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Emergent cerclage.

W H Barth¹, E R Yeomans, G D Hankins

¹Department of Obstetrics and Gynecology, Wilford Hall United States Air Force Medical Center, Lackland Air Force Base, Texas 78236-5300.

Surgery, Gynecology & Obstetrics

|April 1, 1990

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Emergent cerclage, a procedure for advanced cervical dilation, successfully prolonged pregnancies in most cases. This intervention offered a chance for viable fetal delivery with limited maternal complications.

Area of Science:

Maternal-Fetal Medicine
Obstetrics
Perinatology

Background:

Emergent cerclage is performed when the cervix dilates significantly with bulging membranes during pregnancy.
This procedure is typically considered in the second trimester for high-risk gestations.

Purpose of the Study:

To evaluate the efficacy and safety of emergent cerclage in patients with advanced cervical dilation and bulging membranes.
To assess pregnancy prolongation and fetal outcomes following emergent cerclage.

Main Methods:

A retrospective review of 15 patients undergoing emergent cerclage for advanced cervical dilation and bulging/hourglass membranes.
Data collected included maternal complications, pregnancy duration, and fetal-infant survival rates.

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Main Results:

Pregnancy was prolonged sufficiently for viable delivery in 11 out of 15 patients.
Complications included intraoperative membrane rupture (2 patients) and chorioamnionitis (5 patients).
Survival rate for neonates born at 24 weeks or older was 11 out of 13.

Conclusions:

Emergent cerclage can lead to successful fetal salvage with acceptable maternal morbidity.
The procedure warrants further investigation for managing advanced cervical dilation in high-risk pregnancies.