The comparative efficacy of different methods of cervical incompetence treatment.
Ainur Tuletova (KZ), Aikerm Doschanova (KZ), Anna Zvereva (KZ)
[Tuletova] Medical University Astana, [Doschanova] Medical University Astana, [Zvereva] Medical University Astana
Actuality: Currently, the treatment efficiency of the cervical weakness is highly controversial. The aim: to determine the effectiveness of various treatments for cervical incompetence during pregnancy. Materials and Methods: The study included 30 women with cervical incompetence. All patients were divided depending on the treatment: 1group -10 patients cerclage + progesterone 400mg, 2 group-10 patients only hormonal therapy by progesterone 400mg, 3 group -10 patients–obstetrical pessary+micronized progesterone 400mg. The main parameters of the comparative evaluation are the peculiarities of pregnancy and childbirth, the period of delivery. Results: In all groups we don’t register the severe obstetric complications as a syndrome of developmental fetus delay or premature detachment of normally situated placenta. The duration of gestation after cervical incompetence correction can be seen that by using pessaries delivery deadlines are approaching 40 weeks, although they are removed at 37 weeks. In the other groups interval from the end of the preparation (36 weeks) and at delivery was twice less. We have 6 cases of premature delivery: 4 cases of late preterm birth (32-36 g/a) and 2 cases of early preterm birth (22-31g/a). The greatest number of premature births, including early preterm delivery was in monohormonotherapy group. The complications of childbirth are the weakness of labor activity 13.3%, premature rupture of membranes 10%, tearing of the perineum 10%, and prolapsed bladder 6.7%, atonic bleeding 6.7% . But the statistically significant differences were not founded. Conclusion: Combined treatment cervical weakness promotes prolongation up to 39-40 weeks - 80% of cases. The method of cervical weakness correction has no effect on the incidence of complications during childbirth. The risk of complications in childbirth depends on perinatal risk factors.