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Federación Mexicana de Ginecología y Obstetricia, A.C.

2016, Number 06

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Ginecol Obstet Mex 2016; 84 (06)

Cervical tear in a women with cervical pessary

González-Díaz I, Sánchez-Gómez P, García-Lorenzo LM, Esnal-Tres A, Escribano-Tórtola JJ

Language: Spanish
References: 17
Page: 396-402
PDF size: 293.74 Kb.


ABSTRACT

Background: Preterm birth is a major cause of maternal and fetal morbidity and mortality. It affects 6-10% of pregnant women. The cervical pessary is an effective method to reduce preterm delivery in patients with short cervix. So far the only reported side effects have been increased vaginal discharge and mild discomfort during insertion.
Case Report: 24 year old primigravida at 27 weeks gestation went to the emergency after a traffic accident without abdominal trauma. Painful and irregular uterine contractions, and cervicometry of 20 mm, negative funnel, was observed. We use tocolytic therapy and pulmonary maturation. When the patient was discharge cervical pessary indicated with a 10 mm cervical lenght. In the 37th week of gestation the pessary was removal. Labor induction was indicated for chronologically prolonged pregnancy (41+3 weeks of gestation). It was a vaginal delivery after a period of dilation for 3 hours and 45 minutes to expulsion. We obtained a woman of 3,210 g and Apgar 9/10. Ten days after had bleeding. In exploring we observed a cervical tear semicircular displayed all around the anterior lip, which is sutured in the surgeon under sedation, without incident.
Conclusions: Cervical tear could be described as a side effect of cervical pessary in pregnant women. A mode identifying it intends to do speculoscopy after the removal of the pessary.


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