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Emergency cervical cerclage. Does the gestational age make a difference?

Mamdoh A Eskandar¹, Adekunle A Sobande, Ian O Damole

¹Department of Obstetrics and Gynecology and Reproductive Medicine, College of Medicine, King Khalid University, PO Box 641, Abha, Kingdom of Saudi Arabia. mamdoheskandar@hotmail.com

Saudi Medical Journal

|August 24, 2004

Summary

Emergency cervical cerclage (ECC) effectively prolongs pregnancy in women with cervical incompetence. Performing ECC earlier in the second trimester, before 22 weeks, significantly increases the duration the cerclage remains in place.

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Area of Science:

Perinatology
Maternal-Fetal Medicine
Obstetrics

Background:

Cervical incompetence is a major cause of preterm birth.
Emergency cervical cerclage is a procedure to prevent preterm delivery in cases of cervical incompetence.

Purpose of the Study:

To evaluate the effectiveness of emergency cervical cerclage in prolonging pregnancy.
To assess the impact of emergency cervical cerclage on pregnancy outcomes.

Main Methods:

Retrospective review of 20 patients who underwent emergency cervical cerclage for cervical incompetence between 16-26 weeks gestation.
Analysis of duration of cerclage in situ, gestation at delivery, and birth weight.

Main Results:

Mean duration of cerclage in situ was 68.5 days, with delivery at a mean of 30.5 weeks and mean birth weight of 1844 grams.

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Cerclage duration was significantly longer when performed at or before 22 weeks gestation (p<0.02).

No significant difference in delivery gestation or birth weight based on timing of cerclage.

Conclusions:

Emergency cervical cerclage can effectively prolong pregnancy in patients with cervical incompetence.
Performing emergency cervical cerclage in the early second trimester (<=22 weeks) leads to a longer duration of cerclage in situ compared to later in the second trimester.