DOCSLIB.ORG

Getting Ready for Your Cervical Cerclage

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Getting Ready for Your Cervical Cerclage Page 1 of 2 Getting Ready for Your Cervical Cerclage Maternal-Fetal Medicine Center What is a cerclage? A cerclage is a minor surgery to help prevent premature birth. The doctor places stitches in the cervix (opening to the uterus) to pull it closed. This makes the cervix stronger. cervix Your cerclage is scheduled for:_____________ (date) at _____________ (time). Arrive at the hospital two hours early at _____________ (time). stitches placed around cervix How do I prepare for surgery? • Do not eat, drink (including water) or smoke Where do I park? after ___________ (time) on ___________ (date). On 25th Avenue, follow the signs to park in the Green • For 24 hours before surgery, do not douche, have garage beneath the University of Minnesota Masonic sex (intercourse) or put anything in the vagina. Children’s Hospital (South Building). Valet parking is also available at the main entrance (Monday through • If you will leave the hospital the day of surgery, Friday from 5:30 a.m. until 6 p.m.) for the same rate. arrange for someone to drive you home. Someone Bring your parking ticket with you. We will stamp it, should also stay with you for the first 24 hours. and you will pay a lower rate. Where do I go the day of surgery? What happens when I arrive? Your surgery will take place at: • You will register. Please bring your insurance card. Birthplace (4th floor, East Building) • We will bring you to your room and get you ready. University of Minnesota Medical Center - West Bank 2450 Riverside Avenue South, Minneapolis • You must sign a consent form. It states that you After you enter the hospital, follow the signs to the know the risks and benefits of the surgery. East Building. Take the “A” elevator to the 4th floor. • You will meet with your surgeon to discuss the Follow the signs to the main desk. You will need to surgery. ring the doorbell, and someone will let you in. • A doctor will talk with you about the anesthesia options (medicine for pain control) for your surgery. For informational purposes only. Not to replace the advice of your health care provider. Pregnancy illustration page 1 (ID 10105213) © Turhanerbas, www.dreamstime.com. Copyright © 2006 Fairview Health Services. All rights reserved. SMARTworks 520546 – REV 07/18. Page 2 of 2 What to Expect after a Cerclage How will I feel after the cerclage? Which problems I should watch for? You may have mild cramps that feel like menstrual Call your Maternal-Fetal Medicine Center if you have cramps. These may last several hours. any of these symptoms within 7 days of surgery: How long will I be in the hospital? • Bright red bleeding as heavy as a period. • Clear fluid (like water) leaking from the vagina. You may go home the same day or the next day. • Severe cramps or pain in your abdomen. Do I need to limit my activities? • Flu-like symptoms: chills, muscle pain or a fever Yes, while the cerclage is in place. Avoid any activity over 100.4°F (38°C) (taken under the tongue). that puts stress on the muscles of your abdomen (belly). This may mean no lifting of children, laundry • Foul-smelling discharge coming from the vagina. or grocery bags. Do not have intercourse (sex). After a cerclage, it is normal to have an increase in discharge from the vagina. The discharge should Ask your doctor how long you need to restrict your not have a bad smell. activities. You must follow the doctor’s advice. Contact the Maternal-Fetal Medicine Center Do I need to return to the Maternal-Fetal (Open Monday through Friday, 8 a.m. to 4:30 p.m.) Medicine Center for a follow-up visit? M Health Fairview Ridges Hospital Your doctor may suggest an ultrasound of your cervix Maternal-Fetal Medcine Center after surgery. If so, please make an appointment at one 952-892-2270 of our Maternal-Fetal Medicine Centers. M Health Fairview Southdale Hospital Will I stilll need to see my pregnancy care Maternal-Fetal Medcine Center provider? 952-924-5250 Yes. Return to your pregnancy care provider for your M Health Fairview UMMC routine pregnancy care. Your provider and the MFM Maternal-Fetal Medicine Center specialist will decide on your ongoing care. 612-273-2223 If it is after business hours: Call the Birthplace at 612-273-4040. Ask for the “MFM doctor on call.”.
Load more

Recommended publications
  • Alternative Treatment Method for Cervical Ectopic Pregnancy Servikal Ektopik Gebelik İçin Alternatif Tedavi Yöntemi
    J Kartal TR 2016;27(2):147-149 CASE REPORT doi: 10.5505/jkartaltr.2015.065982 OLGU SUNUMU Alternative Treatment Method for Cervical Ectopic Pregnancy Servikal Ektopik Gebelik İçin Alternatif Tedavi Yöntemi Ali Emre TAHAOĞLU, Mehmet İrfan KÜLAHÇIOĞLU, Ahmet ESER, Cihan TOĞRU Diyarbakır Obstetrics and Child Health Hospital, Diyarbakır, Turkey Summary Özet Cervical ectopic pregnancy is a very rare form of ectopic Servikal ektopik gebelik, tüm ektopik gebelikler arasında çok pregnancy. Cervical ectopic pregnancy can be a cause of se- nadir rastalanan bir ektopik gebelik formudur. Servikal ektopik vere bleeding and it is associated with high morbidity and gebelik ciddi bir hemoraji nedeni olabilir. Ayrıca yüksek morbi- mortality. In recent years, many conservative methods of dite ve mortalite ile ilişkilidir. Son yıllarda fertiliteyi korumak treatment seeking to preserve fertility have been reported. amacı ile farklı birçok konservatif yaklaşım rapor edilmiştir. Presently described is case of pregnant woman at gesta- Kliniğimize yedi hafta dört gün ile uyumlu fetal kardiyak ak- tional age of 7 weeks and 4 days who was admitted to clinic tivitesi olmayan gebe vajinal kanama şikayeti ile başvurdu. with vaginal bleeding. Fetal cardiac activity was negative. Hasta yüksek servikal sütür ve Mcdonald serklaj uygulanarak Patient was successfully treated with high ligation suture başarı ile tedavi edildi. Servikal gebelik tedavisi hala tartışma and McDonald cerclage. There is no consensus yet on best konusudur. Fakat tedavi konusunda henüz kesin bir fikir birliği treatment of cervical ectopic pregnancy, but conservative bulunmamaktadır. Konservatif yaklaşım hastayı histerektomi methods can avoid major surgical procedure such as hyster- gibi büyük bir cerrahiden ve bunun getirdiği kötü sonuçlardan ectomy and its consequences.
    [Show full text]
  • 16 Non-Delivery Obstetric Procedures 
    16 Non-delivery Obstetric Procedures Cervical Cerclage ...................... 357 AnestheticOptions.................... 358 Regional Anesthesia .................. 358 General Anesthesia .................. 359 CerclageRemoval.................... 359 Dilation and Evacuation (D&E) .............. 360 AnestheticOptions.................... 360 Postpartum Tubal Ligation ................. 362 TimingofTubalLigation................. 362 Physiologic Changes of Pregnancy in the Postpartum Period ..............363 AnestheticTechniques.................. 363 Epidural Anesthesia .................. 363 Spinal Anesthesia ................... 364 General Anesthesia .................. 365 PostoperativePainRelief................. 366 Cervical Cerclage Cervical incompetence complicates up to 1% of all pregnan- cies. It is characterized by premature dilation of the internal cervical os and shortening of the cervix from the internal os to the uterine cavity. It is associated with early pregnancy loss and premature birth. Cervical cerclage is a procedure performed at least 23,000 times annually in the United States.1 There are three techniques in use at the present time: McDonald transvaginal approach, Shirodkar transvaginal approach, and the abdominal cerclage. The first two techniques are technically easier and much more popular. All cerclage pro- cedures involve a circumferential suture or band tied around the cervical os to strengthen and support the cervix and prevent further dilation. The McDonald technique is simpler and is sim- ply a purse-string suture placed in the neck of the cervix as high S. Datta et al., Obstetric Anesthesia Handbook, DOI 10.1007/978-0-387-88602-2_16, C Springer Science+Business Media, LLC 2006, 2010 358 Non-delivery Obstetric Procedures in the vagina as possible. The Shirodkar involves dissection of the bladder and rectum away from the anterior and posterior aspects of the cervix to allow a imbedded band to be placed higher on the cervix, closer to the internal os.
    [Show full text]
  • ICD~10~PCS Complete Code Set Procedural Coding System Sample
    ICD~10~PCS Complete Code Set Procedural Coding System Sample Table.of.Contents Preface....................................................................................00 Mouth and Throat ............................................................................. 00 Introducton...........................................................................00 Gastrointestinal System .................................................................. 00 Hepatobiliary System and Pancreas ........................................... 00 What is ICD-10-PCS? ........................................................................ 00 Endocrine System ............................................................................. 00 ICD-10-PCS Code Structure ........................................................... 00 Skin and Breast .................................................................................. 00 ICD-10-PCS Design ........................................................................... 00 Subcutaneous Tissue and Fascia ................................................. 00 ICD-10-PCS Additional Characteristics ...................................... 00 Muscles ................................................................................................. 00 ICD-10-PCS Applications ................................................................ 00 Tendons ................................................................................................ 00 Understandng.Root.Operatons..........................................00
    [Show full text]
  • Term Pregnancy in a Bicornuate Uterus: Complications, Diagnostic and Therapeutic Challenges in a Low Resource Setting (Douala, Cameroon)
    International Journal of Medical and Pharmaceutical Case Reports 11(3): 1-4, 2018; Article no.IJMPCR.43964 ISSN: 2394-109X, NLM ID: 101648033 Term Pregnancy in a Bicornuate Uterus: Complications, Diagnostic and Therapeutic Challenges in a Low Resource Setting (Douala, Cameroon) 1,2 1,2 1 3 4* A. A. Tazinya , V. F. Feteh , R. C. Ngu , N. N. Bechem and G. E. Halle-Ekane 1Mboppi Baptist Hospital Douala, Douala, Cameroon. 2Medical Doctors Research Group Douala, Douala, Cameroon. 3Department of Public Health and Epidemiology, Nottingham University, England. 4Department of Obstetrics/ Gynecology, Faculty of Health Sciences, University of Buea, Cameroon. Authors’ contributions This work was carried out in collaboration between all authors. Authors AAT, VFF, NNB and RCN were involved in the management of the patient. Authors AAT and GEHE wrote the first draft of the manuscript. Authors AAT, VFF and NNB managed the literature searches. All authors read and approved the final manuscript. Article Information DOI: 10.9734/IJMPCR/2018/43964 Editor(s): (1) Dr. Erich Cosmi, Director of Maternal and Fetal Medicine Unit, Department of Woman and Child Health, University of Padua School of Medicine, Padua, Italy. Reviewers: (1) Donnette Simms-Stewart, University of the West Indies, Jamaica. (2) Ikobho Ebenezer Howells, Niger Delta University Teaching Hospital, Nigeria. (3) Elisabete Gonçalves, Centro Hospitalar Universitário do Algarve, Portugal. Complete Peer review History: http://www.sciencedomain.org/review-history/26173 Received 16th June 2018 Accepted 5th September 2018 Case Report th Published 10 September 2018 ABSTRACT Severe uterine malformations are usually associated with infertility. Furthermore, a term pregnancy in the case of a severe uterine malformation is rare because spontaneous abortions and uterine ruptures are not uncommon before the third trimester.
    [Show full text]
  • Cervical Stitch
    Information for you Published in May 2018 Cervical stitch About this information This information is for you if you want to know about having a cervical stitch, which is also called cervical cerclage. You may also find it helpful if you are a partner, relative or friend of someone who is in this situation. A glossary of all medical terms used is available on the RCOG website at: www.rcog.org.uk/en/patients/ medical-terms. Key points • A cervical stitch may help to keep your cervix closed and may reduce the risk of you giving birth early. • You may be offered a cervical stitch if you are at risk of giving birth early. • A cervical stitch is usually put in between 12 and 24 weeks of pregnancy and then removed at 36–37 weeks unless you go into labour before this. What is a cervical stitch? A cervical stitch is an operation where a stitch is placed around the cervix (neck of the womb). It is usually done between 12 and 24 weeks of pregnancy although occasionally it may be done at later stages in pregnancy. Transabdominal A cervical stitch is more commonly put in Transvaginal vaginally (transvaginal) and less commonly by an abdominal route (transabdominal) 1 Why is it done? Babies born early (before 37 completed weeks of pregnancy) have an increased risk of short- and long-term health problems. You can find out more about this from the NICE guidance on Preterm Labour and Birth, which can be found at: www.nice.org.uk/guidance/ng25/ifp/chapter/About-this-information.
    [Show full text]
  • Cervical Cancer
    Cervical Cancer Ritu Salani, M.D., M.B.A. Assistant Professor, Dept. of Obstetrics & Gynecology Division of Gynecologic Oncology The Ohio State University Estimated gynecologic cancer cases United States 2010 Jemal, A. et al. CA Cancer J Clin 2010; 60:277-300 1 Estimated gynecologic cancer deaths United States 2010 Jemal, A. et al. CA Cancer J Clin 2010; 60:277-300 Decreasing Trends of Cervical Cancer Incidence in the U.S. • With the advent of the Pap smear, the incidence of cervical cancer has dramatically declined. • The curve has been stable for the past decade because we are not reaching the unscreened population. Reprinted by permission of the American Cancer Society, Inc. 2 Cancer incidence worldwide GLOBOCAN 2008 Cervical Cancer New cases Deaths United States 12,200 4,210 Developing nations 530,000 275,000 • 85% of cases occur in developing nations ¹Jemal, CA Cancer J Clin 2010 GLOBOCAN 2008 3 Cervical Cancer • Histology – Squamous cell carcinoma (80%) – Adenocarcinoma (15%) – Adenosquamous carcinoma (3 to 5%) – Neuroendocrine or small cell carcinoma (rare) Human Papillomavirus (HPV) • Etiologic agent of cervical cancer • HPV DNA sequences detected is more than 99% of invasive cervical carcinomas • High risk types: 16, 18, 45, and 56 • Intermediate types: 31, 33, 35, 39, 51, 52, 55, 58, 59, 66, 68 HPV 16 accounts for ~80% of cases HPV 18 accounts for 25% of cases Walboomers JM, Jacobs MV, Manos MM, et al. J Pathol 1999;189(1):12-9. 4 Viral persistence and Precancerous progression Normal lesion cervix Regression/ clearance Invasive cancer Risk factors • Early age of sexual activity • Cigggarette smoking • Infection by other microbial agents • Immunosuppression – Transplant medications – HIV infection • Oral contraceptive use • Dietary factors – Deficiencies in vitamin A and beta carotene 5 Multi-Stage Cervical Carcinogenesis Rosenthal AN, Ryan A, Al-Jehani RM, et al.
    [Show full text]
  • Chapter 9 Management of Cervical Cancer Complicating Pregnancy
    Page 91 Chapter 9 Management of Cervical Cancer Complicating Pregnancy Overview In recent years, cervical cancer is being seen increasingly often in younger women. More cervical cancer is detected during pregnancy due to women becoming pregnant later in their lives, in turn the result of later marriage. The basic treatment strategy is the same as for non-pregnant women. However, the treating institution must provide individualized management depending on clinical stage, weeks of gestation, and the patient’s desire to continue the pregnancy. If the cancer is at an early stage, concurrent cervical cancer treatment and continuation of pregnancy is possible in many cases. For advanced cancer, the management will differ depending on whether or not the fetus is at a stage in which it is viable outside the uterus. If the fetus is sufficiently developed, treatment for cervical cancer is promptly performed as soon as the mother delivers the fetus. If the fetus has not reached such a stage, the maternal life should be given priority, and the cancer treated. In recent years, neonatal medicine has rapidly advanced, and social values have become diversified. Accordingly, even if a cancer is found at a stage when the fetus is not viable outside the uterus, some patients and their families have a strong desire to wait to begin treatment until it is viable. There is no consensus on the allowable waiting period, and at present treatment should only be delayed with caution. Page 92 CQ33 How should cervical cancer complicating pregnancy be managed? Recommendations (1) Cone biopsy may be delayed until after delivery as long as a microinvasive or more advanced lesion is not suspected on the results of cytology, colposcopy, or biopsy (Grade C).
    [Show full text]
  • Icd-9-Cm (2010)
    ICD-9-CM (2010) PROCEDURE CODE LONG DESCRIPTION SHORT DESCRIPTION 0001 Therapeutic ultrasound of vessels of head and neck Ther ult head & neck ves 0002 Therapeutic ultrasound of heart Ther ultrasound of heart 0003 Therapeutic ultrasound of peripheral vascular vessels Ther ult peripheral ves 0009 Other therapeutic ultrasound Other therapeutic ultsnd 0010 Implantation of chemotherapeutic agent Implant chemothera agent 0011 Infusion of drotrecogin alfa (activated) Infus drotrecogin alfa 0012 Administration of inhaled nitric oxide Adm inhal nitric oxide 0013 Injection or infusion of nesiritide Inject/infus nesiritide 0014 Injection or infusion of oxazolidinone class of antibiotics Injection oxazolidinone 0015 High-dose infusion interleukin-2 [IL-2] High-dose infusion IL-2 0016 Pressurized treatment of venous bypass graft [conduit] with pharmaceutical substance Pressurized treat graft 0017 Infusion of vasopressor agent Infusion of vasopressor 0018 Infusion of immunosuppressive antibody therapy Infus immunosup antibody 0019 Disruption of blood brain barrier via infusion [BBBD] BBBD via infusion 0021 Intravascular imaging of extracranial cerebral vessels IVUS extracran cereb ves 0022 Intravascular imaging of intrathoracic vessels IVUS intrathoracic ves 0023 Intravascular imaging of peripheral vessels IVUS peripheral vessels 0024 Intravascular imaging of coronary vessels IVUS coronary vessels 0025 Intravascular imaging of renal vessels IVUS renal vessels 0028 Intravascular imaging, other specified vessel(s) Intravascul imaging NEC 0029 Intravascular
    [Show full text]
  • Successful Treatment for a Heterotopic Intrauterine and a Twin Cervical
    IMAJ • VOL 13 • FEBRUARY 2011 CASE COMMUNICATIONS Dilation and Curettage: Successful Treatment for a Heterotopic Intrauterine and a Twin Cervical Pregnancy Dana Vitner MD, Lior Lowenstein MD MSc, Michael Deutsch MD, Nizar Khatib MD and Zeev Weiner MD Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel pregnancies, enabling the caregivers to Serum beta-human chorionic gonadotro- KEY WORDS: cervical pregnancy, heterotopic offer conservative treatment. This new pin level was 10,000 mIU/ml 3 days prior pregnancy, dilation and curettage approach reduced the morbidity and to her admission. IMAJ 2011; 13: 115–116 mortality rate and greatly improved On admission, the patient’s vital signs fertility preservation [1,3]. were stable and the abdomen was soft Cervical twin pregnancy is an ex- with no signs of peritoneal irritation. A tremely rare event, with only a few cases speculum and bimanual gynecological reported in the literature. It is reason- examination revealed a small amount of ervical pregnancy represents a rare able to claim that women with this type cervical bleeding with blood clots, and C type of ectopic pregnancy [1-5], rep- of pregnancy are at a higher risk for a normal-size anteverted uterus with orted to be less than 0.1% of all preg- massive hemorrhage due to the wider normal bilateral adnexae. Transvaginal nancies [2,4,5]. Possible risk factors for implantation area and the increased sonography revealed a single intrauterine cervical pregnancy are: prior uterine vascularity [4]. We present the case of a gestational sac, irregular in shape, with no surgery such as cesarean section, dilation rare event of a triplet pregnancy: a single embryo or yolk sac [Figure A].
    [Show full text]
  • Transabdominal Cerclage: Different Indications, Optimal Outcome
    ISSN: 2474-1353 Sabr and Yousef. Int J Womens Health Wellness 2018, 4:067 DOI: 10.23937/2474-1353/1510067 Volume 4 | Issue 1 International Journal of Open Access Women’s Health and Wellness CASE REPORT Transabdominal Cerclage: Different Indications, Optimal Outcome. Two Case Reports Yasser Sabr* and Sara W Yousef Check for Department of Obstetrics and Gynecology, Collage of Medicine, King Saud University, Riyadh, Saudi Arabia updates *Corresponding author: Yasser Sabr, Department of Obstetrics and Gynecology, Collage of Medicine, King Saud University, Riyadh, Saudi Arabia, E-mail: [email protected] Abstract Case 1 Transabdominal placement of a cerclage at the cervicoisth- 25-years-old woman gravida 2 para 0 abortus 1 mic junction appears to be a safe and effective procedure known case of congenital hypoplastic upper vagina, for for reducing the incidence of spontaneous pregnancy loss that she underwent multiple vaginal surgeries including in selected patients with cervical insufficiency, we reported a case series of two woman with different indications for ab- vaginal septum resection, vaginoplasty (vaginostomy). dominal cerclage. Case 1 is a 25-years-old woman gravida After the procedures, Patient was unable to get preg- 2 para 0 abortus 1 known case of hypoplastic upper vagina nant for 1 year, so she came back and hysteroscopy who had 2 vaginal repair (vaginostomy) and had abdominal with examination under anesthesia was done, which cerclage for short cervix and delivered by caesarean sec- revealed stenosed upper vagina and very short cervix tion at 38 weeks a healthy baby boy. Case 2 is a 34-years- old woman gravida 5 para 0 abortus 4 known case of dia- with normal uterine cavity.
    [Show full text]
  • Development of the ICD-10 Procedure Coding System (ICD-10-PCS)
    Development of the ICD-10 Procedure Coding System (ICD-10-PCS) Richard F. Averill, M.S., Robert L. Mullin, M.D., Barbara A. Steinbeck, RHIT, Norbert I. Goldfield, M.D, Thelma M. Grant, RHIA, Rhonda R. Butler, CCS, CCS-P The International Classification of Diseases 10th Revision Procedure Coding System (ICD-10-PCS) has been developed as a replacement for Volume 3 of the International Classification of Diseases 9th Revision (ICD-9-CM). The development of ICD-10-PCS was funded by the U.S. Centers for Medicare and Medicaid Services (CMS).1 ICD-10- PCS has a multiaxial seven character alphanumeric code structure that provides a unique code for all substantially different procedures, and allows new procedures to be easily incorporated as new codes. ICD10-PCS was under development for over five years. The initial draft was formally tested and evaluated by an independent contractor; the final version was released in the Spring of 1998, with annual updates since the final release. The design, development and testing of ICD-10-PCS are discussed. Introduction Volume 3 of the International Classification of Diseases 9th Revision Clinical Modification (ICD-9-CM) has been used in the U.S. for the reporting of inpatient pro- cedures since 1979. The structure of Volume 3 of ICD-9-CM has not allowed new procedures associated with rapidly changing technology to be effectively incorporated as new codes. As a result, in 1992 the U.S. Centers for Medicare and Medicaid Services (CMS) funded a project to design a replacement for Volume 3 of ICD-9-CM.
    [Show full text]
  • Laparoscopically Assisted Cervical Canalization and Neovaginoplasty in a Woman with Cervical Atresia and Vaginal Aplasia
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Elsevier - Publisher Connector Gynecology and Minimally Invasive Therapy 6 (2017) 31e33 Contents lists available at ScienceDirect Gynecology and Minimally Invasive Therapy journal homepage: www.e-gmit.com Case report Laparoscopically assisted cervical canalization and neovaginoplasty in a woman with cervical atresia and vaginal aplasia * Asami Kobayashi, Atsushi Fukui , Ayano Funamizu, Asami Ito, Rie Fukuhara, Hideki Mizunuma Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan article info abstract Article history: Cervical atresia is a Müllerian duct system anomaly, and it is often associated with vaginal aplasia. We Received 24 December 2015 report the case of a 17-year-old girl who presented with primary amenorrhea and cyclical abdominal Received in revised form pain, and was diagnosed with cervical atresia and vaginal aplasia that were treated laparoscopically. 6 May 2016 Laparoscopically assisted cervical canalization and neovaginoplasty were performed to relieve Accepted 9 May 2016 dysmenorrhea and allow for sexual intercourse and fertility. We did not use a bowel segment, skin, or Available online 7 June 2016 peritoneum as a graft for the neovaginoplasty. To prevent adhesions and promote epithelialization, we used an estrogen-containing cream. Moreover, we did not use a vaginal mold. The patient is free of Keywords: cervical atresia cervical stenosis and able to have intercourse. Long-term follow-up is necessary to ensure a future cervical canalization pregnancy and childbirth. laparoscopy Copyright © 2016, The Asia-Pacific Association for Gynecologic Endoscopy and Minimally Invasive neovaginoplasty Therapy. Published by Elsevier Taiwan LLC.
    [Show full text]