Clinical case of management a pregnancy with isthmic-cervical insufficiency and intraventricular hemorrhage in the fetus

This article presents a unique clinical case of management of a pregnant with isthmic-cervical insufficiency (ICI) and laparoscopic cerclage performed at the pre-pregnancy stage for habitual miscarriage. The patient has a history of 4 pregnancies with an unfavorable outcome. Taking into account the burdened obstetric history, the patient was offered a laparoscopic correction of ICI at the pre-pregnancy stage. The first trimester of the 5th pregnancy was uneventful. In the second trimester, ultrasound screening revealed signs of intraventricular hemorrhage (IVH) at the right ventricle. During PCR-RT examination of the cervical canal, Parvovirus B19 was detected. A consultation was held to resolve the issue of the possibility of maintaining this pregnancy. By the decision of the council, the pregnancy was prolonged, ultrasound and ultrasound were performed to track the dynamics. Taking into account the condition of the fetus, it was decided to send the patient for delivery to the Perinatal Center of the Saint Petersburg State Pediatric Medical Universityfor the provision of specialized, high-tech medical care. During the control ultrasound and fetal ultrasound scan, no negative dynamics in the IVH were observed until the moment of delivery. The woman was promptly delivered by caesarean section at the Perinatal Center of the Saint Petersburg State Pediatric Medical Universityat the age of 38 weeks + 6 days.