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Emergency cervical cerclage
1Department of Obstetrics and Gynaecology, University College Hospital, London.
British Journal of Obstetrics and Gynaecology
|December 1, 1991
Summary
Emergency cervical cerclage can extend pregnancy duration and improve outcomes for high-risk pregnancies. This procedure, when performed in cases of cervical dilation, offers a chance for fetal survival, though infection remains a risk.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Surgical Interventions in Pregnancy
Background:
- Cervical insufficiency poses a significant risk to pregnancy.
- Emergency cerclage is a procedure to prevent preterm birth in specific circumstances.
Purpose of the Study:
- To evaluate the effectiveness of emergency cervical cerclage.
- To assess pregnancy prolongation and outcomes following emergency cerclage.
Main Methods:
- Retrospective review of 19 women undergoing emergency cervical cerclage (16-28 weeks gestation, 3-10 cm dilation).
- Procedures included amniocentesis, bacteriological assessment, prophylactic antibiotics, and suture insertion.
- Outcomes measured: gestation prolongation, pregnancy outcome, infection rates, and maternal/fetal morbidity.
Main Results:
- Fifteen live births occurred, with 13 survivors (63% survival rate).
- Gestation was prolonged by 1-19 weeks; delivery occurred between 25-41 weeks.
- Eight deaths were linked to infection; infection prolonged pregnancy ≤5 weeks. One cervical laceration occurred.
Conclusions:
- Emergency cervical cerclage can successfully prolong pregnancy.
- The procedure can positively impact pregnancy outcomes, despite infection-related risks.