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Re: Incompentent Cervix?From: RModugno@aol.comFri Jun 24 16:27:02 2005
In a message dated 6/24/2005 5:23:10 PM Eastern Standard Time, rkaplan@triad.rr.com writes: I have a patient who has had 4 full term deliveries. In her 1st pregnancy she had some mild cramping at 25 weeks and an exam revealed a 2cm dilated cervix, 90%effaced with membranes firmly against the os. I performed a rescue cerclage, put her on oral terbutalene (for whatever good that does) and she delivered at 38 weeks, one week after I removed the cerclage. In her subsequent pregancies I placed prophylactic cerclages early in the 2nd trimester and she carried all these pregnancies to term and usually several weeks after the cerclages were removed. She is pregnant again and asked me if I really felt that cerclage was necessary. I gave her my opinion but told her I would ask my colleges on the internet. Thanks in advance for your imput. Richard Kaplan, MD Greensboro,NC Sorry, Richard, I'm going to have to say no. The original symptoms are not suggestive of cervical incompetence. Serial cervical lengths by vaginal ultrasound would be an alternative for her. Robert Modugno MD MBA FACOG Marietta, GA
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