Emergency cervical cerclage and pregnancy outcomes

Authors

  • N. Nagendra Prasad Department of Obstetrics and Gynecology, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India
  • Sherin Annamma Thampan Department of Obstetrics and Gynecology, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India
  • R. Nagarathnamma Department of Obstetrics and Gynecology, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20171964

Keywords:

Cervical dilatation, Emergency cerclage, McDonald

Abstract

Background: To evaluate the effectiveness and safety of emergency cervical cerclage in women who presented with advanced cervical changes such as cervical dilatation and bulging foetal membranes.

Methods: This is a retrospective study on all women treated with cervical cerclage presented in the late second trimester with advanced cervical dilatation (2 to 4cms) for whom emergency cervical cerclage by McDonald technique.

Results: Out of the 24 patients for whom emergency cervical cerclage was performed, three patients had spontaneous abortion after cervical cerclage, two had PROM and eight of these patients had term delivery. Twenty-one fetus were live born after the period of viability. Nine of these babies were admitted to NICU and 50 percent of the neonates required only regular perinatal care.

Conclusions: Post emergency cervical cerclage, the outcome in terms of prolongation of pregnancy, live births and neonatal survival is better.

References

Norwitz ER, Greene MF, Repke JT. Cervical cerclage - Elective and Emergent ACOG update 1999;24:1-11.

Danforth DN. the fibrous nature of the human cervix and its relation to the isthmic segment in the gravid and nongravid uteri. Am J Obstet Gynecol. 1947;53:541-60.

Coestole K. Hennessy E. The Epicure study: outcomes to discharge from hospital for infants born at the threshold of viability. Pediatrics. 2000;106:659-71.

Rand L, Norwitz. Current controversies in cervical cerclage. Semin Perintol. 2003;27:73-85.

Cunningham FG, Kenneth J. William Obstetrics. 24th ed. United States: McGraw-Hill Education. chapter 18, Abortion; 2004:350-370.

Cousins L. Cervical cerclage: Patient selection, morbidity, and success rates. Clin Perinatol. 1983:10:321-41.

Grimes DA, Schultz KF, Cates WJ. Prevention of uterine perforation during curettage abortion. JAMA. 1984;251:2108-11.

Mc Donald IA. Incompetence and cerclage in Denmark 1980-1990. A register based epidemiological survey. Acta Obstet Gynecol. 1978;18:34-7.

Hibbard JU, Snow J, Moaward AH. Short cervical length by ultrasound and cerclage. J Perinatol. 2000;(3):161-5.

Friedli I, Stamm J, Beguin F. Cerclage by the abdominal route. J Gynecol Obstet Biol Reprod. 1987;(16):951-4.

Benson RC, Durfee RB. Trans abdominal cervico uterine cerclage during pregnancy for the treatment of cervical incompetency. Obstet Gynecol. 1965;(25):145-55.

Lotgering FK, Gaulger IP. Outcome after trans abdominal cervicoisthamic cerclage Obstet Gynecol. 2006;107:779-84.

Heath VCF, Souka AP, Erasmur I. Cervical length at 23 weeks of gestation: The value of Shirodhkar suture for the short cervix. Ultrasound Obstet Gynecol. 1998;(12):318-22.

Balasubramaniam D, Chithra TV. Outcome of emergency cerclage for advanced cervical dilatation: a retrospective analysis. Inter journal Res Med Sci. 2015;3(1):229-34.

Taher A. The Perinatal Outcome in Saudi Women with Emergency Cerclage- a Prospective Study. UTMJ. 2012;90(2):32.

Zhu LQ. Pregnancy outcomes of emergency cerclage Medscimonit. 2015;(21):1395-401.

Ojabo A, Adesiyun AG, Hembah-Hilekaan SK. Pregnancy Outcomes Following Emergency Cervical Cerclage. Open Access Library Journal. 20141;1(7):1.

Purnima D, Aftab N. Prediction of outcome for Emergency Cervical cerclage in the presence of protruding membranes. ISRN Obstetrics and Gynaecology; 2012:1-4.

Cotter PA, Gomez R. Expectant management compare with physical examination indicated cerclage (EM-PEC) in selected woman with a dilated cervix at 140/7-256/7 weeks: results from the EM-PEC international cohort study. The American Journal of Obstetrics and Gynaecology. 2007;197(5):483-88.

Downloads

Published

2017-04-27

Issue

Section

Original Research Articles