Elective cervical cerclage versus no treatment in women with the history of cervical insufficiency: retrospective analysis of pregnancy outcomes

PURPOSE OF INVESTIGATION

To evaluate the effectiveness of elective cervical cerclage (CC) on the pregnancy outcome of patients with cervical insufficiency.

MATERIAL AND METHODS

A retrospective cohort study was conducted on women with an obstetric history of cervical insufficiency on whom CC was applied or not. The two groups were compared for the main measure outcomes of mean gestational age at delivery, birth weight, Apgar scores at five minutes, number of premature and preterm deliveries, rate of preterm premature rupture of membranes, incidence of neonatal death, and admission to the neonatal intensive care unit (NICU).

RESULTS

A total of 183 women were eligible for the final analysis in the CC group and 183 were taken as the control group. There were significant differences in terms of the mean gestational age at delivery (37 ± 4.0 vs. 34±5 weeks, p = 0.001), the mean birth weight (3,000 ± 870 vs. 2,200 ± 860 grams, p = 0.001), the number of preterm deliveries (< 37 weeks) (40% vs. 63%, p = 0.001, OR: 0.4, 95% CI: 0.26-0.61) between CC and control groups, respectively. Median Apgar scores at five minutes were 9 in CC group and 8 in the control group (p = 0.001) and the percentages of admission to NICU were 14% in CC group and 34% in the control group (p = 0.001, OR: 0.30, 95% CI: 0.17-0.52).

CONCLUSION

The placement of elective CC seemed to be effective in patients with a history of mid-trimester abortion or preterm delivery due to cervical insufficiency.

Statistical optimization of a sustained-release matrix tablet of lobenzarit disodium

The statistical optimization of sustained-release matrix tablets of lobenzarit disodium salt (LDS) was performed using the central composite experiment design 2(3) for three independent variables: the amount of polymer (Eudragit RS-PO) AP, the total volume of granulation solvent VS, and the amount of filler (microcrystalline cellulose) CE. The t90% was selected as the response variable. The response surfaces were performed from a statistical mathematical model. The optimal formulation was obtained for the variables (AP = 15 mg, VS = 60 microliters, and CE = 0).

Evaluation of Eudragit RS-PO and Ethocel 100 matrices for the controlled release of lobenzarit disodium

Lobenzarit disodium is a drug for the treatment of rheumatoid arthritis. In this work, inert matrix tablets of lobenzarit disodium were prepared by direct compression using Ethocel 100 and Eudragit RS-PO as polymeric materials in different ratios. The obtained powder mixtures and tablets were evaluated from the rheological and technological points of view. The dissolution test was performed to evaluate the in vitro release kinetic of the matrices. The obtained dissolution profiles demonstrated that the matrices containing Eudragit RS-PO showed a slower release rate and therefore were more suitable for controlling the release of drug. The fit to the Higuchi model indicates that the drug release mechanism from these matrices was controlled by the diffusion step.