Κατεύθυνση Παθολογία της Κύησης
Library of the School of Health Sciences

2024-12-11

2024

Pappa Aikaterini

Mαχαιριώτης Νικόλαος, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Δρακάκης Πέτρος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Σταύρου Σοφοκλής, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ

Ανεπάρκεια τραχήλου - Μέθοδοι αντιμετώπισης

Greek

Cervical insufficiency - Treatment methods

Cervical insufficiency is the inability of the cervix to hold the fetus in the absence of uterine contractions or labor due to functional or structural damage.
The cause of premature reduction in cervical length is unclear. Usually, cervical insufficiency is due to various factors, including uterine activity, congenital or acquired cervical insufficiency, occasional vaginal bleeding, infection / inflammation of the amniotic fluid or fetal membranes and biological or genetic factors.
Cervical insufficiency has an incidence of 0.1-1% and is known to be associated with a high risk of second-trimester miscarriage and / or preterm delivery. The main problem is its diagnosis, as it is not associated with specific symptoms.
The diagnosis of cervical insufficiency is now based on the transvaginal ultrasound measurement of the length of the cervix. Cervical changes, such as dilation of 1 cm or more, found on clinical examination before 24 weeks of pregnancy establish the diagnosis of cervical insufficiency.
Various methods have been proposed to treat cervical insufficiency, including cervical pessary, vaginal or oral progesterone administration and cervical cerclage. Vaginal progesterone reduces the rate of preterm delivery in women with a short cervix and treatment is effective regardless of a history of preterm delivery. Cervical cerclage is also effective in the subgroup of patients with a short cervix and a history of preterm delivery. The application of a cervical pessary has also been proposed as a viable intervention and its effectiveness is the subject of ongoing studies.
In conclusion, preventive treatment should be selected by evaluating specific characteristics for each population, in which obstetric history should be a key factor, such as previous preterm birth and short cervical length.

Health Sciences

Cervical insufficiency, Risk factors, Progesterone, Cervical pessary, Cervical cerclage

No

0

Yes

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https://pergamos.lib.uoa.gr/uoa/dl/object/3446465