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The Outcome of Repeat Cerclage in Women with Prolapsed Membrane following Prior Cerclage
( Hyunjin Tak ),( Ji Eun Song ),( Jieum Cha ),( Soyoon Park ) 대한산부인과학회 2022 대한산부인과학회 학술대회 Vol.108 No.-
Objective: Our aim was to evaluate the outcome of repeat cerclage in women with prolapsed membrane following 1st cerclage. Methods: The retrospective chart review between Jan 2003 and July 2022 was performed. Inclusion criteria was singleton pregnancy with prolapsed membrane following initial cerclage. Twin pregnancies, preterm premature rupture of membrane (PPROM), preterm labor (PTL), vaginal bleeding, intrauterine fetal death (IUFD), or fetal abnormalities were excluded. Results: A total of 48 women with bulging membrane following 1st cerclage were identified. The mean gestational age at 1st cerclage was 16.18 ± 3.08 weeks. The types of 1st cerclage were as following: history-ndicated cerclage (n=24); ultrasound-indicated cerclage (n=11); physical examination-indicated cerclage (n=12); transabdominal cerclage (n=1). The average gestational age at repeat cerclage was 21.86 ± 2.59 weeks. There was no intraoperatively iatrogenic rupture of membrane during repeat cerclage. The mean gestational age at delivery was 28.54 ± 5.99 weeks. The mean neonate weight was 1425.0 ± 963.59 gram. The overall neonatal survival rate was 79.1 % (38/48). Conclusion: Repeat cerclage might be beneficial for prolonging pregnancy in women with prolapsed membrane following prior cerclage.
The Outcome of Vacuum Assisted Delivery (VAD) : 2007-2022 Experiences in a Single Institution
( Ji Eun Song ),( So Yoon Park ),( Hyunjin Tak ),( Jieum Cha ) 대한산부인과학회 2022 대한산부인과학회 학술대회 Vol.108 No.-
Objective: Our aim was to evaluate the outcome of vacuum assisted delivery (VAD). Methods: The retrospective chart review between Jan 2007 and Aug 2022 was performed. Hemoglobin at admission and hemoglobin at postpartal day (PPD) #1 were compared. The incidence of transfusion, cervical laceration, neonatal outcome were reviewed. Subsequent pregnancy outcomes were also evaluated. Results: A total of 303 women with VAD were identified. The mean gestational age at delivery was 39.33 ± 1.42 weeks. The mean neonate weight was 3293.43 ± 397.09 gram. The average admission hemoglobin(Hb) was 12.4, and the mean PPD#1 Hb was 10.9. Only 13 women (4.29 %, 13/303) got transfusion. There were 26 women (8.58 %, 26/303) who got cervical laceration suture. There was one case of neonatal brain complication (subarachnoid fluid collection), but it resolved spontaneously. 70 women had subsequent pregnancies. 55 women (78.5 %, 55/70) had normal spontaneous delivery (NSD) in their next pregnancies. 13 women (18.5 %, 13/70) had VAD, and 2 women had cesarean section in their subsequent pregnancies. Conclusion: VAD is a safe operative vaginal delivery when performed by experienced maternal-fetal-medicine specialists. Most women with prior VAD had NSD in their subsequent pregnancies. VAD might decrease the rate of Cesarean sections.