Management of Cervical Cerclage after Premature Preterm Rupture of Membranes: An argument for retention: Retention vs Removal of Cerclage after Premature Preterm Rupture of Membranes.
Allen A Ghareeb, Alisa Kachikis, Vy Nguyen, Amanda Roman
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引用次数: 0
Abstract
Preterm birth remains the leading cause of infant morbidity and mortality worldwide. Efforts aimed at reducing preterm birth rates have largely focused on mitigating risks in those who have already experienced a preterm delivery. One intervention, the placement of a cervical cerclage, has been shown to reduce the risk of subsequent preterm delivery in the appropriate candidate. However, a cerclage does not mitigate the risk of premature preterm rupture of membranes (PPROM). PPROM is a significant contributor to the incidence of preterm births and can occur with a cerclage in place. Many studies have examined the outcomes associated with immediate vs delayed cerclage removal following PPROM with inconsistent results. In this expert review, we summarize the characteristics of the studies examining timing of cerclage removal following PPROM (Table 1), and current international guidelines (Table 2). In the absence of labor, infection, cervical laceration or vaginal bleeding, we recommend that cervical cerclage remain in situ following PPROM until 32-34 weeks gestation.
期刊介绍:
The American Journal of Obstetrics and Gynecology (AJOG) is a highly esteemed publication with two companion titles. One of these is the American Journal of Obstetrics and Gynecology Maternal-Fetal Medicine (AJOG MFM), which is dedicated to the latest research in the field of maternal-fetal medicine, specifically concerning high-risk pregnancies. The journal encompasses a wide range of topics, including:
Maternal Complications: It addresses significant studies that have the potential to change clinical practice regarding complications faced by pregnant women.
Fetal Complications: The journal covers prenatal diagnosis, ultrasound, and genetic issues related to the fetus, providing insights into the management and care of fetal health.
Prenatal Care: It discusses the best practices in prenatal care to ensure the health and well-being of both the mother and the unborn child.
Intrapartum Care: It provides guidance on the care provided during the childbirth process, which is critical for the safety of both mother and baby.
Postpartum Issues: The journal also tackles issues that arise after childbirth, focusing on the postpartum period and its implications for maternal health. AJOG MFM serves as a reliable forum for peer-reviewed research, with a preference for randomized trials and meta-analyses. The goal is to equip researchers and clinicians with the most current information and evidence-based strategies to effectively manage high-risk pregnancies and to provide the best possible care for mothers and their unborn children.