Cerclage in complete placenta previa preventing preterm labor: A rare case report

Author:

Saroyo Yudianto Budi1ORCID,Madjid Omo Abdul2,Santawi Victor Prana Andika3,Scovani Laurensia3,Purbadi Sigit4

Affiliation:

1. Fetomaternal Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, DKI Jakarta, Indonesia

2. Social Obstetrics and Gynecology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, DKI Jakarta, Indonesia

3. Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, DKI Jakarta, Indonesia

4. Gynecology-Oncology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, DKI Jakarta, Indonesia

Abstract

Placenta previa often leads to antepartum hemorrhage, which warrants the patient for emergency room admission. The bleeding occurs mainly due to cervical dilation, which could be caused by cervical incompetence. Cervical cerclage has been considered as the primary treatment for cervical incompetence. However, evidence is lacking for its application in placenta previa. Here, we present a case of a 30-year-old pregnant woman diagnosed with complete placenta previa where a good obstetrical outcome could be achieved. The patient had antepartum hemorrhage during the 21st week of gestational age due to cervical dilation in a complete placenta previa case. An emergency cerclage using McDonald’s technique was then performed, which prolonged the pregnancy to the 34th week of gestation. The patient had cesarean section and delivered a healthy baby girl weighing 2190 g. The mother and the baby had an uneventful recovery and were discharged after 2 days of hospitalization.

Publisher

SAGE Publications

Subject

General Medicine

Reference16 articles.

1. Anderson-Bagga F, Sze A. Placenta previa. Treasure Island, FL: StatPerals Publishing, 2021. Available at: https://www.ncbi.nlm.nih.gov/books/NBK539818/#_NBK539818_pubdet_ (accessed 22 November 2022).

2. Antepartum haemorrhage. In: RCOG green-top guideline no 63. United Kingdom: Royal College of Obstetricians and Gynaecologists, 2011. Available at: https://www.rcog.org.uk/media/pwdi1tef/gtg_63.pdf

3. Placenta previa with early opening of the uterine isthmus is associated with high risk of bleeding during pregnancy, and massive haemorrhage during caesarean delivery

4. Early preterm delivery due to placenta previa is an independent risk factor for a subsequent spontaneous preterm birth

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