Effectiveness and perinatal outcomes of history-indicated, ultrasound-indicated and physical examination-indicated cerclage: a retrospective study

Abstract

Objective To evaluate the effectiveness and perinatal outcomes of cerclage procedure according to indication. Methods The pregnancy and neonatal outcomes of the patients who underwent cerclage with the diagnosis of cervical insufficiency between January 2016 and December 2020 were retrospectively analyzed. Patients were categorized into three groups: a history-indicated group, an ultrasound-indicated group and a physical examination-indicated group. Results Seventy-three patients who underwent cerclage were included in the study. Of these, 41 (56.2%) had history-indicated, 17 (23.3%) had ultrasound-indicated and 15 (20.5%) had physical examination-indicated cerclages. Compared to history- and ultrasound-indicated cerclage group, duration from cerclage to delivery (18.6 ± 6.9 weeks vs 17.8±5.9 weeks vs 11 ± 5.3 weeks, p = 0.003) was significantly lower and delivery < 28 weeks (9.8% vs 5.9% vs 33.3%, p = 0.042) and delivery < 34 weeks of gestation (26.8% vs 11.8% vs 60%, p = 0.009) were significantly higher in physical examination-indicated cerclage group. In physical examination-indicated cerclage, compared with history- and ultrasound-indicated cerclage low birth weight, low APGAR score, neonatal intensive care unit admission and neonatal mortality were higher, although not statistically significant (p > 0.05). Conclusion Pregnant women who underwent physical examination-indicated cerclage had higher risks for preterm delivery < 28 weeks and < 34 weeks than history- and ultrasound–indicated cerclage.

Comparison of Pregnancy Outcomes of History‐Indicated and Ultrasound‐Indicated Cervical Cerclage: A Retrospective Cohort Study

“…However, this difference was not statistically significant. This result differs from that of Golbasi et al 19 (2:500 ± 0:967 vs. 2:645 ± 0:814). They also found in their study a lower birthweight (1:912 ± 1:232) for those that had emergency cerclage [19].…”

“…This result differs from that of Golbasi et al 19 (2:500 ± 0:967 vs. 2:645 ± 0:814). They also found in their study a lower birthweight (1:912 ± 1:232) for those that had emergency cerclage [19]. In their retrospective study of pregnancy outcomes and factors affecting the clinical effects of cervical cerclage when used for different indications, Chen et al discovered similar birthweight between those who had cervical cerclage due to history indication and those who had emergency cerclage [14].…”

“…Our study showed that more participants had cervical cerclage due to history indication than ultrasound indication, though this was not statistically significant. This finding is consistent with previous research, which found that history-indicated cervical cerclage was more common than other indications [ 10 , 17 , 19 ]. This could be because the majority of participants who underwent cervical cerclage because of a previous history of midtrimester pregnancy will most likely present to the hospital for early pregnancy care in their subsequent pregnancies, increasing the incidence.…”

“…This finding was consistent with the findings of Suhag et al [20], who compared the incidence of preterm birth between the two groups. They found that after adjusting for confounders, the rate of spontaneous preterm birth at less than 37 weeks of gestation was 19 . In their study, Golbasi et al [19], found that patients who underwent a physical examination indicated cerclage have a higher risk of PTB than the history-indicated and ultrasound-indicated cerclage.…”

Assistência de enfermagem a uma gestante com corioamnionite e incompetência istmo cervical: relato de experiência

“…E quando a IIC é diagnosticada contribui para a ascensão de microrganismos pela fraqueza do orifício interno do colo do útero e do segmento uterino. Porém, é importante destacar que esse diagnóstico não é tão simples, já que não há disponibilidade de parâmetros tão precisos (Golbasi et al, 2022). Dessa forma, associada à corioamnionite traz riscos tanto à gestante e ao concepto.…”