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  • Author: Túrós János Levente x
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The therapeutic effect of cervical cerclage in pregnancy with cervical incompetence

Abstract

The shortening of the cervix, cervical incompetence or insufficiency that causes late miscarriage or preterm birth syndrome gives importance and clinical significance for the cervical cerclage or cervical stitch as treatment. Nowadays closure of the cervix with cerclage surgery is an effective way of preventing premature opening of the cervix, helping the pregnancy near due date, thus significantly reducing the risk of miscarriage and premature delivery.

The retrospective longitudinal cohort study is based on an examination of 164 pregnant woman who underwent cervical cerclage surgery at Obstetrics and Gynecology Clinic nr. I Târgu-Mureș, between 2000-2017. The McDonald’s method was used in every case that we have studied.

Cerclage surgery was performed in most cases in the second trimester. The results in the study reflect that in the majority of the cases, intervention is effective in preventing premature opening of the cervix. Most women are multipara and had multiple gestational pregnancy, which can also contribute to the weakening and early opening of the cervical closure system. In 66.5% of the cases, at least one abortion or miscarriage is present in the history of the disease, which may also lead to a weakening of the cervical closing function.

Following cerclage surgery, 11.6% abortion and 88.4% in childbirth occurred, and in most cases, intervention can effectively prevent second trimester abortion while reducing the risk of premature birth (65, 8% had no premature birth in our study).

Open access
The prognostic role of thrombophilia in the treatment of infertility

Abstract

Thrombophilia refers to a coagulation disorder that predisposes to thrombosis and thus increases the risk of thrombotic events. Both inherited and acquired thrombophilia are associated with vascular thrombosis and pregnancy-related complications, including infertility, recurrent miscarriage, and premature birth.

Recently, thrombophilia has been increasingly encountered as an infertility factor, which gives the clinical relevance of the disease.

The aim of the study was to investigate the prognostic role of thrombophilia in the treatment of infertility and the pregnancy of thrombophilic women during assisted reproduction procedures.

Frequency of abortions increases and effectiveness of in vitro fertilization (IVF) decreases with age. Normal weight has a positive effect on assisted reproduction techniques (ART’s) outcome. Repeat IVF failure is more common in thrombophilia than in healthy women, and the “take home baby” ratio for IVF is 24%. Spontaneous abortion was most commonly observed in the PAI homozygous group followed by MTHFR homozygous mutation, MTHFR heterozygous mutation, and Factor V (Leiden) mutation. The most effective treatment was concomitant therapy with low molecular weight heparin and aspirin.

Open access