Novel prospects in cervical incompetence treatment

Abstract

Background. A "Method of cervical incompetence treatment in pregnant women" (RF patent for invention №2746437, priority dated December 25, 2019) is presented. Method details are described. Aim. To evaluate the efficacy and safety of the novel cervical incompetence (CI) treatment method in pregnant women. Materials and methods. The study included 150 pregnant women divided into three groups, with 50 subjects in each group. Group 1 included pregnant women with CI who received the novel treatment method (narrowing of the dilated cervical canal with a flexible tape with a fixation lock); Group 2 included pregnant women who underwent surgical correction of CI (U-shaped sutures to the cervix); Group 3 included pregnant women with the initial stage of CI, in whom obstetric pessaries were used. Patients in the groups were comparable in age, reproductive behavior, somatic diseases, and obstetric and gynecological history. Results. After CI correction, different early complications were observed in 20, 66, and 34% of pregnant women by groups, respectively. The novel method of narrowing the dilated cervical canal with a flexible loop with a fixation lock is technically a simpler manipulation than surgical suturing of the cervix with a prolapsed amniotic sac. Clinical signs of threatening miscarriage in subsequent gestational periods occurred in 22% of patients in Group 1, 64% of Group 2, and 28% of Group 3. Full-term delivery was reported in 88, 68, and 84%, respectively. Conclusion. The novel method of CI correction is technically simple, clinically- and cost-effective. Furthermore, this method does not involve using medications that can affect the pregnant woman and the fetus.

Keywords

• cervical incompetence
• treatment
• correction methods during pregnancy