Abstract
Background: Death of a fetus in-utero or at birth has always been devastating and painful experience for the mother and of concerned in clinical practice. Perinatal mortality remains a challenge in the care of pregnant women worldwide particularly for those who had history of adverse outcome in previous pregnancies. For the modern obstetrician, the cervical insufficiency represents a controversial problem as the treatment modalities for the same have changed with time since its description and there is no clear cut diagnosing criteria for the diagnosis and hence there is need for the presumptive diagnosis of cervical insufficiency in women with recurrent pregnancy losses after ruling out all possible causes and usefulness of cervical encerclage operation in management of cervical insufficiency.
Result: The three pregnant women who presented to Gynaec OPD at around 16-18 weeks of gestation with history of recurrent pregnancy loss during 2nd trimester and early 3rd trimester were provisionally diagnosed to have cervical insufficiency based on clinical history and in all three women prophylactic encerclage procedure was done. Two were delivered at term and one at 34 weeks of gestation. All three newborn babies were healthy with no complications postpartum.
Conclusion: Recurrent miscarriages may increase psychological stress. Managing recurrent pregnancy loss should be individualised. By using the correct weapon, required target can be achieved. In our case series all patients provisionally diagnosed to have cervical insufficiency, were treated with prophylactic encerclage (McDonald procedure). Above said intervention led to fruitful outcome of all three pregnancy.
Keywords: Cervical insufficiency, Cervical circlage, McDonald procedure, Shirodkar procedure.
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Corresponding Author
Dr Vinodkumar Suresh Basavaradder
Postgraduate Trainee, Obstetrics and Gynaecology, JNIMS, Imphal, Manipur, India
DOI: https://dx.doi.org/10.18535/jmscr/v6i11.24
