A gravida 3 female with kilo 2 previous 2nd trimester aboion presents at 22 weeks of gestation with funneling of cervix Most appropriate management would be:
Ans. is d i.e. Apply MC Donald stitch In this question : A gravida 3 female is presenting with 2 previous 2nd trimester losses and with funneling of cervix at 22 weeks of gestation which means that the patient has incompetent cervix. Management of this condition as discussed in previous question is application of Mc Donald stitch Women who may have incompetent cervix and require treatment can be divided into 4 groups : Extra Edge Women presenting with acute presentation of incompetent cervix i.e. ? Complain of Pelvic / Rectal pressure of recent onset Increased mucous vaginal discharge. No contractions Remember * Most common factors associated with failure of rescue cerclage are -- Nulliparity -- Prolapsed membranes -- WBC > 14,000/mm3. -- CRP > 4 mg /dl -- Cervical dilatation > 4 cm -- Cervical length < 0.5 cm Contractions present
Administer dinoprostone and bed rest
Administer misoprostol and bed rest
Apply fothergill stretch
Apply McDonald stitch