Ann Infertil Reprod Endocrinol | Volume 1, Issue 1 | Research Article | Open Access
Z Kilani*, M Hamarsheh, S Kilani, Z Rubaie and L Haj Hassan
Department of Obstetrics and Neonatology, The Farah Hospital, Jordan
Fulltext PDFObjective: Introducing a novel method of dealing with bulging fetal membranes in the mid trimester using Mersilene tape with favorable obstetric and neonatal outcome in terms of prolongation of pregnancy, fetal viability and neonatal survival. Material and
Methods: Analysis of twenty-four pregnancies complicated by bulging membranes in mid-trimester during 26-year study period including 14 singleton, 8 twin and 2 triple pregnancies. All cases of cervical dilatation and bulging of membranes were diagnosed by ultrasound scan and speculum examination. Patients have received perioperative antibiotic, Indomethacin and Progesterone. Emergency cervical cerclage was accomplished using Mersilene 5 mm tape after pulling the margins of the dilated cervix over the bulging fetal membranes without having to touch or push the membranes and without doing amnioreduction. The exclusion criteria were rupture of membranes, uterine contractions, bleeding, chorioamnionitis and fetal anomalies.
Results: Emergency cervical cerclage on 24 patients with bulging membranes in mid-trimester. The pregnancies were prolonged by 9.4 ± 5.6 weeks in the singleton group, 8 ± 5.6 weeks in the twin group, and 8 ± 4 weeks in the triplet group. Fetal viability was achieved in 20 patients (83.3%), and the neonatal survival was 96.6%. Conclusions: Favorable obstetric outcome can be achieved with bulging membranes in midtrimester pregnancies using the novel method. There is no need to push the bulging membranes.
Novel method; Emergency cerclage; Cervical incompetence; Multiple pregnancy; Bulging fetal membranes
Z Kilani, M Hamarsheh, S Kilani, Z Rubaie, L Haj Hassan. A Novel Technique of Emergency Cerclage for Mid Trimester Cervical Dilatation. Ann Infert Rep Endocrin. 2018;1(1):1008.