Managing a pregnancy with cervical insufficiency and fetal intraventricular hemorrhage: a case report

This article presents a clinical case of a pregnant woman with cervical insufficiency who underwent laparoscopic cerclage prior to pregnancy due to recurrent miscarriages. The patient had a history of four pregnancies with unfavorable outcomes. Considering the complicated obstetric history, laparoscopic correction of cervical insufficiency was recommended. The first trimester proceeded without complications. In the second trimester, an ultrasound revealed signs of fetal intraventricular hemorrhage on the right. Reverse transcription polymerase chain reaction of cervical canal swab showed parvovirus B19. A case conference was held, and the decision was made to keep the pregnancy. The progress was monitored using ultrasound and Doppler ultrasound. Owning to the fetus’ condition, the patient was referred to a federal medical institution for delivery and specialized, high-tech medical care. Follow-up ultrasounds and Doppler examinations of the fetus prior to delivery showed no negative changes related to intraventricular hemorrhage. The patient underwent an emergency cesarean section at the Perinatal Center of St. Petersburg State Pediatric Medical University at 38 weeks and 6 days of gestation.