Menu

A+ A A-

Download article

DOI: https://doi.org/10.22263/2312-4156.2019.6.37

Mitskevich K.A., Divakova T.S.
The effectiveness of using polyester tape for the correction of cervical insufficiency in pregnant women
Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus

Vestnik VGMU. 2019;18(6):37-42.

Abstract.
Objectives. To make a comparative assessment of the effectiveness and safety of the use for the correction of cervical insufficiency (CI) during pregnancy of the vaginal cerclage with polyester tape and suture material from 2 nylon threads.
Material and methods. This study included 28 pregnant women with CI who had undergone vaginal cerclage: in the 1st main group (12 patients) polyester tape was used, in the 2nd control group (16 patients) – suture material from 2 nylon threads. Pregnancy and childbirth outcomes were evaluated on the basis of clinical, laboratory, instrumental and statistical methods.
Results. Patients of groups I and II were comparable in age and parity. Preventive, planned and urgent vaginal cerclage was performed. Intraoperative bleeding and suture cutting were observed only in the control group: in 1 (7.1%) and 2 (14.3%) pregnant women; the frequency of abortion after cerclage in groups I and II was 2 (16.7%) and 3 (21.9%) (p=0.848) cases, respectively. The termination of pregnancy at 28-33 weeks of gestation occurred in 1 (8.3%) patient from group I and 3 (21.9%) from group II (p=0.706); at 34-36 weeks of gestation in 5 (41.7%) and 6 (42.9%) (p=0.737); at 37 and more weeks of gestation in 6 (50.0%) and 5 (35.7%) (p=0.737) patients, respectively. 7 (58.9%) children from group I and 7 (50.0%) from group II (p=0.976) were discharged from the maternity home.
Conclusions. The vaginal cerclage allows to prolong pregnancy up to a period of 34 weeks of gestation and more in 78.6% of cases, up to 37 weeks and more in 39.3% of cases; the use of polyester tape for the correction of CI showed comparable efficiency with that of nylon; the safety of the polyester tape use has been confirmed by the absence of cases of intraoperative bleeding, suture cutting, simplicity and convenience of cerclage applying.
Key words: cervical insufficiency, cerclage, polyester tape.

References

1. Recurrent Pregnancy Loss guideline European Society of Human Reproduction and Embryology. Available from: https://www.eshre.eu/Guidelines-and-Legal/Guidelines/Recurrent-pregnancy-loss [Accessed 01th Dec 2019].
2. American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins-Obstetrics. Practice Bulletin No. 171: Management of Preterm Labor. Obstet Gynecol. 2016 Oct;128(4):e155-64. doi: http://dx.doi.org/10.1097/AOG.0000000000001711
3. Brown R, Gagnon R, Delisle M-F. Cervical insufficiency and cervical cerclage. J Obstet Gynaecol Can. 2013 Dec;35(12):1115-27.
4. Istmico-Cervical insufficiency: clinical guidelines (treatment protocol) № 15-4/10/2-7991: utv M-vom zdravookhraneniia Ros Federatsii 28.12.2018 g. Moscow, RF; 2018. 42 р. (In Russ.)
5. Perinatal Practice Guideline Cervical insufficiency and cerclage. Available from: https://www.sahealth.sa.gov.au/wps/wcm/connect/76cd76004ee1f7c6b183bdd150ce4f37/Cervical-insufficiency-cerclage-WCHN-PPG-22052012.pdf?MOD=AJPERES [Accessed 01th Dec 2019].
6. Yuka Sato, Nobuhiro Hidaka, Takahiro Nakano, Saki Kido, Masahiro Hachisuga, Yasuyuki Fujita, et al. Efficacy of an Emergency Cervical Cerclage Using Absorbable Monofilament Sutures. J Pregnancy. 2018;2018:ID 4049792. doi: http://dx.doi.org/10.1155/2018/4049792
7. Israfil-Bayli F, Toozs-Hobson P, Lees C, Slack M, Daniels J, Vince A, et al. Cervical cerclage and type of suture material: a survey of UK consultants' practice. J Matern Fetal Neonatal Med. 2014 Oct;27(15):1584-8. doi: http://dx.doi.org/10.3109/14767058.2013.870551
8. Berghella V, Szychowski JM, Owen J, Hankins G, Iams JD, Sheffield JS, et al. Suture type and ultrasound-indicated cerclage efficacy. J Matern Fetal Neonatal Med. 2012 Nov;25(11):2287-90. doi: http://dx.doi.org/10.3109/14767058.2012.688081
9. Jarde A, Lewis-Mikhael AM, Dodd JM, Barrett J, Saito S, Beyene J, et al. The More, the Better? Combining Interventions to Prevent Preterm Birth in Women at Risk: a Systematic Review and Meta-Analysis. J Obstet Gynaecol Can. 2017 Dec;39(12):1192-1202. doi: http://dx.doi.org/10.1016/j.jogc.2017.07.007

Information about authors:
Mitskevich K.A. – Candidate of Medical Sciences, associate professor of the Chair of Obstetrics & Gynecology of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University;
Divakova T.S. – Doctor of Medical Sciences, professor, head of the Chair of Obstetrics & Gynecology of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University.

Correspondence address: Republic of Belarus, 210009, Vitebsk, 27 Frunze ave., Vitebsk State Order of Peoples’ Friendship Medical University, Chair of Obstetrics & Gynecology of the Faculty for Advanced Training & Retraining. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Katsiaryna A. Mitskevich.

Поиск по сайту