Texas Health Dallas

Fall/Winter 2013

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Risky Pregnancy, Happy Baby In the face of a preexisting condition that threatens the health of an unborn child, Texas Health Presbyterian Hospital Dallas offers an innovative procedure that can lead to a healthy pregnancy and birth. TexasHealth.org 4 t exas Health Dallas is committed to keeping mother and baby as healthy as possible throughout pregnancy and childbirth. Pregnancy can be a harrowing experience for women with a weak or incompetent cervix, because that condition may lead to miscarriage or preterm birth. According to the American Pregnancy Association, a procedure known as an abdominal cervical cerclage (or cervical stitch) is successful in as many as 90 percent of pregnancies complicated by an incompetent cervix. During the procedure, the cervix is sewn closed until the stitch is removed at 37 weeks or when labor begins. Ted Fogwell, M.D., an OB/GYN on the medical staff at The Margot Perot Center for Women & Infants at Texas Health Dallas, is one of the few surgeons in North Texas who performs a cervical cerclage through the abdomen. "By entering the abdomen, I can reduce the risk of funneling by placing a quarterinch-thick band at the top of the cervix. This differs from a vaginal cerclage, which is stitched lower in the cervix," Dr. Fogwell says. "While this minimally invasive procedure is new, data consistently shows that the abdominal cerclage has a higher success rate than the vaginal cerclage." The procedure requires only four small cuts, with three on the side of the abdomen and one on the lower belly. Recovery time also is generally shorter following an abdominal cerclage. COMPLICATIONS AND CORRECTIONS Jennifer Jones, a 34-year-old Dallas resident, speech pathologist and mother of twin toddlers, was no stranger to pregnancy complications. During her first pregnancy, Jones was diagnosed with an incompetent cervix and spent eight weeks on bed rest in the hospital before giving birth to twin boys at 31 weeks' gestation. The twins spent more than a month in the Neonatal Intensive Care Unit and Special Care Nursery at Texas Health Dallas before going home. When Jones became pregnant with her third child, she did not want to risk another long-term hospital stay. After consulting with Dr. Fogwell, Jones knew an abdominal cerclage was right for her. "I had the stitch placed during the 11th week of my pregnancy," Jones says. "I went in for the procedure on a Friday morning and went home later that afternoon." The abdominal cerclage Dr. Fogwell performed completely changed the outcome of this pregnancy. Jones was able to have a successful pregnancy and labor that ended with the birth of a fullterm, healthy baby girl, who soon went home to her two older brothers. For more information about Texas Health Dallas' maternity care, visit TexasHealth.org/Dallas-Women.

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