Gynecology & Obstetrics
Open Access

Abstract

Interest of Late Cerclage on Open Cervix with Amniotic Membrane's Hernia in an African Environment. Review of 11 Collected Cases at Yopougon University Hospital in Abidjan (Ivory Coast, West Africa)

Fanny Mohamed, Koffi Abdoul, Konan Jean Marie, Aka Edele, Adjoussou Stephane, Olou Luc, Fomba Minata, Horo Apollinaire and Kone Mamourou

Objective: To demonstrate effective strapping emergency in the therapeutic management of threat with opencervix.
Methodology: We conducted a descriptive cohort study at Yopougon Abidjan (Côte d'Ivoire) University Hospital. Over a period of two years (February 2015 to January 2017), the study concerned 11 gestantes who presented a severe threat of late miscarriage with the opened cervix, protrusion and intact membranes in the second trimester of Pregnancy. For all pregnant, a strapping of the cervix has been performed according to Mac Donald’s procedure.
Results: Mean’s age of patients was 30 years, 27.30% primigravida and 36.40% nulliparous. More than half (55%) had a history of abortion. Symptomatology was dominated by pelvic pain (63.60%). The average gestational age at the time of strapping was 20 weeks. The average duration of the interventions was 12, 27min and hospitalization of pregnant after cerclage was 3 days. Following up was marked by a new hospitalization in 3 patients, because of membrane’s rupture at 31 weeks of pregnancy.
Average gestational age for childbirth was 36 weeks, 82% of births by cesarean section. 64% of children were born with a score of APGAR greater than 7 at the first minute. No cases of newborn death have been noted. The average time between strapping and childbirth was 115 days or 15 weeks.
Conclusion: Emergency cervical strapping is used to prolong the duration of pregnancy and to reduce the risk of high prematurity, thereby improving fetus viability and prognosis.