scholarly journals Emergency Cervical Cerclage

2021 ◽  
Vol 10 (6) ◽  
pp. 1270 ◽  
Author(s):  
Magdalena Wierzchowska-Opoka ◽  
Żaneta Kimber-Trojnar ◽  
Bożena Leszczyńska-Gorzelak
Keyword(s):  
Premature Birth ◽  
Emergency Treatment ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Cervical Insufficiency ◽  
Second Trimester ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Cervical Cerclage ◽  
Preterm Premature Rupture

Despite the progress of medicine in the last decades, recurrent pregnancy loss, premature birth, and related complications are still a vast problem. The reasons for recurrent pregnancy loss and preterm delivery are diverse and multifactorial. One of the main reasons for these complications is cervical insufficiency, which means that the cervix is weak and unable to remain closed until the date of delivery. It manifests as painless softening and shortening of the cervix without contractions. The aim of the study was to review the available literature on rescue sutures, which are an emergency treatment in pregnancies with premature cervical dilatation and protrusion of the fetal membranes in the second trimester of pregnancy. This review confirms that emergency cerclage reduces the rate of preterm birth in patients with advanced cervical insufficiency. This procedure prolongs gestational age and improves the chances of survival of the newborn without increasing the risk of chorioamnionitis and preterm premature rupture of membranes.

scholarly journals Klebsiella pneumoniae Chorioamnionitis: An Underrecognized Cause of Preterm Premature Rupture of Membranes in the Second Trimester

2021 ◽  
Vol 9 (1) ◽  
pp. 96
Author(s):  
Maria Paola Bonasoni ◽  
Andrea Palicelli ◽  
Giulia Dalla Dea ◽  
Giuseppina Comitini ◽  
Paola Nardini ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Maternal Blood ◽  
Community Acquired Pneumonia ◽  
Etiologic Agent ◽  
Intestinal Lumen ◽  
Second Trimester ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Threatened Abortion

Klebsiella pneumoniae is a Gram-negative, rod-shaped bacterium, responsible for hospital and community acquired pneumonia, urinary tract and wound infections, and bloodstream dissemination. K. pneumoniae infection in pregnancy, leading to acute chorioamnionitis (AC), preterm premature rupture of membranes (PPROM) and early pregnancy loss in the second trimester, has been rarely reported. Herein, we present a case of K. pneumoniae AC that caused intrauterine fetal demise (IUFD) at 19 weeks + 5 days. The 36-year-old mother was admitted at 18 weeks + 1 day of gestation for threatened abortion. IUFD occurred 11 days after. Fetal postmortem showed severe AC and funisitis, neutrophils within alveoli and intestinal lumen, associated with rod-like bacteria. Fetal blood and lung cultures grew K. pneumoniae, β-lactamase-non-producing strain. Antibiogram revealed sensitivity for piperacillin/tazobactam. Three days after IUFD, the mother presented with fever (37.8 °C) which persisted for one week. Maternal blood and urine cultures were negative. According to fetal microbiological results, available 6 days after IUFD, initial treatment with amoxicillin/clavulanic acid was replaced with piperacillin/tazobactam with full patient recovery. Therefore, in the event of PPROM and IUFD, fetal microbiological investigations should always be performed to isolate the proper etiologic agent and start the correct medical treatment.

Funisitis is more common in cervical insufficiency than in preterm labor and preterm premature rupture of membranes

2016 ◽  
Vol 44 (5) ◽  
Author(s):  
Joohee Choi ◽  
Jeong Woo Park ◽  
Byoung Jae Kim ◽  
Ye-Jin Choi ◽  
Jong Hee Hwang ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Gestational Age ◽  
Preterm Labor ◽  
Cervical Insufficiency ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Histologic Chorioamnionitis ◽  
Gestational Age At Delivery ◽  
The Difference

AbstractTo compare the frequency of histologic chorioamnionitis and funisitis among women experiencing preterm labor, preterm premature rupture of membranes (PROM) and cervical insufficiency.This retrospective cohort study included singleton pregnant women who delivered at ≤36 weeks of gestation. The patients with preterm birth were subdivided into preterm labor (n=117), preterm PROM (n=153), and cervical insufficiency (n=20). All placentas were examined for pathology, according to the criteria of1) Histologic chorioamnionitis was diagnosed in 48.7% (57/117) of cases with preterm labor, 47.4% (73/153) with preterm PROM, and 75.0% (15/20) with cervical insufficiency. Funisitis was detected in 11.1% (13/117) of cases with preterm labor, 15.7% (24/153) with preterm PROM, and 40.0% (8/20) with cervical insufficiency. 2) Frequency of histologic chorioamnionitis was higher in cases with cervical insufficiency compared to preterm PROM. Frequency of funisitis was higher in cases with cervical insufficiency compared to both preterm labor and preterm PROM (P<0.05). The difference in frequency of funisitis remained significant after adjustment for gestational age at delivery and cervical dilatation at diagnosis. 3) Frequency of grade 2 funisitis was higher in cases with cervical insufficiency (35.0%, 7/20) compared to both preterm labor (6.8%, 8/117) and preterm PROM (9.8%, 15/153) (P=0.001). And the difference remained significant after adjustment for gestational age at delivery and cervical dilatation at diagnosis.: The highest frequency of funisitis was observed in cervical insufficiency among cases with spontaneous preterm birth.

scholarly journals Second Trimester Fetal Loss Due to Citrobacter koseri Infection: A Rare Cause of Preterm Premature Rupture of Membranes (PPROM)

Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 159
Author(s):  
Maria Paola Bonasoni ◽  
Giuseppina Comitini ◽  
Mariangela Pati ◽  
Giuseppe Russello ◽  
Loredana Vizzini ◽  
...  
Keyword(s):  
Fetal Loss ◽  
Second Trimester ◽  
Maternal Transmission ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Abdominal Organs ◽  
First Case ◽  
The Family ◽  
Severe Infections

Citrobacter koseri is a facultative anaerobic, motile, non-spore-forming Gram-negative bacillus, which belongs to the family of Enterobacteriaceae. Severe infections due to Citrobacter spp. have been reported in the urinary tract, respiratory airways, intra-abdominal organs, skin and soft tissue, eye, bone, bloodstream, and central nervous system. In newborns, C. koseri is a well-known cause of meningitis, cerebral abscesses, brain adhesions, encephalitis, and pneumocephalus. Infection can be acquired through vertical maternal transmission or horizontal hospital settings; however, in many cases, the source is unknown. Preterm premature rupture of membranes (PPROM), caused by C. koseri, has rarely been described. Herein, we describe a case of PPROM at 16 weeks and 3 days of gestation, leading to anhydramnios. The parents opted for legal termination of the pregnancy, as the prognosis was very poor. C. koseri was isolated postmortem from a placental subamniotic swab and parenchymal sample, as well as fetal blood and lung. To the best of our knowledge, this is the first case of early second-trimester PPROM in which C. koseri infection was demonstrated.

RESCUE CERVICAL CERCLAGE: PREVENTION OF A PREVIABLE BIRTH

2021 ◽  
pp. 36-37
Author(s):  
D. Sruthi ◽  
V. Radhalakshmi
Keyword(s):  
Uterine Cervix ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Signs And Symptoms ◽  
Salvage Procedure ◽  
Second Trimester ◽  
Cervical Cerclage ◽  
Successful Pregnancy ◽  
In Pregnancy

Pregnancy loss at any stage is distressing especially when this happens later in pregnancy, and this further worsens when it recurs in subsequent pregnancies. The reasons for recurrent pregnancy loss and preterm delivery are diverse and multifactorial. One of the main reasons for these complications is cervical insufciency, which means the inability of the uterine cervix to retain a pregnancy in the absence of signs and symptoms of clinical contractions, or labor or both in second trimester. Rescue cervical cerclage also known as Emergency cerclage/ rescue stitch is fundamentally a salvage procedure to prolong pregnancy in women with advanced cervical dilatation or prolapsed membranes in the second +3 trimester. Here, we present a case study of a 25-year-old antenatal woman Gravida 4 Para 0 with advanced cervical changes at 20 weeks who beneted from the rescue cervical cerclage procedure to have a successful pregnancy outcome.

Antibiotics for Preterm Premature Rupture of Membranes

2021 ◽  
pp. 43-47
Author(s):  
Katherine S. Kohari ◽  
Christian M. Pettker
Keyword(s):  
Risk Reduction ◽  
Broad Spectrum ◽  
Premature Birth ◽  
Neonatal Outcomes ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Membrane Rupture ◽  
Preterm Premature Rupture ◽  
Prelabor Rupture Of Membranes ◽  
Prolonged Latency

Antibiotics for preterm prelabor rupture of membranes (PPROM) have been shown to prolong the length of pregnancy as well as improve neonatal outcomes as demonstrated by the landmark article by Mercer et al. PPROM complicates 3% of all pregnancies, and approximately one-half of patients will deliver within 1 week of membrane rupture. Infection is thought to play a role in both the etiology of PPROM and subsequent maternal and neonatal complications. Premature birth further complicates neonatal outcomes, therefore prolongation of pregnancy after PPROM is essential for risk reduction. Administration of broad spectrum antibiotics have been associated with prolonged latency in women with PPROM at less than 32 weeks and 0 days of gestation as well as improved neonatal outcomes.

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