Emergency cervical cerclage and pregnancy outcomes

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.

The efficiency of emergency cerclage for the prevention of pregnancy losses and preterm labor

“…However, in cases where the procedure is not or cannot be done, high rate of pregnancy loss has been reported. [9][10][11][12][13] Ciavattini et al [9] compared the clinical characteristics of 19 cases that are on bed rest and 18 cases that underwent emergency cerclage, who all received diagnosis at similar weeks. They found that the interval period (16.8±7.9 weeks) up to delivery was significantly higher in the group which underwent emergency cerclage.…”

“…In the same study, the authors found pregnancy loss in 2 (2/15; 13.3%) cases, preterm labor rate as 80% and excessively premature preterm labor rate as 20%. Prasad et al [12] analyzed 24 cases which underwent emergency cerclage in their study, and reported pregnancy loss 12.5%, and preterm labor rate 42%.…”

A case report on management of cervical insufficiency using Chhattisgarh balloon in second trimester cerclage for fetal membrane prolapse

“…During cerclage the prolapsed membranes must be placed back in the uterine cavity before the procedure to avoid high risk of iatrogenic PPROM. This is accomplished least traumatically by placing the patient in the lithotomy position with a steep Trendelenburg tilt, combined with the administration of tocolytics 3 . Urinary catheterization can also help to reposition the membranes in the uterus.…”

Successful cerclage on cervix in the mid trimester: case report

“…17 A review done on all women treated with CC in the late second trimester with advanced cervical dilatation for whom emergency CC by McDonald method were performed, showed that for post emergency CC the results for extension of pregnancy, live births and neonatal survival is better. 18 A study of 158 women under emergency CC showed that emergency CC is successful in extending pregnancy and recuperating neonatal result in patients having cervical deficiency. 19 The results of 14 patients having twin pregnancies were studied with substantial cervical dynamics undergoing cerclage showed that the average duration between cerclage placement and giving birth was 71.1 days indicating patients carrying twin pregnancies with advanced cervical changes may profit by therapeutic cerclage.…”

“…32 A study on 24 women treated with emergency CC in the late second trimester having advanced cervical dilatation showed that pregnancy continuation, live births and neonatal survival results are better in post emergency CC. 33 A study including 158 women having emergency CC due to cervix dilatation and bulging membranes in mid-trimester showed that having emergency cerclage provided live infants births with 82.28% success. 34…”