The effect of second trimester emergency cervical cerclage on perinatal outcome

TLDR

Cervical incompetence remains inadequately studied, and large prospective randomized controlled trials are needed. The study aimed to evaluate the effectiveness of emergency cervical cerclage and identify predictors of success or failure in women with cervical incompetence. Medical records of 43 women at 18–25 weeks gestation were reviewed for clinical and demographic data, gestational age at cerclage, cerclage‑delivery interval, gestational age at delivery, and birth weight, and predictors of success and failure were analyzed. Emergency cervical cerclage performed at a mean of 21 weeks prolonged pregnancy to a mean gestational age of 31 weeks, produced a mean birth weight of 2166 g, and significantly improved neonatal outcomes, although infection, symptoms, membranes through the cervix, and dilation >3 cm were associated with failure.

Abstract

To evaluate the effectiveness of emergency cervical cerclage and to determine predictors of failure or success in women with cervical incompetence.Medical records were reviewed for clinical and demographic data, gestational age at time of cerclage, cerclage-delivery interval, gestational age at time of delivery; and birth weight. Predictors of success and failure were analyzed.Forty-three pregnant women between 18 and 25 weeks of gestation were recruited. The mean gestational age at time of cerclage was 21 weeks. The mean cerclage-delivery interval was 64 days. The mean gestation at delivery was 31 weeks and the mean neonatal birth weight was 2166 g. Whether cerclage done before or after 20 weeks, the difference in cerclage-delivery interval was insignificant while the difference in gestational age at time of delivery and neonatal birth weight was significant. Presence of infection, presence of symptoms, membranes through the cervix and dilated cervix >3 cm are frequently associated with failure.Emergency cervical cerclage is effective in prolonging pregnancy and improving neonatal outcome in patient with cervical incompetence. However, large prospective randomized controlled studies are recommended.