Cervical insufficiency in pregnant women after IVF: A retrospective research
DOI:
https://doi.org/10.37800/RM.1.2023.29-34Keywords:
in vitro fertilization, cervical insufficiency, Obstetrical pessary, surgical correction of the cervix, premature birth, short cervix, high-risk pregnancyAbstract
Relevance: Even though various in vitro fertilization (IVF) methods help achieve the desired pregnancy, there is a problem with an effective personalized approach to minimizing obstetric and perinatal losses during pregnancy and childbirth in patients who have undergone an in vitro fertilization program. A special distinction of the second trimester in IVF-induced pregnancy is the risk of developing isthmic-cervical insufficiency (CI). CI incidence in the general population is 1-9%. In cases of miscarriage, CI incidence reaches 15-42%.
The study aimed to assess the effectiveness of using an obstetrical pessary for CI in pregnant women after IVF.
Materials and Methods: The study was conducted based on the Center for Perinatology and Pediatric Cardiac Surgery in Almaty. A retrospective analysis of 200 outpatient records of women after the IVF program was carried out. Two research groups were created: the main group (n=84) – pregnant women after IVF with an established diagnosis of CI, and a comparison group (n=116) – pregnant women after IVF without CI.
Results: Cervical insufficiency is significantly more common in patients with endocrine infertility. The use of an obstetrical pessary contributes to the prolongation of pregnancy up to 29-33 and 34-36 weeks of pregnancy, the reduction of very early preterm birth, and the birth of children with extremely low body weight. The use of the obstetrical pessary contributed to prolonging pregnancy to the term of delivery in 71% of cases. There were no significant differences in the delivery methods in the studied groups. In patients with CI, the number of postpartum hemorrhages is significantly more often recorded.
Conclusion: Considering the obtained results, it can be assumed that in the diagnosis of CI before 20 weeks of gestation, it is preferable to use surgical correction or a combination of surgical methods and the insertion of an obstetrical pessary, which will reduce the number of premature births.
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