Etiologic, diagnostic, and management aspects of patients with isthmic-cervical insufficiency

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Abstract

Isthmic-cervical insufficiency (ICI) is one of the main causes of recurrent miscarriage, leading to an increase in perinatal mortality rates and a deterioration of women’s reproductive health. There are currently several methods for diagnosing ICI during pregnancy. In the non-pregnant state, its diagnosis is mainly made retrospectively based on a history of preterm birth due to shortening of the cervix. The main treatment for ICI during pregnancy is cervical cerclage. Despite the well-established technique, this surgical intervention is not always effective for prolonging pregnancy and is associated certain pregnancy risks, including uterine contractions, bleeding, and infection. Cases of cervical rupture after suturing have also been reported, which can ultimately lead to miscarriage or preterm delivery. There have been repeated cases of pregnancy loss in women even after the timely detection of ICI and surgical treatment, suggesting that these women are at risk of miscarriage in the future. For such patients, it is necessary to develop an examination algorithm to identify the various aspects of their cervical insufficiency and treatment at the pregravid stage.

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About the authors

Al’fiya G. Yashchuk

Bashkir State Medical University

Email: alfiya_galimovna@mail.ru
ORCID iD: 0000-0003-2645-1662

MD, Dr. Sci. (Med.), Professor

Russian Federation, Ufa

Ol’ga V. Yakovleva

Bashkir State Medical University

Email: olgayakov-leva@mail.ru
ORCID iD: 0000-0002-0429-2368

Assistant Lecturer

Russian Federation, Ufa

Il’nur I. Musin

Bashkir State Medical University

Email: ilnur-musin@yandex.ru
ORCID iD: 0000-0001-5520-5845

MD, Cand. Sci. (Med.), Assistant Professor

Russian Federation, Ufa

Aliya R. Yanbarisova

Bashkir State Medical University

Author for correspondence.
Email: yanbarisova1999@mail.ru
ORCID iD: 0000-0003-3799-4080

Student

Russian Federation, Ufa

Ehnzhe F. Berdigulova

Bashkir State Medical University

Email: berdigulova_enzhe@mail.ru
ORCID iD: 0000-0002-5111-0256

Student

Russian Federation, Ufa

Dar’ya D. Gromenko

Bashkir State Medical University

Email: dasha.gromenko@mail.ru
ORCID iD: 0000-0001-5638-1779

Student

Russian Federation, Ufa

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