Please wait a minute...
Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (2): 238-242    DOI: 10.31083/j.ceog.2020.02.5149
Original Research Previous articles | Next articles
Prophylactic cervical cerclage, fully embedded, for twin pregnancies following fertility treatment
L. Mamas1, *(), E. Mamas1
1 Neogenesis IVF Centre, Marousi, Athens, Greece
Download:  PDF(1993KB)  ( 33 )
Export:  BibTeX | EndNote (RIS)      
Abstract  
Purpose of Investigation: With the advent of fertility treatment the number of twin gestations has increased considerably. These pregnancies are associated with many maternal and perinatal complications, mainly due to prematurity. The aim of this study was to assess the effectiveness of a fully embedded prophylactic vaginal cervical cerclage in reducing the rate of prematurity in twin pregnancies following ART. Materials and Methods: A prophylactic vaginal cervical cerclage was applied in forty three twin pregnancies conceived following fertility treatments. The cerclage suture was fully embedded under the vaginal mucosa in order to minimize the risk of infection. Results: The mean gestational age at delivery was 35+4 weeks and the mean delivery weight was 2,238 grams. No differences between the type of fertility treatment used was noted in the outcome measures studied. Conclusion: Twin pregnancies conceived with the aid of fertility treatment, benefited from the application of a prophylactic vaginal cervical cerclage.
Key words:  Cervical cerclage      Twins      Premature delivery      Fertility treatment      ART     
Published:  15 April 2020     
*Corresponding Author(s):  L. MAMAS     E-mail:  leon.mamas@gmail.com

Cite this article: 

L. Mamas, E. Mamas. Prophylactic cervical cerclage, fully embedded, for twin pregnancies following fertility treatment. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(2): 238-242.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.02.5149     OR     https://ceog.imrpress.com/EN/Y2020/V47/I2/238

[1] De Geyter C., Calhaz-Jorge C., Kupka M.S., Wyns C., Mocanu E., Motrenko T., et al.: "European IVF-monitoring Consortium (EIM) for the European Society of Human Reproduction and Embryology (ESHRE): "ART in Europe, 2014: results generated from European registries by ESHRE: The European IVF-monitoring Consortium (EIM) for the European Society of Human Reproduction and Embryology (ESHRE)". Hum Reprod., 2018, 33, 1586.
[2] Sunderam S., Kissin D.M., Crawford S.B., Folger S.G., Boulet, S.L., Warner L., Barfield W.D.: "Assisted Reproductive Technology Surveillance - United States, 2015". MMWR Surveill. Summ., 2018, 67, 1.
[3] Santolaya J., Faro R.: "Twins – twice more trouble?" Clin. Obstet. Gynecol., 2012, 55, 296.
[4] Bamberg C., Fotopoulou C., Neissner P., Slowinski T., Dudenhausen J.W., Proquitte H., et al.: "Maternal characteristics and twin gestation outcomes over 10 years: impact of conception methods". Fertil. Steril., 2012, 98, 95.
[5] Källén B., Finnström O., Lindam A., Nilsson E., Nygren K.G., Olausson P.O.: "Selected neonatal outcomes in dizygotic twins after IVF versus non – IVF pregnancies". BJOG, 2010, 117, 676.
[6] Bromer J.G., Ata B., Seli M., Locdwood C.J., Seli E.: "Preterm deliveries that result from multiple pregnancies associated with assisted reproductive technologies in the USA: a cost analysis". Curr. Opin. Obstet. Gynecol., 2011, 23, 168.
[7] Himpens E., Van den Broeck C., Oostra A., Calders P., Vanhaesebrouck P.: "Prevalence, type, distribution, and severity of cerebral palsy in relation to gestational age: a meta-analytic review". Dev. Med. Child. Neurol., 2008, 50, 334.
[8] Maloni J.A., Margevicious S.P., Damato E.G.: "Multiple gestation: side effects of antepartum bed rest". Biol. Res. Nurs., 2006, 8, 115.
[9] Da Silva Lopes K, Takemoto Y., Ota E., Tanigaki S., Mori R.: "Bed rest with and without hospitalisation in multiple pregnancy for improving perinatal outcomes". Cochrane Database Syst Rev., 2017, 3, CD012031.
[10] Sotiriadis A., Papatheodorou S., Makrydimas G.: "Perinatal outcome in women treated with progesterone for the prevention of preterm birth: a meta-analysis". Ultrasound Obstet. Gynecol., 2012, 40, 257.
[11] Hernandez W.R., Francisco R.P.V., Bittar R.E., Gomez U.T., Zugaib M., Brizot M.L.: "Effect of vaginal progesterone in tocolytic therapy during preterm labor in twin pregnancies: Secondary analysis of a placebo-controlled randomized trial". J. Obstet. Gynaecol. Res., 2017, 43, 1536.
[12] Dodd J.M., Grivell R.M., O'Brien C.M., Dowswell T., Deussen A. R.: "Prenatal administration of progestogens for preventing spontaneous preterm birth in women with a multiple pregnancy". Cochrane Database System Rev., 2017, 10, CD012024.
[13] Carreras E., Arévalo S., Bello-Muñoz J.C., Goya M., Rodó C., Sanchez-Duran M. A., et al: "Arabin cervical pessary to prevent preterm birth in severe twin-to-twin transfusion syndrome treated by laser surgery". Prenat. Diag., 2012, 32, 1181.
[14]Nicolaides K.H., Syngelaki A., Poon L.C., de Paco Matallana C., Plasencia W., Molina F.S., et al.: "Cervical pessary placement for the prevention of preterm birth in unselected twin pregnancies: a randomized controlled trial". Am. J. Obstet. Gynecol., 2016, 214, e1.
[15] Shirodkar J.N.: "A new method for operative treatment of habitual abortions in the second trimester of pregnancy". Antiseptic, 1955, 52, 299.
[16] McDonald I.A.: "Suture of the cervix for the inevitable miscarriage". J. Obstet. Gynecol. Br. Emp., 1957, 64, 346.
[17] Benson C.R., Durfee R.B.: "Transabdominal cervivouterine cerclage during pregnancy for the treatment of cervical incompetency". Obstet. Gynecol., 1965, 25, 145.
[18] Mamas L.: "Comparison of fallopian tube sperm perfusion and intrauterine tuboperitoneal insemination: a prospective randomized study". Fertil. Steril., 2006, 85, 735.
[19] Magann E.F., Haram K., Ounpraseuth S., Mortensen J.H., Spencer H.J., Morrison J.C.: "Use of antenatal corticosteroids in special circumstances: a comprehensive review" Acta Obstet. Gynecol. Scand., 2017, 96, 395.
[20] Yamamoto R., Ishii K., Muto H., Ota S., Kawaguchi H., Hayashi S., Mitsuda N.: "Incidence of and risk factors for severe maternal complications associated with hypertensive disorders after 36 weeks' gestation in uncomplicated twin pregnancies: A prospective cohort study". J. Obstet. Gynaecol. Res., 2018, 44, 1221.
[21] Moini A., Shiva M., Arabipoor R., Hosseini R., Chehrazi M., Sadeghi M.: "Obstetric and neonatal outcomes of twin pregnancies conceived by assisted reproductive technology compared with twin pregnancies conceived spontaneously: a prospective follow – up study". Eur. J. Obstet. Gynecol. Reprod. Biol., 2012, 165, 29.
[22] Kalra S.K., Radcliffe S.J., Barnhart K.T., Coutifaris C.: "Extended embryo culture and an increased risk of preterm delivery". Obstet. Gynecol., 2012, 120, 69.
[23] Ericson A., Nygren K.G., Olausson P.O., Källén B.: "Hospital care utilization of infants born after IVF". Hum. Reprod., 2002, 17, 929.
[24] Rozenberg P., Sénat M.V., Gillet A., Ville Y.: "Comparison of two methods of cervical cerclage by ultrasound cervical measurement". J. Matern. Fetal Neonatal Med., 2003, 13, 314.
[25] Wong C.H., Chen C.P., Wang K.G., Sun F.J., Chen C.Y.: "Compari-son of two cervical cerclages for the prevention of preterm birth and neonatal complications". J. Matern. Fetal Neonatal Med., 2017, 30, 551.
[26] Elimian A., Figueroa R., Nigam S., Verma U., Tejani N., Kirshenbaum N.: "Perinatal outcome of triplet gestation: does prophylactic cerclage make a difference?" J. Matern. Fetal Med., 1999, 8, 119.
[27] Ayman S., Hesham B., Naglaa H., Maher A.H.: "Prophylactic Cerclage in ICSI Twins: To Do or Not to Do? A Randomized Controlled Study". Womens Health Gynecol., 2016, 2, 042.
[28] Skentou C., Souka A.P., To M.S., Liao A.W., Nicolaides K.H.: "Prediction of preterm delivery in twins by cervical assessment at 23 weeks". Ultrasound Obstet. Gynecol., 2001, 17, 7.
[29] Bergelin I., Valentin L.: "Cervical changes in twin pregnancies observed by transvaginal ultrasound during the latter half of the pregnancy: a longitudinal, observational study". Ultrasound Obstet Gynecol, 2003, 21, 556
[30] Gupta M., Emary K., Impey L.: "Emergency cervical cerclage: predictors of success". J. Matern. Fetal Neonatal Med., 2010, 23, 670.
[31] Blair O., Fletcher H., Kulkarni S.: "A randomized controlled trial of outpatient versus inpatient cervical cerclage". J. Obstet. Gynaecol., 2002, 22, 493
[32] Charles D., Edwards W.R.: "Infectious complications of cervical cerclage". Am. J. Obstet. Gynecol., 1981, 141, 1065.
[33] De Geyter C.: "Eight million IVF babiew since the birth of the world's first in 1978". 34th Annual ESHRE Meeting, Barcelona. https://www.focusonreproduction. eu/article/ESHRE News_ GlobalIVFL8
[34] Pinborg A., Loft A., Rasmussen S., Schmidt L., Langhoff-Roos J., Greissen G., et al.: "Neonatal outcome in a Danish national cohort of 3439 IVF/ICSI and 10362 non-IVF/ICSI twins born between 1995 and 2000". Hum. Reprod., 2004, 19, 435.
[35] Kruse M., Michelsen S.I., Flachs E.M., Brønnum-Hansen H., Madsen M., Uldall P.: "Lifetime costs of cerebral palsy". Dev. Med. Child. Neurol., 2009, 51, 622.
[36] Lee A.M., Connell M.T., Csokmay J.M., Styer A.K.: "Elective single embryo transfer- the power of one". Contracept. Reprod. Med., 2016, 1, 11.
[37] Ikemoto Y., Kyroda K., Ochiai A, Yamashita S., Ikuma S., Nojiri S., et al.: "Prevalence and risk factors of zygotic splitting after 937 848 single embryo transfer cycles". Hum. Reprod., 2018, 33, 1984.
[38] Blennborn M., Nilsson S., Hillervik C., Hellberg D.: "The couple's decision-making in IVF: one or two embryos at transfer?" Hum. Reprod., 2005, 20, 1292.
[1] S. J. Knight, A. D. Smith, H. Kim, A. C. Collier. Human placental suppressors of cytokine signalling (SOCS) and inflammatory cytokines are dysregulated in assisted reproduction, advanced maternal age and pre-term birth[J]. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(2): 277-286.
[2] D. Yang, H.F. Zhang, Q. Liu, Y.N. Li, J. Zhang, T. Zheng. Pregnancy outcomes in women with congenitally corrected transposition of the great arteries[J]. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(2): 291-295.
[3] S. Dikić, S. Dragojević, L. Nejković, J. Štulić, A. Jurišić, D. Radojičić, A. Dikić, Dj Radak. Management of the postpartum ovarian and partial cava inferior vein thrombosis[J]. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(2): 299-302.
[4] K. Relakis, A. Pontikaki, I. Kosmas, S. Sifakis. Bilateral ascending uterine arteries ligation for conservative management of complete placenta previa: three case reports[J]. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(1): 144-146.
[5] N. Al-Husban, O. Al-Kuran, M. Khadra, K. Fram. Thrombocytopenia in pregnancy; prevalence, causes and fetomaternal outcome[J]. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(1): 21-26.
[6] A. P. Londero, S. Visentin, L. Marin, M. C. Bongiorno, D. Visentin, S. Bertozzi, E. Cosmi, A. Cagnacci, L. Driul. Second trimester prediction of small for gestational age and intrauterine growth restriction[J]. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(1): 70-74.
[7] L. Andrejevic, A. Andrejevic, V. Nestorovic, B. Milosevic, S. Andrejevic, S. Nestorovic. Multiparty, relation with patology of pregnancy and delivery[J]. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(1): 117-121.
[8] D. Sarpkaya Güder, M. Yalvaç, G. Vural. The effect of childbirth preparation training on primiparous women’s birth plans and the childbirth processes[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(6): 924-932.
[9] Y. Wang, F.Y. Luo, Y.D. Xia, L. Mei, L. Xie, H.X. Liu. Clinical analysis of 211 cases of cesarean scar pregnancy[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(6): 948-952.
[10] Y. Wu, L. Tong, L. Xiao. Artificial neural network models for prediction of premature ovarian failure[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(6): 958-963.
[11] G. Chiu, A. Zhao, B. Zhang, T. Zhang. Clinical value of isolated intracardiac echogenic focus in the fetal heart: A retrospective study in Chinese women[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(6): 972-976.
[12] T. Murata, S. Suzuki, H. Kyozuka, M. Chishiki, H. Tanaka, K. Fujimori. Fetal primary volvulus with abnormal heart rate patterns on cardiotocography[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(6): 1003-1004.
[13] K. Lee, S. Lee, H. N. Lee, H. Lim, I. J. Kim, I. Y. Park, M. J. Kim. Uterine necrosis following selective embolization for postpartum hemorrhage: report of four cases and review of literature[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(6): 1020-1025.
[14] Qianhong Liang, Wei Gong, Dongming Zheng, Risheng Zhong, Yunjie Wen, Xiaodan Wang. Preliminary analysis of risk factors for congenital heart disease: a retrospective review of 145 cases in a single institution[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(5): 713-722.
[15] S. Borna, B. Teimoori, A. Esmailzadeh, M. Shariat, E. Lesha. Association of cervical length and uterine artery Doppler with threatened preterm labor[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(5): 748-751.
No Suggested Reading articles found!