ARCHIVEOBSTETRICS AND GYNECOLOGY
International Medical Journal, Vol. 21., Iss. 4, 2015, P. 37−41.
MODERN APPROACHES TO DIAGNOSIS AND TREATMENT OF CERVICAL INCOMPETENCE
Kharkiv National Medical University, Ukraine
The aim of this study was to determine the clinical and diagnostic features and the state of hemodynamics in the descending branches of the uterine artery using Doppler ultrasound in cervical incompetence (CIN) before pregnancy and to evaluate the effectiveness of modern methods of its correction. The study involved 85 pregnant patients at risk of CIN, the main group, and 20 healthy women included in the control group. The main group was divided into two clinical groups: group 1 included 48 women with CIN, who before pregnancy were treated with fillers based on hyaluronic acid, group 2 included 37 women with CIN, who, in addition to rehabilitation of the vagina, did not receive any treatment before pregnancy. The blood flow in small vessels of the cervix in women at risk for CIN was investigated. It was found that decrease in peripheral resistance index at three levels of cervical perfusion in the descending branch of the uterine artery, peripheral and stoma areas of the cervix, as well as increased resistance to blood flow in the central area, allow establishing the risk of CIN. Therefore the patients are recommended correction with biorevitalisation methods using fillers based on hyaluronic acid before pregnancy. The parameters of Doppler blood flow investigation in the uterine arteries, as well as the history data, palpation assessment of cervix, transvaginal ultrasound diagnosis may serve as an additional diagnostic test and determine CIN risk development during pregnancy. Hemodynamic changes revealed in the descending portion of the uterine artery, and three levels of cervical perfusion, are apparently related to the compensatory−adaptive changes in the cervix at CIN.
Key words: cervical incompetence, Doppler investigation, diagnosis, treatment.