cervical_cerclage

cervical_cerclage - Dr. Mohammed Abdalla Domiat General...

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Unformatted text preview: Dr. Mohammed Abdalla Domiat General Hospital Cervical incompetence Definition Condition in which the cervix fails to retain the conceptus during pregnancy. Cervix length less than ?? Premature ripening of the cervix. Etiology I diopathic (most) C ongenital disorders (congenital mullerian duct abnormalities. D ES exposure in utero. C onnective tissue disorder (Ehlers-Danlos syndrome. S urgical trauma (conization, (repeated cervical dilatation associated with termination of pregnancies). Although cervical length can be measured transabdominally and transperineally , transvaginal assessment is most accurate Basic parameters Standard cervical measurements use the "white stripe" of the internal cervical os as an anatomic landmark for proper caliper placement Anderson found an average length of 45 7 mm at 14 to 30 weeks, Iams et al found a mean cervical length of 35 8 mm at 24 weeks' Basic parameters Defining the short cervix The discriminatory length of cervical shortening varies widely between 26mm (Iams et al ) to 15mm ( Hassan et al ) so, the progressive shortening and other cervical qualities such as funneling (and measurement of the residual cervix if funneling is present), v-shaped lower uterine segment , and dynamic changes with fundal or suprapubic pressure. Are the most important. role of routine ultrasound screening of the cervix ACOG Practice Bulletin No. 48November 2003 in low-risk women lacks enough discriminatory power to recommend routine use. role of ultrasonography in evaluating women who have had a previous pregnancy loss is limited to populations at greatest risk ACOG Practice Bulletin No. 48November 2003 role of ultrasonography in evaluating women who have had a previous pregnancy loss ACOG Practice Bulletin No. 48November 2003 serial TVS should not begin before 16 to 20 weeks as the upper portion of the cervix is not easily distinguished In whom is a cerclage indicated?indicated?...
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cervical_cerclage - Dr. Mohammed Abdalla Domiat General...

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