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EP03.05: Sequential ultrasoundgraphic findings and perinatal outcomes of decidual polyps treated with cervical cerclage
Author(s) -
Nakai K.,
Tachibana D.,
Suekane T.,
Yokoi N.W.,
Kurihara Y.,
Hamuro A.,
Misugi T.,
Nakano A.,
Koyama M.
Publication year - 2018
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.19810
Subject(s) - medicine , cervical cerclage , preterm labour , gestation , obstetrics , gestational age , abortion , pregnancy , preterm delivery , gynecology , genetics , biology
Objectives: Decidual polyps (DPs) are highly associated with spontaneous abortion and preterm birth, although the management still remains to be established. We aimed to meticulously observe the sequential ultrasoundgraphic findings of DPs which were treated with cervical cerclage (CC) because of the shortening of cervical length (CL) and evaluate their clinical outcome. Methods: The patients who presented DPs which had more than 8 mm stalks in its diameter protruding out of the external os from upper side of the internal os were retrospectively reviewed. Polypectomy was not performed in any cases. CC was performed using McDonald method for the patients whose CL was less than 25mm before 25 weeks of gestation. Results: Fifteen patients were diagnosed with DPs between 2016 to 2018. Migration of DPs into placental parenchyma and the shortening of cervical length were observed simultaneously in eight cases and CC was performed. Median values and ranges were as following at the time of surgery: gestational age (GA), 18+6 (11+5-22+3) weeks / WBC, 10700 (7300 13000)/μl; CRP, 0.18 (0.02 0.79) mg/dl; CL, 14.5 (0-21.6) mm. Median GA of delivery was 36+5 (35+0-38+5) weeks and all the mothers and neonates discharged uneventfully. Conclusions: CC was successfully performed even in the cases with internal migration of DPs. Clinical obstetricians should keep in mind that CC might be effective in the patients who suffer from threatened abortion or preterm delivery because of DPs. EP03.06 Assisted reproductive technology and the risk of preterm birth