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首页> 外文期刊>Journal of obstetrics and gynaecology: the journal of the Institute of Obstetrics and Gynaecology >Failure of a trans-abdominal cervical cerclage following successful term pregnancy with said cerclage.
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Failure of a trans-abdominal cervical cerclage following successful term pregnancy with said cerclage.

机译：用所述环扎成功足月妊娠后经腹宫颈环扎失败。

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摘要

We report what we believe to be the first case of failure of a transabdominal cervical cerclage (TAC) resulting in late second trimester miscarriage following a successful term pregnancy with that cerclage. A 36-year-old Caucasian woman presented in her fourth pregnancy at 9 weeks' gestation. Previous medical history included a trachelectomy for CIN3, a mid-trimester miscarriage (22 weeks) with a transvaginal cervical cerclage (TVC) in situ, a 35-week caesarean delivery with a TAC in situ and an 8-week miscarriage. Routine transvaginal ultrasound surveillance of cervical length was started in the index pregnancy, at 17 weeks' gestation cervical length was 3.7 cm. Three weeks later, she presented with a 2-day history of vaginal discharge and abdominal pain. Examination revealed a dilated cervix, and ultrasonography confirmed intrauterine fetal death. Subsequently, she delivered vaginally through the TAC and was discharged 5 days later with antibiotics. Post-delivery cervical examination confirmed tissuedistortion and friability, although it was not possible to assess the cerclage. Maternal investigations excluded an infective or hypercoagulable process. Post-mortem examination revealed a non-macerated fetus with no congenital malformations, but fetal sepsis secondary to group B streptococcus (GBS) was described. Placental histology demonstrated evidence of acute necrosing chorioamnionitis and hypoxia. PCR confirmed normal chromosomal complements.
机译：我们报告了我们认为这是第一例经腹环宫颈环扎术（TAC）失败，导致该环扎术成功足月妊娠的妊娠中期晚期流产。一名36岁的白人妇女在妊娠9周时第四次怀孕。先前的病史包括对CIN3进行气管切开术，妊娠中期流产（22周）和经阴道宫颈环扎术（TVC）原位剖腹产，35周剖腹产，原位TAC和8周流产。指数妊娠开始常规经阴道超声检查宫颈长度，在妊娠17周时宫颈长度为3.7 cm。三个星期后，她出现了两天的白带和腹痛史。检查显示宫颈扩张，超声检查证实胎儿宫内死亡。随后，她通过TAC阴道分娩，并于5天后使用抗生素出院。分娩后的宫颈检查证实了组织变形和脆性，尽管无法评估环扎。产妇调查排除了感染性或高凝性过程。验后检查显示胎儿无畸形，无先天性畸形，但描述了继B组链球菌（GBS）后继发的胎儿败血症。胎盘组织学显示了急性坏死性绒毛膜羊膜炎和缺氧的证据。 PCR证实正常的染色体补体。

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