A 32-week-pregnant woman with a history of two previous mid trimester aboions presents with regular contraction of the uterus. The cervix is 2 cm dilated. All the following are done EXCEPT
Correct Answer: Emergency encirclage
Description: Recurrent mid trimester aboions is suggestive of incompetent cervix: characterized classically by painless cervical dilatation in the second trimester. It can be followed by prolapse and ballooning of membranes into the vagina, and ultimately, expulsion of an immature fetus. Glucocoicoids are advocated where the pregnancy is less than 34 weeks to accelerate fetal lung maturation and reduce incidence of respiratory distress of newborn Antibiotics - Prophylactic antibiotics are given to minimize maternal and perinatal risk of infections (i.v.ampicillin) Tocolytics - arrest the preterm labour and inhibit uterine contractions, to buy time for steroids to act for inducing lung maturity ContraIndications of encerclage are: Placenta in lower segment Ruptured membranes Intra Uterine fetal death Malformations of the fetus Intra Uterine sepsis Cervix>4 cm dilated Gestational age more than 32 weeks
Category:
Gynaecology & Obstetrics
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