Methods of efferent therapy in prolongation of pregnancy in the isthmic-cervical insufficiency (two clinical observations)

Abstract

The report presents two clinical observations of pregnancy outcome in patients with isthmic-cervical insufficiency of functional (first observation) and functional-organic (second observation) origin. In both cases, previously treated cervical erosion by laser (in the second observation – carried out excision of the cervix). In secundiparous women in the present pregnancy were noted recurrent urogenital (first observation) and genital (second observation) infection with a threatened miscarriage and the need for re-hospitalizations. Complex therapy with the introduction of obstetric discharge pessarium was not effective enough, there were manifestations of the inflammatory response of the body, isthmic-cervical insufficiency progressed, up to prolapse of the fetal bladder into the cervical canal (first observation). When entering the perinatal center, the treatment of pregnant women included methods of low-volume membrane plasmapheresis and photomodification of blood with ultraviolet and laser rays (alternated). In both cases, it was possible to stop the manifestations of inflammatory response, to improve the condition of the cervical canal, to prolong pregnancy to the term of normal childbirth. In the first observation, the birth occurred naturally, in the second case cesarean section was performed due to organic changes in the cervix. Childbirth, the postpartum period in women proceeded normally. Children were born healthy, full-term, develop normally, receive breastfeeding.