Publication:

Comparision of pregnancy outcomes of history indicated and ultrasound indicated cervical cerclage: a prospective cohort study

Background Cervical cerclage is a widely used intervention to prevent preterm birth in women at risk for cervical insufficiency. Indications for cervical cerclage may arise from clinical history or clinical finding of cervical shortening and or dilatation or ultrasound guided cervical length measurements in pregnancy. Despite its widespread use, there is ongoing debate about which indication yields better pregnancy and neonatal outcomes.

Methods Prospective cohort study included pregnant women who underwent cervical cerclage due to either history of preterm birth or findings from cervical ultrasound. Key outcomes such as gestational age at delivery, incidence of preterm birth, neonatal birth weight, NICU admissions, and APGAR scores were analyzed. Statistical methods included chi-square tests for categorical data and independent t-tests for continuous data, with a significance threshold set at p<0.05.

Results The study found that both history-indicated and ultrasound-indicated cervical cerclage were effective in prolonging pregnancy and preventing preterm birth. In our study, history indicated cerclage resulted in lower rate of preterm births and better neonatal outcomes compared to ultrasound indicated cerclage. Although there were differences in gestational age at delivery and neonatal outcomes between the two groups, these differences were not always statistically significant.

Conclusions This study suggests that both history-indicated and ultrasound-indicated transvaginal cervical cerclage as an effective clinical treatment for cervical insufficiency.