Clinical subtypes and pregnancy outcome of cervical incompetence

Abstract

Objective: Cervical incompetence is an important cause of mild-term miscarriage or premature birth.This article intends to investigate the effect of surgical treatment of cervical incompetence at difference time and its influence on maternal and fetal outcomes. Methods: The clinical data of 246 patients in our hospital were divided into selective group (150 cases) and emergency cerclage group(96 cases). According to the different degree of cervical dilatation and amniotic sac protrusion during operation, the emergence cerclage group was divided into 4 types: Type I(43 cases of cervical intraoral dilatation only),Type II(27 cases of cervical intraoral and extraoral dilatation with amniotic sac), Type III(14 cases of amniotic sac protrusion in the upper 1/3 of the vagina ), and the Type IV(12 cases of the amniotic sac protrusion in the middle and lower part do the vagina). The general conditions, high risk factors, postoperative complications, pregnancy outcome and neonatal prognosis were analyzed and compared. Conclusion: Timely cerclage can significantly prolong the pregnancy time, increase the live birth rate and improve the neonatal outcome. Cervical incompetence can be classified into four types based on the degree of cervical dilation during surgery and the degree of amniotic sac protrusion; Transvaginal amniotic fluid reduction surgery provides an effective surgical solution for patients with cervical incompetence type IV.