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At least 19 recordsLinked to original sources
PubMed1977

[Pregnancy after conisation for atypical epithelial processes of the uterine cervix (author's transl)].

At the First Department of Obstetrics and Gynecology, University of Vienna Medical School, 148 females aged under 35 years at the time of conisation were examined between 1963 and 1974 to determine their desire for children, their fertility status and the course of pregnancy. After conisation a total of only 42 females (28,4%) wanted children. Of 104 patients with preinvasive carcinoma, a desire for children was reported by no more than 21 (20,2%); among the cases with dysplasia, the number of women desiring children was equally 21 (47,7%). By the end of 1976, after a followup period of 1 to 13 years, 16 of 42 females wanting children failed to conceive, while the remaining 26 gave birth to 20 children. Judging from our admittedly small material, conisation thus apparently has no effect on conception. However, the course of pregnancy was found to be impaired in some cases by the incompetent cervical function. Twelve patients required a Shirodkar operation, which failed to prevent late abortion in 2 cases and premature delivery in 4. Nine women gave birth at or at best 3 weeks before term without preventive methods.

Adult↗
PubMed1978

[Conisation during pregnancy (author's transl)].

The paper reviews 15 cases undergoing conisation during pregnancy. In 2 conisation was immediately followed by radical operation for invasive squamous carcinoma. 11 patients had pre-invasive carcinoma by microscopic evidence on serial step sections, while the remaining 2 showed high-grade dysplasia of the cervix. Atypical tissue was successfully removed in toto in 6 of the 8 cases with lesions predominantly localizing at the cervical surface. Of the 5 abnormal epithelial processes which were almost entirely endocervical only 1 was completely removed. Abortion occurred in 4 of the 13 patients undergoing conisation without prophylactic cerclage. Shirodkar's operation was done at the time of conisation in 7 cases, in one after an interval of 10 weeks. This prophylactic measure failed to prevent prematurity in 2 cases, while the remaining 6 gave birth to living and mature infants between the 37th and the 40th week of gestation.

Abortion, Spontaneous↗
PubMed1979

Complications of cerclage.

The published results of cervical cerclage are almost invariably good and there is little mention of complications. Forty per cent of 52 pregnancies, with 38 early "prophylactic" and 14 late "therapeutic" operations, ended after 260 days' gestation. In 73 per cent a viable infant was born. The most frequent complication was premature rupture of the membranes (12 cases) followed by slipping suture (7) and premature delivery (6). Intra-uterine infection was fairly common. The implications and possible causes of this high rate of complications are discussed.

Female↗
PubMed1977

[Results with a new method for objectivation of rheobase measurements in normal pregnancy and risk of miscarriage or premature birth (author's transl)].

The rheobase (fundamental current strength), which can be used in obstetrics as a parameter of neuromuscular excitability, alters at the onset of labor, as Jung et al. first reported in 1969. It can be determined objectively to a considerable degree using the single-channel myograph manufactured by the Thönnies company, and an improved measuring method. Results of preliminary investigations can be confirmed which indicate that the rheobase in patients with premature labor and bleeding is lower than in women whose pregnancy is normal. Thus, where there is a risk of miscarriage or premature birth, neuromuscular excitability is increased. The fact that rheobase values in some patients who had undergone cerclage for cervical insufficiency are depressed indicates that the insufficiency is partly due to premature labor. It remains open to question whether etiology of the depressed rheobase is an indicator of increased neuromuscular excitability where there is a risk of miscarriage or premature birth.

Abortion, Threatened↗
PubMed1978

[Physiology of uterine contractions (author's transl)].

The number of contractions was recorded in 26 healthy primiparae and 28 multiparae from the 25th to 41st week of pregnancy. A remarkable incidence peak was seen around the 32nd week. The number of pregnancy contractions is not sufficient as the only parameter for recognising an impending premature delivery. However, it does represent a valuable aid when taking the anamnesis and portio findings into consideration. The authors consider tocolysis indicated if more than two contractions per hour are recorded as mean value over a period of one week in conjunction with a tendency of the portio to open up, or if more than three contractions are recorded independent of this sign. Taking individual daily into consideration, the relevant limit is three contractions per hour between the 25th and 28th week, and five contractions per hour between the 29th and 32nd week of pregnancy.

Cervix Uteri↗
PubMed1979

Maternal sepsis, uterine rupture and coagulopathy complicating cervical cerclage.

A previously healthy woman with a Shirodkar cerclage for cervical incompetence had a spontaneous rupture of the membranes at the 37th week of pregnancy. Three days later after a short period of weak labor pains, she developed a severe sepsis, uterine rupture and coagulopathy leading to renal failure, beta-hemolytic streptococcus group B and peptostreptococcous could be cultured from the amniotic fluid immediately after rupture of the membranes and from the uterus and placenta.

Adult↗
PubMed1979

Cervical cerclage: twenty years' experience.

During a 20-year period, 40 pregnancies were managed in 32 patients with a diagnosis of an incompetent cervix, a ratio of 1:775 deliveries. Diagnosis before development of symptoms produced a 92% fetal salvage, with 68% reaching 36 weeks of gestation. Development of symptoms before cerclage resulted in only a 40% fetal salvage. Fetal salvage was reduced in cases where membranes bulged beyond the cervix, the cervix was more than 3 cm dilated, or the gestational age was greater than 26 weeks at the time of suture placement. No difference was noted between the Shirodkar and McDonald procedures. Major complications included uterine rupture in three patients and acute chorioamnionitis in two. Because of complications, treatment is contraindicated based on history alone or where close follow-up is not available.

Adolescent↗
PubMed1976

[Indications and results of cerclage in cervical incompetence (author's transl)].

The results of 79 cerclage operations in gestation are reported. The rate of abortion increased in cases of more severe symptomatics: firstly, without labour and bleeding: 83 p.c. successful operations; secondly, with labour: 77 p.c.; thirdly, bleeding and without labour: 70p.c.; and lastly, with labour and bleeding: 40p.c. Before treatment with tocolytic pharmaca was possible, the period of gestation time could not successfully be prolonged if labour had started. With tocolytic pharmaca 56p.c. patients of this group gave birth to a living child. The rate of premature children was 23p.c. Cerclage operations were most successful after the 25th week of gestation. When applied before the 16th week of gestation, the success rate was below 69p.c. Treatment with tocolytic pharmaca increased the indication for cerclage operations. Cerclage operations together with tocolytic treatment are indicated in cases where labour and bleeding occur in gestation.

Female↗