomy. J. Minim. InvasiveGynecol. 2014; 21(6): 987-93. https://dx.doi.org/10.1016/j.jmig.2014.05.015.
  18. Ades A., Aref-Adib M., Parghi S., Hong P. Laparoscopic transabdominal cerclage in pregnancy: A single centre experience. Aust. N. Z. J. Obstet. Gynaecol. 2019; 59(3): 351-5. https://dx.doi.org/10.1111/ajo.12848.
  19. Demirel C., Goksever Celik H., Tulek F., Kucukdemir B., Gokalp D., Ergin T., Lembet A. Fertility outcomes after preconceptional laparoscopic abdominal cerclage for second-trimester pregnancy losses. Eur. J. Obstet. Gynecol. Reprod. Biol. 2021; 257: 59-63. https://dx.doi.org/10.1016/j.ejogrb.2020.12.012.
  20. Clark N.V., Einarsson J.I. Laparoscopic abdominal cerclage: a highly effective option for refractory cervical insufficiency. Fertil. Steril. 2020; 113(4): 717-22. https://dx.doi.org/10.1016/j.fertnstert.2020.02.007.
  21. Ades A., Hawkins D.P. Laparoscopic transabdominal cerclage and subsequent pregnancy outcomes when left in situ. Obstet. Gynecol. 2019; 133(6): 1195-8. https://dx.doi.org/10.1097/AOG.0000000000003263.
  22. Hulshoff C.C., Hofstede A., Inthout J., Scholten R.R., Spaanderman M.E.A., Wollaars H., van Drongelen J. The effectiveness of transabdominal cerclage placement via laparoscopy or laparotomy: a systematic review and meta-analysis. Am. J. Obstet. Gynecol. MFM. 2023; 5(1): 100757. https://dx.doi.org/10.1016/j.ajogmf.2022.100757.
  23. Tian S., Zhao S., Hu Y. Comparison of laparoscopic abdominal cerclage and transvaginal cerclage for the treatment of cervical insufficiency: a retrospective study. Arch. Gynecol. Obstet. 2021; 303(4): 1017-23. https://dx.doi.org/10.1007/s00404-020-05893-9.
  24. Shennan A., Chandiramani M., Bennett P., David A.L., Girling J., Ridout A. et al. MAVRIC: a multicenter randomized controlled trial of transabdominal vs transvaginal cervical cerclage. Am. J. Obstet. Gynecol. 2020; 222(3): 261.e1-261.e9. https://dx.doi.org/10.1016/j.ajog.2019.09.040.

Arquivos suplementares

Arquivos suplementares
Ação
1. JATS XML
Baixar
2. Figure. Frequency of preterm births in GBUZ "RPC"

Baixar (82KB)
Metadados

Declaração de direitos autorais © Bionika Media, 2024

Este site utiliza cookies

Ao continuar usando nosso site, você concorda com o procedimento de cookies que mantêm o site funcionando normalmente.

Informação sobre cookies