[Premature birth in patient with cervix incompetence and history of myasthenia gravis]. / Parto prematuro en paciente con incompetencia cervical y antecedentes de miastenia gravis.
Ginecol Obstet Mex
; 81(9): 545-9, 2013 Sep.
Article
em Es
| MEDLINE
| ID: mdl-24187819
Cervical incompetence it's a dilatation of the cervix during the third trimester of pregnancy that ends with the interruption of it. The incidence in Chile is about 0.1-2% of the total pregnancies and it's one of the causes of preterm birth. A 34 years old pregnant patient. Timectomized at age 18 to treat her miastenia gravis, previously trated with medication, had 4 previous preterm labours all of them under 25 weeks and vaginal births. All fetuses died postpartum. A cerclage was made during the third, fourth and fifth pregnancies. She didn't present hypertension during the gestation and no cervical diameter under 15mm. Since the fourth gestation the following tests are taken: Antifosfolipidic antibodies, APTT,PT. All the results are either normal or negative. Microbial cultures were negative. No amniocentesis was made. A McDonald cervical cerclage was made during pregnancies number 3, 4 and 5 on the 16th week to delay the labor. Also oral micronized progesterone, on a 400mg/24 hours dosis, was administered to avoid preterm birth. On the 24th week the pharmacological treatment started including Intramuscular Betamethasone, 12 mg/24 hours (2 doses), to induce lung maturity on the fetus. It is thought that the administration of progesterone could have improved the situation of the patient, because it acts as a labour repressants. The use of cerclage could have helped, but the factors that may influence the effectiveness of this method are unknown. Perhaps there is some immunologic factor associated with the miastenia gravis that alters the normal course of pregnancy.
Buscar no Google
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Incompetência do Colo do Útero
/
Nascimento Prematuro
/
Miastenia Gravis
Limite:
Adult
/
Female
/
Humans
/
Pregnancy
Idioma:
Es
Revista:
Ginecol Obstet Mex
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Chile
País de publicação:
México