Publication:

Elective and emergency cervical cerclage and pregnancy outcomes-a prospective observational study

Background Aim of the study was to analyze the prolongation of pregnancy (the mean cerclage to delivery interval) after elective and emergency cervical cerclage and to analyze the maternal and fetal outcome following cerclage.

Methods It is a prospective observational study conducted in the Department of Obstetrics and Gynecology at Sri Ramachandra Medical College among 130 patients who underwent cervical cerclage at our hospital. History of previous preterm deliveries, abortions, recent ultrasonography (USG) cervical length findings noted. The USG findings of cervical length, funneling, ballooning of membrane and internal os diameter has been recorded. Cerclage related details like gestational age at suture, cerclage to delivery interval, type of suture material, method of cerclage, gestational age at delivery and neonatal outcomes has been noted.

Results In the USG and history-based cerclage group, prolongation of pregnancy was a mean of 21 weeks, and majority-77.8% delivered at term, compared to the rescue cerclage group where prolongation was a mean of 10 weeks, and majority-76.2% had late preterm deliveries.

Conclusions Albeit rescue cerclages known to be associated with infections, rupture of membranes, preterm labor/preterm premature rupture of membranes (PPROM), it has significantly reduced the perinatal morbidity and mortality by prolongation of pregnancy to at least late preterm, in most patients, in this present study.