BALTIMORE, Md. (Ivanhoe Newswire) — For women who lose babies after twenty weeks, one of the most common causes is cervical insufficiency, meaning the cervix is weakened or compromised. Now, a minimally-invasive procedure is helping at-risk women deliver healthy babies.
Michael and Jamie Good have a busy household; brothers Zach and Gabe watch over baby sister Adrianna. But getting to this point was far from easy.
“The last two babies I had, I left the hospital alone,” Jamie Good explained to Ivanhoe.
Jamie miscarried twins at ten weeks. Then lost two boys; one at 17 weeks and another at 20 weeks. Each loss was crushing … even for Michael, who saw his share of tragedy when he served in Iraq.
Michael said, “I expect that we’re in combat; we may lose somebody. And so you can mentally prepare yourself for this. This, there’s nothing you could do to prepare.”
Robert Atlas MD, OB/GYN at Mercy Medical Center is a specialist in maternal-fetal medicine. He says, in some cases, pregnancy loss is due to cervical insufficiency.
“There are things we can potentially do that can prevent that from happening, even in their first pregnancy,” Dr. Atlas stated. (Read Full Interview)
It’s called cerclage. Doctors surgically tighten or close the cervix, before or during pregnancy. Instead of major surgery, doctors can now perform robotic cerclage, working through five small keyholes in the abdomen.
Dr. Atlas continued, “We’re going in and out of the cervix and then we tie it down tight just like that purse string.”
Doctors delivered Adrianna by C-section at 36 weeks. Six pounds, five ounces.
“This little bundle of joy was active and nursing, and just a normal baby girl,” Jamie said.
After cerclage the stitches remain in the body. The procedure is outpatient, and most patients can try to conceive just a few months after.
Contributors to this news report include: Cyndy McGrath, Field and Supervising Producer; Gabriella Battistiol, Assistant Producer; Roque Correa, Videographer and Editor.
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TOPIC: ROBOTIC CERCLAGE STOPS PREGNANCY LOSS!
REPORT: MB #4317
BACKGROUND: Cervical insufficiency or incompetent cervix occurs when a woman’s cervix starts to efface and dilate too soon. This can cause them to give birth too early, typically from 16 up to 24 weeks. It can result in miscarriages or preterm deliveries. Patients most at risk for this are those who’ve had a procedure such as a cone biopsy or LEEP done on their cervix, if their cervix was injured during a previous birth, dilation, and curettage. Also if they’ve had one or more second-trimester miscarriages with no known causes, or one or more spontaneous preterm deliveries. Finally if a patients mother took the drug DES or diethylstilbestrol while pregnant with the patient. A patient may show no symptoms, but mild symptoms may show up, including; pelvic pressure, vaginal discharge that changes from clear, white or light yellow to pink or tan, premenstrual-like cramping, spotting, or vaginal discharge that increases in volume or becomes wetter.
STANDARD PROCEDURE: Traditional treatment for cervical incompetence is a surgical procedure called cerclage, where the cervix is sewn closed during pregnancy. The best time for this procedure is in the third month or between 12-14 weeks of pregnancy; however, some may require emergent cerclage later in the pregnancy. Cervical cerclage helps prevent miscarriage or premature labor and is successful in 85-90 percent of cases. Most women receive anesthesia for pain control during the procedure, and may stay overnight to be monitored for premature contractions or labor. Patients post procedure may experience light bleeding and cramping for several days, followed by an increased thick vaginal discharge which may continue for the remainder of the pregnancy. Generally the thread is removed at the 37th week of pregnancy but it can be removed before if a woman’s water breaks or contractions start.
NEW TECHNOLOGY: Instead of major surgery, doctors can now perform robotic cerclage, working through four or five small keyholes in the abdomen. This new minimally-invasive procedure is outpatient, and most patients can try and conceive just a few months post-procedure. After surgery, the stitches remain in the body.
(Source: Robert Atlas, MD)
MORE FROM DR. ATLAS: “Cervical cerclages are typically placed during pregnancy. Abdominal cerclages can be placed either during or prior to pregnancy.”
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